Toyin Saraki

Toyin Saraki is the former First Lady of Kwara State, Nigeria, and Founder-President of the Wellbeing Foundation Africa (WBF Africa), a pan-African maternal health and wellbeing charity.

One day in 1991, when I was 28 weeks pregnant with twins, I started retaining a lot of water and my blood pressure skyrocketed. Then I started to bleed. I didn’t know it then, but it was eclampsia, a life-threatening complication of pregnancy.

Simply providing voluntary family planning to the 222 million women worldwide who want it but lack access to it would cut maternal mortality by 30% and infant mortality by up to 20%.

By the time I got to a doctor in Lagos, Nigeria, it was too late. One of my baby girls died. The other repeatedly stopped breathing and had to be revived; one of her heart valves hadn’t closed. My doctors were excellent, but their information was inadequate – they said all I could do was pray.

I did pray, promising God I would spend my life helping other mothers if my baby lived. Then I learned about an experimental drug in England called digoxin, and because I was economically privileged I managed to get some of it. My daughter’s heart valve closed and she survived.

I have worked to keep my promise ever since for the millions of mothers in Nigeria who are not as lucky as I was. Many are not aware that advance preparations can help prevent tragedy. Worldwide, some 800 women die every day from complications of pregnancy and childbirth – that’s one in every 31 women in sub-Saharan Africa. Four million newborns also die every year for the same reasons.

We know relatively easy and cost-effective ways to save most of those lives – family planning, prenatal care, trained attendants at delivery. One dollar invested in reproductive health care for women can save up to nine dollars in other development costs. Simply providing voluntary family planning to the 222 million women worldwide who want it but lack access to it would cut maternal mortality by 30% and infant mortality by up to 20%.

At first I didn’t grasp the dire situation in my country. My first charity, LifeStream, raised funds to send children with heart valve problems to a wonderful surgeon in Israel. In five years we sent 78 children, and the surgeries were a joyous success, but far too few in the context of Nigeria’s then-population of more than 150 million people. I still hadn’t seen the whole picture.

When my husband became governor of Kwara State in 2003, my duties included reaching out to people at major moments in their lives. I congratulated them on marriages and births and consoled them at family deaths. I realized that in an average week I was consoling more people than I was congratulating. Sometimes I would congratulate a woman for giving birth on Monday and on Wednesday she would be dead. I began to ask all new mothers about their blood pressure, the bleeding, the breathing – and I saw it was not just bad luck in a few cases but a terrible problem across my entire country.

How bad was it? We had no proper records of births, deaths, illnesses, marriages, so we didn’t know. Doctors were reluctant to fill out more paperwork, but without it how could we develop policies and target programs? The first project of my WellBeing Foundation Africa was to establish national Personal Health Record books that put in a pregnant woman’s hand a list of all available health services and the treatments and medications she receives from the beginning of her pregnancy until her child is five years old. This pan-African maternal health and well-being charity has reached 220,000 women and children with these books so far – still nothing in a country where six million women are pregnant every year, but we hope soon to digitize these records for cell phone use. When something goes wrong, we and the woman should be able to know why.

Hospitals and clinics in Nigeria always ask pregnant women to supply their own equipment for deliveries – a navel clamp, mentholated spirits, razor blades, plastic sheets for the bed. For lack of these simple things, many women give birth at home in unsanitary conditions, and their risk soars as a result. Now the WellBeing Foundation has a pilot program to provide “MamaKits” of those items to pregnant women through midwives, adding medications for blood pressure and prolonged delivery to kits given to hospitals. We are also organizing groups of pregnant women to set up 1,000-day savings accounts together, adding cash transfer programs, loans and insurance that give us regular contact with the women to provide information and monitoring.

I had a son in 1995 and another set of twins in 2000, again with complications but this time with much more knowledge about what could be done. My children are all well, and now I am engaged with Every Woman Every Child, a United Nations program sharing information worldwide on what works. Our hope is that even the smallest clinic will be able to adapt these best practices to its local circumstances. The program aims to save the lives of 16 million women and children by 2015.

Donor countries like the United States should support these and similar initiatives because women and their children are the greatest resource any country possesses. Investing in them is the best possible investment in global stability and security.