Response to opinion piece saying global maternal health programs deserve more support

The New York Times on Sunday published several letters to the editor in response to a Feb. 25 Times column by Nicholas Kristof. According to Kristof, maternal health programs should receive support from the U.S. in part because the country knows how to lower maternal mortality and morbidity.

Kristof writes that "neither Democrats nor Republicans have ever shown great interest in maternal health" and that President Bush last month proposed reducing total spending for global maternal and child health programs to a "negligible" $346 million. About 530,000 women die annually from pregnancy and childbirth complications, and for "every woman who dies in childbirth worldwide, another 20 are injured," Kristof writes, adding that "because the victims are born with three strikes against them -- they are poor, rural and female -- they are invisible and voiceless, receiving almost no help either from poor countries or from the developed world" (Kaiser Daily Women's Health Policy Report, 2/26). Summaries appear below.

• Laura Katzive: The "failures that result in more than a half million maternal deaths every year are not primarily those of health professionals, but of governments," Katzive, deputy director of the Center for Reproductive Rights' International Legal Program, writes in a Times letter to the editor. Katzive writes that the U.S. and other wealthy countries hold "much of the blame" but adds that developing countries can take actions to save women's lives. "Until maternal death and disability are recognized as a reflection of governments' disregard for women's human rights," some women "will continue to suffer needlessly," she concludes.
• Sandra Krause: Women and girls in the "war-torn region" of northern Uganda "will continue to suffer debilitating injuries like obstetric fistula" without access to "safe and effective contraception," Krause, director of the Reproductive Health Project for the Women's Commission for Refugee Women and Children, writes in a Times letter to the editor. The Ugandan government, donor countries, United Nations agencies and nongovernmental organizations should "ensure that family planning services are available to people displaced by conflict," she concludes.
• Elizabeth Mach: "Global maternal and child health programs must be made a priority, instead of being cut as proposed in President Bush's recent budget," Mach -- a registered nurse at Bugando Medical Center in Mwanza, Tanzania -- writes in a Times letter to the editor. According to Mach, poverty and "the women's lack of decision-making power in the family" are the main reasons that many women in sub-Saharan Africa "continue to be traumatized by injuries caused by obstructed labor."
• Rep. Carolyn Maloney (D-N.Y.): Millions of women worldwide "suffer needlessly as a result" of Bush's decision to withhold a total of $161 million that Congress has appropriated for the U.N. Population Fund in the last five years, Maloney writes in a Times letter to the editor. Maloney writes that she plans to reintroduce legislation this year that will allocate funds to UNFPA to combat obstetric fistulas. "Let's hope ... Kristof's wrenching report jars the president's conscience," she concludes (Katzive et al., New York Times, 3/4).