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Overcoming the Odds to Make a Lasting Impact

For anyone who doubts that change can happen, it’s time you met Esther.

Esther first gave birth as a teenager. Illiterate and a mother of 10, she gave birth only once at a hospital; another delivery left her legs paralyzed. For seven years, Esther dragged her body around her home—and rarely elsewhere. Eventually, she was treated, regained mobility, and joined the Piave Women’s Group (PWG), an HIV prevention group that also helps women get health care.

PWG appointed Esther to a new health committee focused on preventing maternal deaths and injuries. In a public forum of both men and women, Esther learned about contraception (another first), the toll of unsafe abortions in Piave, and the needless suffering of pregnant women from delayed treatment during labor and delivery. With leadership training from EngenderHealth and support from the U.S. Agency for International Development (USAID), Esther began her inspiring crusade for maternal health.

Information is power: Esther began organizing. First up was a government meeting to allocate community development funds where a new market was being planned—that is, until Esther arrived with 300 supporters, demanding a medical dispensary, road repairs, and a bridge. This seemed to be an odd mix of infrastructure, but Esther knew it would help pregnant women get to the hospital in an emergency. Esther and PWG then lobbied to set up a police post near the dispensary, ensuring 24-hour safety, so women can visit as needed without fearing nighttime attacks.

Next, Esther and PWG members started going door-to-door, imploring women to seek immediate attention for bleeding during pregnancy and offering advice about getting prenatal care and family planning services. Even the 2008 postelection riots that rocked Nakuru didn’t stop Esther: She organized refugees to help pregnant women get care.

Back in Piave, Esther also realized her vision of assigning a full-time nurse and doctor to the community and finding both international and local funds to complete a maternity dispensary. When the dispensary opened in May 2009, the community was elated and initiated a ceremony celebrating life and a peaceful future. The gratitude for Esther was overwhelming.

Four years after Esther joined the PWG, women in Piave no longer die from unsafe abortions, miscarriages, or other treatable pregnancy-related causes. The community knows that pregnant women need medical care. Many, with Esther’s counsel, are also using modern contraception to delay, space, and limit births—and are planning smaller families than Esther has herself.

As for Esther, Kenya’s Ministry of Health, USAID, and EngenderHealth’s RESPOND Project have tapped her to establish a new Center for Learning in Nakuru, where women and men will come from across Kenya (and perhaps neighboring Tanzania, too) to learn how to organize and inspire communities to create better maternal health care.

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