Writing in December on the Big C, I was at least half way convinced that my friend, Jan — I can write her name now — would, by some miracle, have beat the dreaded disease. She didn’t. And I am compelled, daily, to face that.
It is said that there are five stages of grief: Denial, Anger, Bargaining, Depression, and Acceptance. I don’t know where I am at the moment. I feel like a pendulum, suspended and swinging from one to the other — today in denial, convinced I need only pick up the phone to hear her at the other end; and tomorrow, accepting, barely, that there is no such option.
Now close to seven months since her death, I am convinced it will be some time yet before I can truly accept that Jan is gone and, critically, that she won’t be back — not in the way that my human consciousness would like her to be — and I must, as my husband and I did with Alexandra, continue the onward march that is life.
The thing is, if I am honest, Jan would have it no other way. Her lasting gift to me, after all, was the reminder to LIVE and to live well and in purpose, God’s purpose.
It’s been a few days since the celebration of International Day for Maternal Health and Rights on April 11.
Still, with maternal deaths at 89 per 100,000 live births up to 2015, compared to 79 per 100,000 in 1990, what is a few days late in helping to draw attention to this day and its value? Certainly it matters, if to no one else, then to the families of women who lose their lives in pregnancy and childbirth each year or who, even as I write, are at highest risk of death and/or compromised health.
I am using this space, therefore, to share a statement from the ‘Partnership for the Promotion of Patients’ Rights in Maternal, Neonatal and Infant Health in Jamaica’ project.
This three-year project is being implemented as part of the European Union-funded Programme for the Reduction of Maternal and Child Mortality (PROMAC) and aims to, among other things, enhance the capacity of civil society organisations to advocate for maternal and child health and rights, and to effectively participate in healthcare planning and monitoring.
Among the planned outputs of the project are a civil society consultative forum, a charter of patients’ rights and an agreed complaints and redress system.
Below is the statement issued by project implementing partners, the University of the West Indies Department of Community Health and Psychiatry and the Women’s Resource and Outreach Centre.
KINGSTON, Jamaica. 12 April 2018
As Jamaicans we are known to refer to each other as ‘wagonists’, particularly when it comes to the performance of their sports stars, who, while loved, do not always enjoy their favour.
For International Day for Maternal Health and Rights, celebrated each year on April 11, we are counting on that label to begin the conversation on the plight of our women and girls when it comes to pregnancy and childbirth.
The goal is to have individuals and organisations transformed into advocates for maternal and child health and rights, as we remain on the wagon to achieving Sustainable Development Goal 3, which has among its targets the reduction of the global maternal mortality ratio (MMR) to less than 70 per 100,000 live births by 2030.
From hypertension to unsafe abortions, together with heart disease and sickle cell disease, among other illnesses, Jamaican women and girls continue to die in pregnancy and childbirth. The result is that the island’s maternal mortality ratio (MMR) stood at 89 per 100,000 live births in 2015. That 2015 figure represents a worsening of the health outcomes for pregnant women and girls when compared to 1990 when it was 79 per 100,000 live births.
It is against this background that the ‘Partnership for the Promotion of Patients’ Rights in Maternal, Neonatal and Infant Health’ project has taken the time to get behind the celebration of International Day for Maternal Heath and Rights, and calls on other Jamaicans, from the Government to the private sector and civil society, to offer their own support to the day and to champion the cause of maternal and child health and rights.
The International Day for Maternal Health and Rights was launched in 2014 by the Centre for Health and Gender Equity (CHANGE) and other global sexual and reproductive health and rights organisations, who continue to work towards its official endorsement by the United Nations. Meanwhile, support for the day continues to grow.
To have the day recognised in Jamaica, we feel, presents a number of benefits, not the least of which is a vehicle to bring public attention to issues of maternal health and rights in Jamaica, since it is at the point of awareness that the labour for change begins. As citizens, we must, of necessity, understand that there is something that needs to be changed before we can become invested in the effort toward it.
This awareness can then be amplified by a national discourse on the subject, one that can be engaged in among and between different stakeholders, from patients, their families and local communities to healthcare providers, policymakers and members of industry, as well as international development partners.
The recognition of the day can also help to set the stage for the sustainability of the current efforts to improve maternal and child health outcomes. These efforts include the European Union-funded Programme for the Reduction of Maternal and Child Mortality, of which the ‘Partnership for the Promotion of Maternal, Neonatal and Infant Health in Jamaica’ project is one component.
Launched in April last year (2017), that component of the work – implemented jointly by the University of the West Indies Department of Community Health and Psychiatry and the Women’s Resource and Outreach Centre – is focused on advocacy for the human rights approach to the delivery and receipt of maternal and child healthcare, and to improve the role and effectiveness of civil society in addressing this goal.
Further, local recognition of the day may serve the island’s brand as one committed to maternal and child health, anchored in the human rights approach to patients’ care. This approach sees respect accorded to each actor in the care provider-patient relationship, as rights such as the right to informed consent to treatment, as well as to privacy and confidentiality are upheld.
It’s been close to 20 days since we celebrated International Women’s Day 2018 on March 8, under the theme “Time is Now: Rural and urban activists transforming women’s lives”, and with the call to action #PressForProgress.
In paying homage to that theme and in responding to the call, The Women’s Resource and Outreach Centre (WROC), a non-profit established 30 years ago, recognised the work of five phenomenol women who have worked tirelessly and for decades, in the interest of community development.
Green Seeds takes the time to share this story, in hopes that the light of these women will shine well beyond its current reach, inspiring others among us.
“Nuh trouble wi, leave di women alone”
WROC hosts International Women’s Day Forum and 35th Anniversary Awards Luncheon
The Women’s Resource & Outreach Centre recognised five (5) women from the Lyndhurst/Greenwich Community on International Women’s Day for their outstanding contribution to community development and nation building.
The women recognised were:
Joy Matthews, who has dedicated her life to community development, youth and peace advocacy for over 27 years;
Sister Grace Yapp, a member of the Franciscan Ministries, who has worked in numerous communities across Jamaica for over 30 years, providing upliftment and support to Jamaicans in need;
Joyce Linton, who has has worked through the Lyndhurst Methodist Church to help the Community of Lyndhurst/Greenwich;
June Barnes Lewis, who has taken a leadership role in promoting participation in representational politics while working to ensure her community receives the maximum benefits accorded them by the Government; and
Agatha Lewis, who has dedicated 15 years of her life to working with WROC, sticking with the organisation through thick and thin, in service to residents of surrounding communities.
“Community work: I sleep it, I walk it, I dream about it, and today I say thank you,” noted Barnes Lewis, after receiving her award.
The other women shared her sentiments.
Matthews was moved to tears by the recognition and encouraged WROC to continue its work.
“Mi haffi big up WROC fi dem initiatives weh mek mi so powerful as a community mobiliser,” she said tearfully.
The celebration was held at the Lyndhurst Methodist Church, where more than 60 women from the Lyndhurst/Greenwich community gathered to “reason”.
Advocacy specialist and a founding member of WROC, Linnette Vassell, asked the women to reflect on leadership within their homes as this will then reflect on how they lead in the society.
The discussion called for an end to issues that not only these women face on a daily basis, but those which also affect women around the world, such as domestic abuse, disrespect, rape, injustice and inequality.
This day’s activity was funded by National Integrity Action, under the “Strengthening a Culture of Integrity in Jamaica” project. It was one in a series of events planned by WROC to celebrate women throughout the month of March.
My life changed a year ago, with the news that one of my best friends has cancer.
With just two words — delivered over the phone in one of our routine evening chats — I began to take a different view of the world.
The words? ‘It’s cancer’.
In the typical style of girlfriends, my friend, who I will call ‘M’ — a woman with a heart of gold, the workaholic tendencies of a true feminist and eclectic tastes of one of life’s true creative types — had kept us abreast of all the symptoms of illness, from a swollen stomach to pain that seemed to never go away.
We, her friends, were also kept in the loop regarding the battery of tests performed to get to the bottom of her ailment. Through it all, I — we, I think — never for a moment considered cancer. But I suppose no-one ever does; no-one ever wants to.
And then the words.
Up to that point, cancer — outside of the stories I had heard or read — had really meant little to me. I know that now.
Yes, I felt sympathy for those who I understood to live with the disease and for the families of those who had died because of it.
Yes, I was moved to participate in cancer runs.
Yes, I had worn the pink ribbon over the years.
But it had never saturated my consciousness.
After the words, I no longer sit in a safe zone, isolated from cancer’s brutality, the sheer power of the blows it deals — and not only to the body of the people waging war against the physical toll it can take, but also to your dreams, to your ideas about who you are and what you are capable of achieving.
I get it now; cancer is a cancer.
After months of the experience, I find myself at a crossroads.
Yes, my friend is alive.
Yes, I am extremely grateful for this.
I am also compelled to write for write I must — or burst at the seams from equal parts anger and extreme sadness.
“Where, after all, do universal human rights begin? In small places, close to home — so close and so small that they cannot be seen on any maps of the world. […] Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.” — Eleanor Roosevelt
These words by Eleanor Roosevelt are especially powerful as I take stock of a recent workshop to raise awareness about the human rights linkages to maternal, and child health in Jamaica — one that has won the praise of civil society and public sector stakeholders alike.
They include Alisha Coleman, the mother whose child was reportedly left with the mental capacity of a baby due to medical negligence and for which the assessment of legal damages is now set for next year.
“It is important to know your rights and to know where you stand with everything and to find out the best way to deal with whatever you are going through. It is good to know and workshops like these make you know,” she said from the event, staged at Alhambra Inn in Kingston on November 29.
The discussions were timely, coming as they did only days ahead of International Human Rights Day, celebrated globally on December 10 each year.
Meanwhile, the workshop — which looked at rights, including the right to enjoy the highest attainable standard of physical and mental health, including sexual and reproductive health — was put on under the European Union-funded project titled “Partnership for the Promotion of Patients’ Rights in Maternal, Neonatal and Infant Health (MNIH)” in Jamaica.
Implemented by the University of the West Indies’ (UWI’s) Department of Community Health and Psychiatry and the Women’s Resource and Outreach Centre, the project is to strengthen patients’ rights and improve the role and effectiveness of civil society in advocacy for MNIH.
This is to be achieved through, among other things, research, the establishment of an inter-civil society organisation consultative forum and an agreed framework to receive and resolve complaints.
Gender and development advocate Judith Wedderburn lauded the organisation for the workshop, which brought together entities such as the Ministry of Health and the Child Development Agency with others, including Caribbean Vulnerable Communities, Fathers United for Change and the Lyndhurst Greenwich District Development Organisation.
“I loved how vibrant the discussions were. It reinforced the understanding that maternal, neonatal and infant health are rights issues. I don’t think many people know that when a woman carries her baby and the baby is born, that there are rights that need to be observed,” she said.
There is a movement afoot in Jamaica, one designed to have people look with fresh eyes and through a human rights lens, at the health of women, their newborns and infants.
It is being marshalled by the Women’s Resource and Outreach Centre and partners, the University of the West Indies’ Department of Community Health and Psychiatry, with their efforts entailed under the project titled “Partnership for the Promotion of Patients’ Rights in Maternal, Neonatal and Infant Health in Jamaica”.
THE RIGHTS-BASED APPROACH
There are a range of human rights “directly implicated” by maternal morbidity and mortality, including:
the right to life;
the right to be free from cruel, inhumane and degrading treatment;
the right to privacy;
the right to an effective remedy;
the right to be equal in dignity;
the right to education;
the right to seek, receive and impart information;
the right to freedom from discrimination;
the right to enjoy the benefits of scientific progress; and
the right to enjoy the highest attainable standard of physical and mental health, including sexual and reproductive health.
The rights-based approach to MNIH also affirms that maternal, newborn and infant morbidity and mortality cannot be reduced to simply the risk women and teenage girls run when, whether by choice or circumstance, they become pregnant.
Rather, states are obligated to ensure, by virtue of the right to enjoy the highest attainable standard of physical and mental health, including sexual and reproductive health, as one example, that maternal morbidity and mortality is given priority.
The promotion and protection of this right, according to Paul Hunt and Judith Bueno de Mezquita (2010), “demands actions that lead to a significant and sustained reduction in maternal mortality”.
Those actions include:
ensuring access to goods and services, including sexual and reproductive health care and information;
breaking down political, economic, social and cultural barriers that women face in accessing the interventions that can prevent maternal mortality; and
participation by stakeholders in policy and service development.
“And it requires accountability for maternal mortality,” write Hunt and Bueno de Mezquita.
The WROC/UWI project is intended to spotlight these rights when it comes to #MNIH in Jamaica. This is with the goals to
strengthen patients’ rights in #MNIH among members of the vulnerable population and other stakeholders, and
enhance the capacity of civil society organisations to become involved in patients’ rights advocacy and health policy planning and monitoring, in relation to #MNIH.
The project team is working to realise those objectives through a variety of activities, including stakeholder consultations, the development of an advocacy plan and toolkit, and the development of curricula and training manuals, together with a public education and awareness campaign.
The 33rd session of the Human Rights Council, meanwhile, has adopted the resolution on preventable maternal mortality and morbidity and human rights.
In that resolution, the Council urged all states “to renew their political commitment to eliminate preventable maternal mortality and morbidity at the local, national, regional and international levels; and to strengthen their efforts to address multiple and intersecting inequalities and to remove all barriers” to access to sexual and reproductive health facilities, etc..
This, in order “to ensure full and effective implementation of their human rights obligations”, and their commitments to, for example, the 2030 Agenda for Sustainable Development and the Sustainable Development Goals.
With some 216,000 per 100,000 women dying globally each year; 43 children under 5 per 1,000 and 19 per 1,000 newborns, it is past time that we stepped up those efforts.
I met Mike Shanahan in my nascent years of the journey through the maze the end-of-year global climate change negotiations can be. In true Shanahan style, he served as a guide to me and many other journalists, ensuring we were able to make sense of it all, and in the interest of our diverse publics. Today, we are regarded as pros and that is thanks to him and the great team of Climate Change Media Partners, as they were known. Mike continues to inspire, this time, where art meets science. Cheers, Mike. Figs rock! I see that.
“Science and art ask the same questions.” — Lawrence Krauss, theoretical physicist and cosmologist.
Leonardo da Vinci was an artistic as well as a scientific genius of the Renaissance period when the study of art and science was not perceived as separate fields. The world also has seen great achievers in the field of science such as Albert Einstein and Richard Fenyman who were scientists as well as artists at the same time. A scientist being a serious artist is a rare phenomenon today. The number of scientists using arts to assist in their research or science communication is still a minority.
While there are a handful of scientists in the field of Ecology like Nalini Nadkarni, the well known canopy biologist who reaches out to the non scientific audience through art to create awareness on Forest Canopies, Mike Shananan is a rare class of ecologist who harbours…
Recently it emerged in the news that Jamaicans are using the Ministry of Health’s complaints mechanism concerning the use of the public health system and the handling of these complaints.
It is news that has been welcomed by local players, not the least of these the Women’s Resource and Outreach Centre (WROC), which is involved in a project to promote patients’ rights and responsibilities in maternal, neonatal and infant health in Jamaica.
For WROC, this mechanism and its use is timely and presents a unique opportunity, certainly for the project, which takes a human-rights-based approach to maternal, neonatal and infant health in Jamaica.
Below is a media release recently issued from that project.
KINGSTON, Jamaica. 20 November 2017. The Ministry of Health’s complaints mechanism has received the approval of stakeholders involved in a project to promote patients’ rights and responsibilities in maternal, neonatal and infant health (MNIH) in Jamaica.
“The minister of health (Dr. Christopher Tufton) and his team should be commended for this initiative. It is consistent with current health care strategies, which are client based and rights driven,” noted Professor Wendel Abel, a University of the West Indies (UWI) representative on the project called ‘Partnership for the Promotion of Patients’ Rights in #MNIH in Jamaica’.
“We want to congratulate the ministry on implementing a complaints mechanism and providing the public with the results. We are aware of how sensitive this issue is,” added Kristin Fox, coordinator for the project, which is being implemented by the Women’s Resource and Outreach Centre (WROC) and the UWI.
Launched in April, the project is to strengthen patients’ rights, engender a sense of personal responsibility among users of the health care system and improve the role and effectiveness of civil society in advocacy for #MNIH. This is to be achieved through, among other things, the establishment of an inter-civil society organisation consultative forum and an agreed framework to receive and resolve complaints.
News broke Sunday that more than 100 complaints were lodged with the ministry in the first three months of the year. Of that number, only 13 per cent were reportedly resolved and five per cent closed. One per cent was referred; another one per cent was handled by the Medical Review Panel and 80 per cent is still to be resolved.
To these figures, Fox said: “We recognise that this is a work in progress, but we are concerned about the pace of the resolution of the complaints”.
Linnette Vassell, advocacy specialist with #WROC, agreed.
“The complaints received and the ministry’s response show that there is growing consensus about the need to address human rights and responsibilities in health care, and to bring local communities and their organisations to the centre of decision-making. People are ready to engage in this process and we must ensure that a collaborative framework is developed and managed with accountability, respect and compassion,” she said.
Abortions in Jamaica have once again been sling shot into the spotlight, this time by a set of articles published this past Sunday in one of the local newspapers.
They reveal an eyebrow-raising number of attempted abortions among patients visiting the Victoria Jubilee Hospital (VJH) and the reaction of Health Minister Dr. Christopher Tufton.
According to this week’s Sunday Gleaner, “between January and September of this year, of the 1,088 expectant mothers who presented to VJH with bleeding in early pregnancy, 91 admitted to having attempted to abort the foetus while an additional 47 had complications that suggested they had attempted abortion”.
Tufton has since ordered an audit that is to take stock of the abortions, together with an assessment of family planning methods, fostering and adoption as well as public education.
“It is a sad commentary on our society when women, mostly young and poor, put their lives at risk, with apparently not much consideration for themselves or unborn foetus … it tells me that we are doing something wrong as a society and that we are failing to adequately respond to their concerns and needs,” the minister is quoted as saying.
This is an instructive quote. It gives one pause to think on the contending views and realities, political and otherwise, of abortions.
But also, more broadly, on maternal, neonatal and infant health (MNIH) in the country and the challenges (and, yes, opportunities) that exist on the road to reaching Sustainable Development Goal 3.
The targets for that goal in relation to MNIH include:
By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births;
By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births; and
By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
These are sobering targets that warrant more than the audit ordered by the minister.
With unsafe abortions among the leading causes of maternal mortality, it is vital that this most recent ‘buzz’ not amount to a mere “nine day wonder”, as is often said of issues that attract much chatter but no appropriate response actions that yield real gains — from informed policy shifts to concrete local interventions.
Abortions are not going to fade into the background. The statistics tell that story. The Sunday Gleaner references a 2014 study that found “more than 43 per cent of expectant mothers who were admitted with complications had attempted abortions”.
Of that 43 per cent, the article said, “only 10 per cent had at first admitted that they attempted to abort the pregnancy”.
Isn’t it time to put to bed the “nine day wonder” and rise to action?
You can read more on this issue at the links below.