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‘I felt humiliated’: parents respond to NHS maternity care racial bias inquiry | Maternal mortality

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Feeling manipulated into having medical procedures, dismissed by professionals and labelled with racial stereotypes are among the complaints of parents who responded to a national inquiry into racial injustice in UK maternity care.

A panel established by the charity Birthrights is investigating discrimination ranging from explicit racism to racial bias and microaggressions that amount to poorer care.

It comes as parliament is due on 19 April to debate the large racial disparity in maternal mortality in British hospitals, after a petition from the campaign group Five X More gathered 187,519 signatures. Black women are four times more likely than white women to die during pregnancy or childbirth in the UK.

Testimonies include that of a British Bangladeshi woman who said her labour concerns were dismissed. “I felt unsafe and like maternity professionals are not used to being challenged by brown women,” she said. “There is a stereotype of Asian women that we are tame, quiet and compliant people who have no voice and will be obedient.

“I was treated like a vessel, not like a human. The experience left me feeling humiliated, disempowered and ashamed.”

During labour she was denied pain relief and told she must have a low pain threshold. “Manipulative and coercive language was used to force me to go along with their care plan – one doctor told me my baby would be born with cerebral palsy if I didn’t consent to a procedure and did an impression of what someone with this condition looks like,” she said.

A woman of African-Caribbean heritage said her first experience of her local maternity services was discovering that there was no category to match her ethnicity when she was filling out a form. She said she was told to “pick another one”.

After being left in a waiting room for several hours to see a consultant who had already gone home, white members of staff called her “aggressive” when she queried the appointment. “I feel like my race means I’m seen as less and meant to endure more,” she said.

Lorraine Pryce, is a trained doula – a non-medical role providing support and advocacy during pregnancy and childbirth – and a member of the Birthrights panel.

She said demand for doulas is rising due to concerns over maternal mortality data. Figures published by MBRRACE-UK found women from Asian ethnic backgrounds face twice the risk of dying in childbirth as white women.

Lorraine Pryce, a trained doula who says demand for such services is rising because of concerns over maternal mortality data.
Lorraine Pryce, doula: ‘The overriding feeling is … not being heard, believed or trusted.’ Photograph: handout

“We hear the statistics about those who have died in the worst cases but we don’t hear from all the people suffering poorer outcomes because of their race who are still living with trauma,” said Pryce. “This inquiry intends to give those people a voice.”

“The overriding feeling I get when I talk to people about their experience is something I felt when I was giving birth – that is not being heard, believed or trusted,” she said. “I’ve seen it time and time again especially with clients of colour.”

Tricia Boahene struggled to be taken seriously after her premature baby developed jaundice. “My whole family could see it but the health visitor was not convinced. She said she’d test the levels to put my mind at ease. He tested super high but she kept insisting the machine was broken.”

Eventually, the baby was referred to hospital where a doctor said the reading was alarming but agreed with the health visitor that her son did not look jaundiced apart from a “slight yellowing” in the eyes. “The white staff did not recognise jaundice in a black baby but to me he looked neon,” said Boahene. Her newborn was hospitalised for several weeks.

Pryce, who works in the north of England supporting clients in Manchester, Leeds and Bradford, said such stories are commonplace.

“It’s heartbreaking to see and hear it,” she said. “There are pockets of good practice to improve the outcomes for black, brown and mixed ethnicity people but the NHS doesn’t seem to be tackling it on a wider scale.

“There is a lot of unlearning to be done in terms of how black and brown people are perceived and some of the messages that have been passed down over the years such as our bodies don’t feel pain in the same way.”

A machine monitors the unborn baby in a hospital maternity ward, Kingston Upon Thames, Surrey, England.
A machine monitors an unborn baby in a hospital maternity ward, Kingston Upon Thames, Surrey, England. Photograph: Jeff Gilbert/Alamy

Benash Nazmeen, co-chair of the inquiry and director of the Association of South Asian Midwives, said while issues raised were very concerning there were also positives.

“Even those with very traumatic births identified at least one professional who was ‘amazing’ – whether a community midwife, health visitor or doctor. This shows good, compassionate, culturally sensitive care is possible.”

The NHS said it was taking action to level up health outcomes for mothers and their babies from black, Asian and mixed ethnicity groups through a range of initiatives including the Maternity Voices Partnership.

Jacqueline Dunkley-Bent, England’s most senior midwife, said: “We continue to tackle poorer outcomes for women from ethnic minority backgrounds … including fast-tracking our continuity of carer programme for these groups, meaning women receive care from the same midwife and team before, during and after they give birth, which we know improves experiences and outcomes.”

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Missing child in Germany: German boy found alive after surviving eight days in sewer | International

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German police have found an eight-year-old boy who went missing from his home in Oldenburg, a city of 170,000 people in northwestern Germany. The child, named Joe, was discovered on Saturday in a sewer just 300 meters from his house. He had survived in the sewer for eight days while hundreds of officers and volunteers frantically searched the surface for clues to his whereabouts. “Eight-year-old Joe lives!” police in Oldenburg announced on Twitter.

The boy, who suffers from learning disabilities, disappeared on June 17 from the garden of his house. Police launched a large-scale search with drones, helicopters, sniffer dogs and dozens of officers, who were joined by hundreds of volunteers. As the days passed, a homicide team joined the investigation amid growing fears that Joe – who is only identified by his first name due to Germany’s privacy laws – could have been the victim of a violent crime. A witness claimed to have seen him in the company of an unidentified man and it was feared he may have been kidnapped.

“It was absolute luck,” said Stephan Klatte, the Oldenburg police spokesman, said of Joe’s discovery. A neighbor who was walking in the area raised the alarm when he heard “a whining noise” coming from the ground, just under a drain. When officers lifted the manhole cover, they found the boy, completely naked. He had no serious external injuries, but was dehydrated and suffering from hypothermia, for which he was taken to hospital for treatment. According to German media, he is recovering well. “If he hadn’t made a sound, or if no one had heard him, we might never have found him,” Klatte said.

In a statement, the police reported that they believed that Joe likely entered the rainwater drainage system through a sewer on the same day of his disappearance and “lost his bearings after walking several meters.” Police have ruled out any foul play in the incident.

On Sunday, the day after Joe was discovered, police commissioned a specialized company to inspect the sewage system with a robot equipped with a camera. The robot examined the sewer between the boy’s home and the place where he was found. It recorded several items of clothing, including what he was wearing when he disappeared, in a pipe about 60 centimeters in diameter that runs under one of the streets of the neighborhood where he lives with his parents. The robot found, for example, the child’s vest, 70 meters from the point of entry.

Officers found an entrance to a three-foot-wide drainage channel near the farm where he was last seen on the day of his disappearance. Authorities believe the boy entered the channel while playing. After 23 meters, the tunnel leads to another narrower plastic pipe and police think it is likely the eight-year-old continued down this path. Joe was eventually found about 290 meters from where he entered the sewer system.

Police believe that Joe became more and more disoriented until he could no longer find a way out. “A first statement from the child confirms this assumption,” said the statement, which does not provide more details about what he told officers. Investigators say they have not been able to question the boy in detail, as he remains in hospital. Nothing has been found to suggest that the child came to the surface in the eight days in which he was missing. In the statement, police asked that no questions about his state of health be made out of respect for him and his family.



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Bereaved then evicted by in-laws: Kenya’s widows fight disinheritance | Global development

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Within months of the death of her husband in 2014, Doreen Kajuju Kimathi, from Meru, eastern Kenya, was told that his bank accounts had been frozen, and she had been forced out of her home by her in-laws.

The pregnant 37-year-old was left with no resources to fight back, and returned to her parents’ home. “It was traumatising, and I went into depression for five years,” says Kimathi.

Doreen Kajuju Kimathi
Doreen Kajuju Kimathi, who now volunteers for a widows’ support group. Photograph: Courtesy of Widows Empowerment Initiative for Africa

Her experience is far from unique. While Kenya protects widows’ inheritance in theory, the patriarchal culture and the influence of colonial legislation that restricted married women’s property rights means the law is often not enforced.

“There is an entire parallel system operating outside succession laws,” says Roseline Njogu, a Kenyan lawyer. “Years of law reform have led us to formal equality, but equality of law doesn’t mean equality of power, and that’s where we get tripped up.”

Human rights groups report that discriminatory practices in marriage limit women’s capacity to own land. According to the Kenya Land Alliance, only 1% of land titles are registered to women, and another 6% are registered jointly with a man.

While children have equal inheritance rights, land is more often passed on to sons, leaving daughters with fewer assets, and making a future wife vulnerable to eviction if her spouse’s family regard the property as theirs.

For young widows such as Kimathi, it can be even harder to hold on to marital property. “You’re considered less entitled to it because you’re expected to remarry,” she says.

But a fightback is under way. Grassroots organisations are emerging all around the country to build community awareness of women’s legal rights. One group, the Come Together Widows and Orphans Organization (CTWOO), has offered legal advice and support to nearly 500,000 widows since 2013.

The NGO is trying to address disinheritance at its roots. It works with other groups to increase financial and legal literacy across the country, especially among married couples, encouraging them to discuss finances openly, and to write wills.

Dianah Kamande, the founder of the Come Together Widows and Orphans Organization.
Dianah Kamande, the founder of the Come Together Widows and Orphans Organization. Photograph: Courtesy of CTWOO

The founder, Dianah Kamande, says that – contrary to popular belief – most dispossessed widows are middle-class, like Kimathi, not poor. The poor usually have less property, and the rich have access to lawyers.

Kamande says death and estate planning are still taboo topics for many married couples, and that some people obscure their wealth. “Men keep lots of secrets about money from their wives, and trust their mothers and siblings more – who in turn disinherit the wife and children,” she says.

Widows Empowerment Initiative for Africa logo
Grassroots groups are emerging to build awareness of widows’ rights. Photograph: Courtesy of Widows Empowerment Initiative for Africa

The country’s Unclaimed Financial Assets Authority says it has 50bn Kenyan shillings (£347m) in unclaimed assets, and about 40% is money left by people after they die. Concerned by the rising number of unclaimed assets, research by the authority found roughly 43% of Kenyan respondents said they would not disclose their financial assets to anyone – even people they trusted.

“There’s secrecy around financial investments. For many of the people who find out about the assets left by their spouse, it’s a eureka moment,” says Paul Muya, of the UFAA.

Five years after being widowed, Kimathi’s life was still on hold. She had looked into hiring a lawyer but could not afford it. Without access to the family property, it was difficult for her and her son to get by, and she had to rely on help from her parents and sister.

But through the CTWOO, she found out that she did not need a lawyer to access the courts. She filed a claim, and within a year had gained access to almost all of her dead husband’s property. Last year, Kimathi opened a bar and restaurant in Kitui, 110 miles east of Nairobi.

“It was a huge relief to get the money. Being a widow in Kenya is financially and socially isolating, and knowing what that’s like pushed me to help others in the same situation,” says Kimathi, who now volunteers with a widows’ support group.

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WHO concerned about first cases of monkeypox in children | Science & Tech

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Reports of young children infected by monkeypox in Europe – there were at least four in recent days, with a fifth one recorded a few weeks ago – have raised concern about the progress of an outbreak now affecting more than 5,500 people in 51 countries.

The health organization’s Europe chief, Hans Kluge, also warned on Friday that overall cases in the region have tripled in the last two weeks. “Urgent and coordinated action is imperative if we are to turn a corner in the race to reverse the ongoing spread of this disease,” said Kluge.

The WHO has not yet declared the outbreak a global health emergency, however. At a meeting last Saturday, the agency ruled it out but said it could change its views if certain scenarios come to pass, such as a spike in cases among vulnerable groups like children, pregnant women and immunocompromised people. Available data shows that children, especially younger ones, are at higher risk of serious illness if they become infected.

The last known case of a child contracting monkeypox was reported on Tuesday in Spain, where a three-year-old was confirmed to have the disease. Cases in Spain are now in excess of 1,500 according to health reports filed by regional governments.

Also on Tuesday, Dutch authorities reported that a primary school student had become infected and that contact tracing had been initiated to rule out more cases within the child’s close circle of contacts. On Saturday, France reported one confirmed case and one suspected case among elementary school students.

The UK has so far recorded at least two infections in minors. The first case, reported in May, involved a baby who had to be taken to intensive care for treatment with the antiviral Tecovirimat, of which few doses are available but which has already begun to be distributed in several countries. British authorities this week reported a second case of a child with monkeypox. The UK currently has the biggest monkeypox outbreak beyond Africa.

The main vaccine being used against monkeypox was originally developed for smallpox. The European Medicines Agency said earlier this week it was beginning to evaluate whether the shot should be authorized for monkeypox. The WHO has said supplies of the vaccine, made by Bavarian Nordic, are extremely limited.

Until May, monkeypox had never been known to cause large outbreaks beyond Africa, where the disease is endemic in several countries and mostly causes limited outbreaks when it jumps to people from infected wild animals.

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