Why should a man spend the last three years working on a project about maternal health? Because it is not a matter of gender, but of human beings.
My name is Paolo Patruno and I am an Italian social-documentary photographer and videomaker. I have traveled throughout Africa over the last ten years documenting social matters with my camera. Maternal health is an untold matter! That’s why since 2011 I have run my personal project “BIRTH IS A DREAM”, which aims to document and raise awareness about maternal health in Africa.
Many women give birth in facilities without adequate equipment and services, or don’t have access when living in rural areas where they give birth at home without any skilled health workers. When a mother dies it is a human tragedy that affects families and communities. Her death endangers the life of a surviving newborn and any other young children.
Maternity should stand for serenity, joy, happiness, hope. Unfortunately in Africa it’s not always like that.
I’ve been quite shocked when I learned that in Malawi, where I started my project, the words for pregnancy in the local language – ‘pakati’ and ‘matenda’ – translate into “between life and death” and “sick”.
I’m a father of two, 8 and 6 years old, and I’ve been in the labour ward for both of them, in a modern and quality service maternity hospital in Italy with a private room only for my wife and me. I followed every moment of her labour: I’ve been excited, moved, scared and finally I cried tears of joy for both of my children for this new life coming into the world. But also because in the last part of labour I was a bit scared for the pain of my wife, feeling powerless for what was happening. But why scared? We had more than one midwife during the labour. When the night shift ended, immediately the one for day shift came in.
You will see this very seldom in Africa. First of all women live their pregnancy, till the moment of giving birth, alone, without their partners. In more than three years, I’ve seen just partners two or three times in a post-natal ward. But I’ve never seen fathers in the ante-natal ward, during ante-natal visits.
I’ve been asked more than one time what strikes me the most about my work on maternal health in Africa and I always answer the lack of happiness in the women’s faces, and eyes. As a social photographer, I often visit hospitals, mainly when documenting NGO projects, and I found in maternity units almost the same atmosphere you can find in wards with sick patients.
In 2012 I was in Uganda, documenting home birth, and I met a woman, Elisabeth, who told me: “There isn’t any pregnancy that could be the same as the other, but is only God who is upon us. It’s only God who helps us to deliver”.
I think these words explain in the best way how most of African women live their pregnancy and giving birth.
Maternal health is a very complex matter. That’s why I’ve made that a long term project, working every day. I’ve spent hours, days in maternity wards, talking with women, mothers, midwives, and nurses. I’ve seen and heard things people will never hear about. That’s why through my documentary project I wish to raise more awareness about this matter, to convey more attention and to let people know what they still ignore.
Another situation I found, that might seem contradictory, is the different atmosphere and women’s psychological conditions I found in some health facilities in comparison with home birth, with TBAs (traditional birth attendants). In hospitals there is almost no privacy, with women delivering just one next to the other, sometimes totally naked with many male medical staff around in the room. You might hear nurses or midwives shouting at women to stop crying too loud. Home birth is instead totally different, with a very familiar and intimate atmosphere. Alice, a TBA who in Uganda gave me the opportunity to follow her work for more than a week, was like a mother for the young pregnant women. I went to her home-based labour ward and assisted for five hours when a young mother gave birth. Alice took care of every moment of the labour of the young mother who never cried, never yelled.
Sharing all that through my images I realized that people need and want to know much more about maternal health. One day I received a message on my FB from a young girl living in Kenya, telling me that BIRTH IS A DREAM has been eye-opening for conditions women have to face in Africa, where she lives. And thanks to that she has been inspired to create more awareness about maternal health in her community, working towards positive changing.
I receive these kinds of comments and feedback almost every day by women from around the world. It gives me great encouragement to go ahead with my project. Documenting the most private moment in a woman’s life is not easy at all, most of all for a man, a white man with a camera. But I do believe this is more of a personal social commitment, rather than simply a documentary work.
I have many other stories to tell from Africa, but I’ve also realized how there is a need for another BIRTH IS A DREAM outside of Africa as well. Just recently, I was talking with some women and midwives from the United States, where maternal mortality ratio is the highest among developed and industrialized countries, even four times more than Sweden, Italy, and France. That’s why I’m now working to expand the BIRTH IS A DREAM project in U.S.
I am determined to make people aware of the maternal health issue and to show that a safe birth should be a reality for every mother, not just her dream.
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