Angela Gorman, Dr Grace Kodindo and a mother who survived pregnancy with their help. Photos © Simon Granville
Angela Gorman often wonders about the tiny, spur of the moment decision, made 15 years ago, that changed her life.
Arriving home after a 14-hour shift as a nurse at University Hospital Cardiff’s neonatal intensive care unit (NICU), she had sunk into the sofa to watch the news headlines before heading for bed.
Normally Angela would have turned the TV off by remote. But this time she decided to turn it off at the socket, to save electricity. Just as she reached for the switch, she heard the announcement for the next programme – a Panorama report on the central-African country of Chad, where a lone doctor was fighting to save the lives of pregnant women.
Angela returned to the sofa. As she did, she heard the doctor, Grace Kodindo, tell the cameras: “We lost a woman on Saturday. A woman on Sunday. And we lost two women today.”
And that was that. If not for those few extra seconds, Angela would probably be a lot less busy in her retirement. And maybe hundreds of thousands of African mothers who are alive today, would not be.
A simple problem
She recalls her shocked reaction to the programme, all that time ago: “They had lost four women in three days. In Cardiff, at that time, we had lost two women during pregnancy in 12 years.”
It was a simple problem. Women in Chad just couldn’t access the everyday medications available in the UK, particularly a drug called Misoprostol which combats catastrophic haemorrhaging.
At that time, Angela was chair of Cardiff and Vale UNISON health branch. Make Poverty History month was approaching and the branch hadn’t yet picked a cause to support. At Angela’s suggestion the branch meeting committed £5,000 to send some of those medications to Chad.
The hospital in question was delivering around 12,000 babies a year, and they were losing, on average, between 30 and 40 mothers a month and about a quarter of the babies. Due to the shipment, which arrived within a few months, they were saving around 25 women a month and new-born deaths had fallen from 23% to 7%.
For some, that might have been the end of the story. But after Angela travelled to Chad herself and met the doctor she’d seen on television, Grace Kodindo, in her hospital, she decided to co-found the charity Life for African Mothers (LFAM).
“I loved my job in NICU, I always said they would have to drag me out of there, but with my full-time job and my TU work, I didn’t have any more time than what I was giving,” she says. So when she was offered the opportunity to go on secondment in order to run the charity full-time for three years, she grabbed it.
Life for African Mothers
LFAM was advised to focus on haemorrhage in birth, expanding from Chad to combat the same problem in other countries across sub-Saharan Africa. Over the next decade, Angela worked with everyone from Welsh Assembly politicians to government ministers in Sierra Leone and Liberia, from UN doctors to enormous pharmaceutical companies.
Crucially, LFAM teamed with a charity called International Health Partners (IHP), which stockpiles donations of medications to be used in the aftermath of disasters. “We realised that IHP had stores of Misoprostol,” says Angela. “It’s considered an emergency drug in an obstetric sense, but not in terms of a natural disaster, so they offered to pass it on to us.”
LFAM sends shipments of Misoprostol to hospitals with three main conditions:
- Women must never be charged for access. “Imagine a woman goes into hospital with her husband,” says Angela. “She’s very sick… Unlike here, the first thing they think is, ‘I have no money, I’m going to die’. But then the doctor says, ‘It’s OK, we have the medication you need, it’s the best on the market, and it’s free’.”
- They must not be told where it’s come from. “The second thing they think is, ‘I’m worth saving. Somebody thinks I have value’. But if you thought your life depended on some crazy Welsh woman running round dragging money out of people, it wouldn’t do much for your self-esteem!”
- Hospitals should send LFAM reports about the use and effect of the tablets. Angela began forwarding reports to IHP, which passed them onto the pharmaceutical donors. In late 2014, when she asked if they would be able to provide a particularly large shipment of Misoprostol, the manufacturer replied: “As long as the reports are coming, Angela can have as many tablets as she wants.” Since then, LFAM has distributed around 4.5 million tablets (1.5 million doses) – and all hospitals have to do is keep sending the reports.
LFAM also organises regular trips for volunteer midwives to visit these countries and impart vital knowledge to the local health workers.
“We like to keep it simple – midwives and Misoprostol,” says Angela. “They lost so many frontline staff due to Ebola that a lot of people had to step up and do what they could. A lot of those who were left were traumatised. Imagine: you get up in the morning, go to work and wonder if this is the day you contract a deadly disease and die?”
With COVID-19 grounding any trips over the last year, they’ve been trying to keep up with the need by organising weekly Zoom calls with various hospitals, to answer the clinical questions of the midwives and nurses.
Fated to do the job
“We’ve had some remarkable reports,” Angela concludes. “Hospitals going from losing 300 women a year, to 40. The number of women dying fell from around 550,000 to 287,000 a year. However, with everything else happening in the world right now, politics and the pandemic, the number has plateaued and is back above 300,000.”
The final piece of Angela’s ‘jigsaw’, as she puts it, is that five years ago her family uncovered the death certificate of her grandmother, who had died in childbirth of catastrophic haemorrhage. “It was almost like I was left with a job to do.”
In June 2020 Angela received an email, saying she had been awarded an MBE. She thought it was a scam. “I thought it was going to say, send us £100 and we’ll send you the certificate,” she laughs.
It wasn’t a scam and, though she still hasn’t been able to attend the Palace to receive it, she looks forward to doing so.
Angela can be excused for her modesty, for wondering if this all happened because she chose to save a couple of pennies of electricity. But thrift doesn’t save lives, people like Angela do.