At the age of 23, Eva Paulo is in labour with her fourth child.
I meet her outside the Nyarugusu health clinic in the Geita district of North West Tanzania. She?s pacing barefoot under a canopy of Jacaranda trees, accompanied by her sister-in-law, and cursing her fate like almost every woman who has ever found herself in this particular situation.
Unlike Eva?s previous three labours, this one has been slow and extremely painful. Now in her 36th hour, her narrow face and long neck are slick with sweat in the late-morning heat. As a wave of pain overcomes her, she collapses at the waist like a marionette whose strings have been cut, small hands gripping her bent knees for support. As the contraction subsides she pulls herself back up and drinks deeply from a pink plastic cup of tea, shaking her head the entire time as if to indicate she?s almost given up. But in fact, this is just the beginning for Eva.
I?ve come to Tanzania to watch women give birth without water. The NGO WaterAid has brought me here as part of their campaign to raise awareness about the relationship between water, sanitation and maternal and infant health. And while I?m awed by the stoicism of health care workers and women like Eva, I?m also terrified on their behalf.
My own two recent birth experiences were complicated and, for entirely separate reasons, required serious medical intervention. (My first baby was an undetected breech and my second emerged unconscious and barely breathing due to a traumatic f...