Family

Moms in India are dying in preventable ways. How are they being saved?

Most deaths resulting from pregnancy-related complications can be prevented. Here's how Merck's doing its part.

Moms in India are dying in preventable ways. How are they being saved?
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Merck

For three months, Pennsylvania-based Scott Wright left his regular day job as a global communications expert to work in direct collaboration with Jhpiego, an international nonprofit health organization in India.

"How often do you get to say that you were part of a global initiative to reduce maternal mortality and save ... lives?" he tells us, beaming.


What's the state of maternal health in India?

It's getting better. The number of lives lost to pregnancy-related complications has been reduced by 65% since 1990.

That's great news, right? Impressive results, all around. In less than 25 years, the number of women in India who died from complications due to pregnancy and childbirth has dropped significantly, from 152,000 to 45,000.

A selfie with over 20 nurses during a field visit and interview at a mission hospital, with all enrolled in MNH quality-of-care training. They deliver over 700 babies a month.

Unfortunately, though, that means tens of thousands of women in India still die each year from complications with pregnancy and childbirth.

"Two leading causes [of maternal mortality] are preeclampsia [high blood pressure] and postpartum hemorrhaging [bleeding]," Scott says. "In many cases, the deaths that occur from these conditions are entirely preventable."

There's still a lot more work to be done, and while assistance initiatives like the Janani Suraksha Yojana and Rashtriya Swasthya Bima Yojna have increased access to quality care, there is now a need to reap the benefits by focusing on ensuring that access.

So, how do you begin to address the still-staggering number of deaths?

That's what organizations like Merck (known as MSD outside of the U.S. and Canada) — through its Merck for Mothers initiative — are committed to figuring out.

Merck for Mothers is a 10-year, $500-million commitment to improve maternal health around the world.

Launched in 2011, Merck for Mothers works with more than 75 partners on more than 50 programs to increase access to, and the quality of, maternal health care for women in more than 30 countries, including India, Senegal, Uganda, Zambia, and the United States.

Ambitious? Absolutely.

"You can make a difference, but having a difference that lasts? That's what matters."

Scott was part of the Merck Fellowship for Global Health program (known as the MSD Fellowship for Global Health outside of the U.S. and Canada), where employees have opportunities to share their skills with selected nonprofit organizations around the world, many of which are Merck for Mothers’ partners.

Between 2012 and 2015, 101 fellows like Scott from 16 different countries worked for 27 nonprofit organizations. Their goal? To support meaningful and systematic improvements in health service delivery for people with the greatest needs.

On the flip side, the fellows bring back experiences and insight that can contribute to the company’s success and ability to deliver innovative health solutions to people around the world.

Scott’s work centered on helping to communicate and perform higher quality of care standards for maternal health by private maternity health care providers in India.


Children need their mothers. With the right quality of care training, no woman needs to die giving life.

Why does a focus on private maternity health care matter?

According to the India's National Sample Survey Office, 40-50% of all births occurring within medical institutions in India are happening in the local private sector.

Jhpiego's project involves training private maternity providers on the standards of quality care, and Scott’s work was largely focused on two critical fronts: developing a strategy with private maternity providers to adopt and implement higher standards of care and then to create awareness of and drive education about those standards with patients.

The strategy also involves training nurses to recognize and react to some of the most common causes of maternal mortality.

At the end of their initial three-year pilot with Jhpiego, they realized that nurses are a key factor in reducing maternal mortality.

Training nurses is "meant to implement not just better maternal health, but also safer and healthier pregnancies and births," says Scott.

“You talk to the doctors and they will tell that for every two minutes they get to spend with the patient, nurses are spending about two hours. There is a tremendous opportunity to integrate nurses more.”

Before the training, "not all the nursing staff or paramedic staff are fully qualified [to administer medical care]," Scott explains.

"The nurses, unlike the doctors, aren't always formally trained to deliver maternal care," he says. "They may be technically knowledgeable, but they don't necessarily know the best way how to do it. Once they’re trained in actually delivering care, and I saw it first-hand, there’s an incredible level of excitement because their level of impact and empowerment just skyrocketed."


A mother and her newborn smile in recovery thanks to a complication-free delivery due to maternal and newborn health (MNH) quality-of-care training. No mother should die giving life.

Merck for Mothers' work with global partners is creating real sustainable results.

As of 2015, 4,751 health care workers were trained and the quality of care was improved at 787 facilities in India, reaching more than 467,000 women. It's proof that these partnerships have created an atmosphere of sustainable improvement in India.

Working with local partners, like the Federation of Obstetric and Gynecological Societies of India (FOGSI), the initiative is helping set and maintain standards that can be passed down in training for years to come.

Time will tell whether his work will help reduce the country's rate of maternal mortality, but Wright seems pretty confident.

"That's what it's about," says Scott. "You can make a difference, but having a difference that lasts? That's what matters."

For more information about the work being done by Merck for Mothers, visit their website.

Photo courtesy of Kenneth and Jill Gonsalves
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It can be expensive to have a pet. It's possible to spend between $250 to $700 a year on food for a dog and around $120-$500 on food for a cat. But of course, most of us don't think twice about the expense: having a pet is worth it because of the company animals provide.

But for some, this expense is hard to keep up, no matter how much you adore your fur baby. And that's why Kenneth and Jill Gonsalves decided to help.

Kenneth had seen a man scraping together change in a store to buy pet food, so he offered to buy the man some extra pet food. Still, later that night he couldn't stop thinking about the experience — he worried the man wasn't just struggling to pay for pet food, but food for himself, too.

So he went home and told his wife — and immediately, they both knew they needed to do something. So, in December 2020, they converted a farm stand into a take-what-you-need, leave-what-you-can Pet Food pantry.

"A lot of people would have watched that man count out change to buy pet food. Some may have helped him out like my husband did," Jill says. "A few may have thought about it afterward. But, only someone like Kenny would turn that experience into what we have today."

"If it weren't for his generous spirit and his penchant for a plan, the pantry would never have been born," she adds.

A man with sunglasses hands a box of cat food to a woman smiling Photo courtesy of Kenneth and Jill Gonsalves

At first, the couple started the pet food pantry with a couple hundred dollars of pet food they bought themselves. And to make sure people knew about the pantry, they set up a Facebook page for the pantry, then went to other Facebook groups, such as a "Buy Nothing group," and shared what they were doing.

"When we started, we weren't even sure people would use us," Jill says. "At best, we were hoping to be able to provide enough to help people get through the holidays."

But, thanks to their page and word of mouth, news spread about what they were doing, and the donations of more pet food started flooding in, too. Before long, they were coming home to stacks of food — and within a couple of months, the pantry was full.

Yellow post-it note with handwritten note that reads: "Hi, I read your story on Facebook. Here is a small donation to help. I have a 3-year-old yellow lab who I adore. I hope this helps someone in need. Merry Christmas. Meredith" Photo courtesy of Kenneth and Jill Gonsalves

"The pounds of food we have gone through is well, well, well into the thousands," Jill says. "The orders from our Amazon Wish List alone include several hundred pounds of dry food, a couple of hundred cases of canned food, and thousands of treats and toys. But, that does not even take into account the hundreds of drop-offs, online orders, and monetary donations we have received."

They also got many 'Thank you notes' from the people they helped.

"I would like to thank you for helping us feed our fur babies," one note read. "My husband and I recently lost our jobs, and my husband [will] hopefully [find] a new one. We are just waiting for a call."

Another read: "I just need to say thank you from the bottom of my heart. I haven't worked in over a month with a two-year-old at home. Dad brings in about $300/week. From the pandemic to Christmas, it has been tough. But with the help of beautiful people like you, my fur baby can now eat a little bit longer, and my heart is happy."

Jill says that she thinks the fact that the pet pantry is a farm stand helps people feel better.

A woman holding a small black dog and looking at the camera is greeted by Jill Gonsalves Photo courtesy of Kenneth and Jill Gonsalves

"When we first started this, someone who visited us mentioned how it made them feel good to be able to browse without feeling like they were being watched," she says. "So, it's been important to us to maintain that integrity."

Jill and Kenneth aren't sure how many people they've helped so far, but they know that their pet food pantry is doing what they hoped it would. "The pet owners who visit us, much like donations, come in ebbs and flows," Jill says. "We have some regulars who have been with us since the beginning. We also have some people that come a few times, and we never see again."

"Our hope is that they used us while they were in a tough spot, but they don't need us anymore. In a funny way, the greatest thing would be if no one needed us anymore."


Today, the Acushnet Pet Pantry is still going strong, but its stock is running low. If you want to help out, visit their Facebook page for updates and to find ways to donate.
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Dr. David McPhee offers advice for talking to someone living in a different time in their head.

Few things are more difficult than watching a loved one's grip on reality slipping away. Dementia can be brutal for families and caregivers, and knowing how to handle the various stages can be tricky to figure out.

The Alzheimer's Association offers tips for communicating in the early, middle and late stages of the disease, as dementia manifests differently as the disease progresses. The Family Caregiver Alliance also offers advice for talking to someone with various forms and phases of dementia. Some communication tips deal with confusion, agitation and other challenging behaviors that can come along with losing one's memory, and those tips are incredibly important. But what about when the person is seemingly living in a different time, immersed in their memories of the past, unaware of what has happened since then?

Psychologist David McPhee shared some advice with a person on Quora who asked, "How do I answer my dad with dementia when he talks about his mom and dad being alive? Do I go along with it or tell him they have passed away?"

McPhee wrote:

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When Sue Hoppin was in college, she met the man she was going to marry. "I was attending the University of Denver, and he was at the Air Force Academy," she says. "My dad had also attended the University of Denver and warned me not to date those flyboys from the Springs."

"He didn't say anything about marrying one of them," she says. And so began her life as a military spouse.

The life brings some real advantages, like opportunities to live abroad — her family got to live all around the US, Japan, and Germany — but it also comes with some downsides, like having to put your spouse's career over your own goals.

"Though we choose to marry someone in the military, we had career goals before we got married, and those didn't just disappear."

Career aspirations become more difficult to achieve, and progress comes with lots of starts and stops. After experiencing these unique challenges firsthand, Sue founded an organization to help other military spouses in similar situations.

Sue had gotten a degree in international relations because she wanted to pursue a career in diplomacy, but for fourteen years she wasn't able to make any headway — not until they moved back to the DC area. "Eighteen months later, many rejections later, it became apparent that this was going to be more challenging than I could ever imagine," she says.

Eighteen months is halfway through a typical assignment, and by then, most spouses are looking for their next assignment. "If I couldn't find a job in my own 'hometown' with multiple degrees and a great network, this didn't bode well for other military spouses," she says.

She's not wrong. Military spouses spend most of their lives moving with their partners, which means they're often far from family and other support networks. When they do find a job, they often make less than their civilian counterparts — and they're more likely to experience underemployment or unemployment. In fact, on some deployments, spouses are not even allowed to work.

Before the pandemic, military spouse unemployment was 22%. Since the pandemic, it's expected to rise to 35%.

Sue eventually found a job working at a military-focused nonprofit, and it helped her get the experience she needed to create her own dedicated military spouse program. She wrote a book and started saving up enough money to start the National Military Spouse Network (NMSN), which she founded in 2010 as the first organization of its kind.

"I founded the NMSN to help professional military spouses develop flexible careers they could perform from any location."

"Over the years, the program has expanded to include a free digital magazine, professional development events, drafting annual White Papers and organizing national and local advocacy to address the issues of most concern to the professional military spouse community," she says.

Not only was NMSN's mission important to Sue on a personal level she also saw it as part of something bigger than herself.

"Gone are the days when families can thrive on one salary. Like everyone else, most military families rely on two salaries to make ends meet. If a military spouse wants or needs to work, they should be able to," she says.

"When less than one percent of our population serves in the military," she continues, "we need to be able to not only recruit the best and the brightest but also retain them."

"We lose out as a nation when service members leave the force because their spouse is unable to find employment. We see it as a national security issue."

"The NMSN team has worked tirelessly to jumpstart the discussion and keep the challenges affecting military spouses top of mind. We have elevated the conversation to Congress and the White House," she continues. "I'm so proud of the fact that corporations, the government, and the general public are increasingly interested in the issues affecting military spouses and recognizing the employment roadblocks they unfairly have faced."

"We have collectively made other people care, and in doing so, we elevated the issues of military spouse unemployment to a national and global level," she adds. "In the process, we've also empowered military spouses to advocate for themselves and our community so that military spouse employment issues can continue to remain at the forefront."

Not only has NMSN become a sought-after leader in the military spouse employment space, but Sue has also seen the career she dreamed of materializing for herself. She was recently invited to participate in the public re-launch of Joining Forces, a White House initiative supporting military and veteran families, with First Lady Dr. Jill Biden.

She has also had two of her recommendations for practical solutions introduced into legislation just this year. She was the first in the Air Force community to show leadership the power of social media to reach both their airmen and their military families.

That is why Sue is one of Tory Burch's "Empowered Women" this year. The $5,000 donation will be going to The Madeira School, a school that Sue herself attended when she was in high school because, she says, "the lessons I learned there as a student pretty much set the tone for my personal and professional life. It's so meaningful to know that the donation will go towards making a Madeira education more accessible to those who may not otherwise be able to afford it and providing them with a life-changing opportunity."

Most military children will move one to three times during high school so having a continuous four-year experience at one high school can be an important gift. After traveling for much of her formative years, Sue attended Madeira and found herself "in an environment that fostered confidence and empowerment. As young women, we were expected to have a voice and advocate not just for ourselves, but for those around us."

To learn more about Tory Burch and Upworthy's Empowered Women program visit https://www.toryburch.com/empoweredwomen/. Nominate an inspiring woman in your community today!