Author: Wandermama

Tahoy nurse and mothers

Promoting safe birth in remote areas of Laos

By Kristyn Zalota, founder, In my last post, I wrote about the challenges mothers in rural areas face accessing prenatal and delivery care. The safe-delivery rate in cities in Lao PDR is six times higher than in rural areas, where my organization works. The reasons for this disparate care of rural and urban mothers range from Mother Nature to infrastructure to a lack of information. When it rains it pours. “When the rains come, that’s when we have problems,” a nurse from Samouai District, Lao PDR shared at a recent nurses’ training.   Her colleagues concurred.  From May to September some clinics in Samouai and Taoi Districts are totally cut off from phone communication and supplies.  While attempting to restock kits in one village, I received this response from my local partner: “I asked our field staff to take the kits to the clinic but its impossible because of the bad road and rain but we will find a way to send the kits to the clinic as soon as possible.” The challenges …

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MDG 5: Moms still need our help, especially in rural areas

By Kristyn Zalota, Founder of As we approach the 2015 deadline for achieving the Millennium Development Goals, it is clear that many countries will not achieve the 75% reduction in maternal mortality prescribed by MGD Goal 5.  According to the World Bank, “…of all the MDGs, the least progress has been made toward the maternal health goal.” The good news is there has been 45%
 drop in maternal mortality between 1990-2013 with the rate of maternal deaths shrinking from 380 per 100,000 live births in 1990 to 210 deaths per 100,000 live births in 2013. There is consensus that future efforts must be focused on women in developing countries. 99% of the 800 women who die each day due to birth-related complications live in the developing world. Just 50%
of women in developing areas receive sufficient antenatal care. More than 24% women/girls in sub-Saharan Africa lack family planning services, leading to unplanned pregnancies and HIV. We also now know that within developing countries, there are often disparities in maternal care between rural and urban areas. UNDP finds, …

Laos Breastfeeding Campaign

Chewed Rice, not Exclusive Breastfeeding in Laos

In villages in southern Laos, breastfeeding mothers are as ubiquitous as thatched roofs and playing children. In my time among villagers, I have never seen a breastfeeding mother cover up or go inside to continue feeding. Breastfeeding stigma seems non-existent. On front stoops and in gathering places, babies get their fill, comfortably ensconced in slings or resting on laps. This freedom to feed however, isn’t reflected in Lao’s exclusive breastfeeding rates: just 39% of babies benefit from early initiation of breastfeeding and only 40% are exclusively breastfed until 6 months. With child mortality rates in Laos among the highest in the region – nearly 79 deaths per 1,000 children under 5 – the government has taken measures at improving child survival.  One such initiative is a joint Lao government-UNICEF program to promote exclusive breastfeeding. In a 2012 presentation on the progress of this joint program, Dr.Khamseng Philavong from the Lao Ministry of Health tied breastfeeding to improving child survival: “Evidence indicates breastfeeding as the most important preventive intervention with potentially the single largest impact on …


Give & Take: Working with Local Nurses to Make Birth Safer in Laos

Written by Kristyn Zalota, Founder, In my first Girls’ Globe post, I wrote of Laos’ high rates of infant and maternal mortality. While progress is being made, Laos is expected to fall short of Millennium Development Goals 4 and 5.  In 2014, Laos ranked 129th of 178 on Save the Children’s 2014 Mothers’ Index. Knowing these bleak statistics, I started because I believe that no mom or baby should die from preventable causes.  In 2 years, we’ve provided 4,000 AYZH Clean Birth Kits containing hygienic birthing supplies that prevent infection to our local nurses in Southern Laos.  In partnership with the Yale School of Nursing, we have trained 110 nurses and staff in the use and distribution of the kits and the WHO’s Essentials of Newborn Care. While the kits are important, education and training have made the difference between kits being used correctly or not. We’ve made it clear to the nurses that the trainings are a two way street. We teach them. They teach us.  Open exchanges about the realities of birth in remote villages have led to innovative …

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Laos: Midwives Wanted

Around 60% of mothers in Laos give birth without any trained attendant. That rate is closer to 80% in remote areas.  Unsurprisingly, Laos has the highest rates of infant and maternal mortality rates in Southeast Asia. Why? One factor is a desperate lack of midwives. From the late 1990s to 2010 – more than 20 years – no midwives were trained.  In 2010, Laos had just 100 formally trained midwives for a population of 6.5 million.   The Lao government has begun taking action to improve Maternal and Child Health and, specifically, increase the number of midwives.  With the UNFPA, the government developed the Skilled Birth Attendance Development Plan to address acute staff shortages. At a “Month of Midwives” event in June 2012, Lao Vice-Minister of Health, Som Ock Kingsada, declared: Every community needs to have its own professional midwife to work with community leaders, families, individual women and adolescent girls to improve knowledge of safe pregnancy, childbirth and care of mothers and babies after birth. While government intentions appear good and progress is being seen, …

Yai, with her baby.

Carol Perks: My Maternal Health Hero

Post by ​Kristyn Zalota, Founder I want to tell you about Carol Perks, an Australian nurse who has transformed maternal and child healthcare in northern Laos. She has inspired my maternal heath work in Laos and shown me the importance of generously sharing knowledge. The Encouragement I Needed When I started, my maternal-infant health project in southern Laos, some said, “Are you qualified to do that? You’re not a midwife” or “Can Clean Birth Kits have a real impact?” Carol Perks, a true expert in this field, never asked me those questions. Her first words to me via email were: Good to hear from you and congratulations on trying to help the situation for women and children in Salavan. I’d be happy to help you in any way that I can… Into the Unknown When Carol arrived in Sayaboury Province in 1991, on a 2-year Save the Children contract, there were no other foreigners, “virtually no transport, no electricity, no water.” In this video, she explains with a laugh, Sayaboury was “very wild in …