Four Born Every Second: Documentary chronicles four births in extreme poverty

With the maternal mortality rate at 287,000 annually worldwide, Ros Wynne-Jones reports on a problem both here in the West and developing countries

Hawa, 25, has just given birth to her fifth baby with the help of Mammie, a traditional birth attendant, in Bengie village, rural Sierra Leone. With a thatch of thick hair, and his mother’s almond eyes, baby Michael Brian has just survived the world’s worst statistics on neonatal and maternal mortality.

A few miles away across Bo District at the Gondama referral centre run by Médecins Sans Frontières (Doctors Without Borders), obstetrician Dr Phillip de Almeida weeps into his hands. He has just delivered a stillborn child by caesarian section, and he knows the baby’s mother, Cadeta, has little chance of surviving the night. “We do what we can,” he says, quietly, but by morning, Cadeta has died.

This is the emotional rollercoaster of Four Born Every Second, a documentary that tonight chronicles the lives of four babies born into poor families in Sierra Leone, Cambodia, the United States and the UK – in a world where 287,000 women die giving birth each year. The launch film of a ground-breaking cross-media event across 70 broadcasters including the BBC, the Why Poverty project is screening the same eight documentaries across 180 countries during November. Each film will ask the same question: why, in the 21 century, do a billion people worldwide still live in poverty?

In Sierra Leone, Four Born Every Second also challenges the idea that high maternal mortality is inevitable in poor countries. A new Doctors Without Borders report released today shows the clinic featured in the documentary is making pioneering progress reaching the Millennium Development Goal on maternal mortality that UN countries signed up to in 2000.

MSF has been using a series of simple and cost-effective measures – including an ambulance referral system that transports pregnant women in need of emergency care to an MSF hospital where round-the-clock obstetric treatment is provided free of charge.

“This has reduced maternal mortality by an astonishing 75 percent at an estimated cost of just 1.7 euros per person,” says Dr de Almeida.

Throughout the film – beside which the jeopardy of the UK domestic original, One Born Every Minute pales – BAFTA-winning filmmaker Brian Hill reveals an international childbirth lottery beseiged by hostile statistics. At 25, Hawa has already lived half her life expectancy, in a country where there are only 200 doctors for six million people. Of the 20 worst places to be born in the world, 19 are in Africa. In Sierra Leone, 840 out of every 100,000 women die in childbirth. In Italy, that statistic is just four.

Things are little better for 36-year-old Neang, a pregnant mother from rural Cambodia with HIV. By pure geographical accident of birth, her children are more likely to grow up malnourished than attend high school. Divorced from the husband whose philandering infected her with HIV, Neang has a toddler daughter she adopted when her parents died, and a 12-year-old son, Pisey. “I just want my children to go to school,” she says. But Pisey also has to support the family by scavenging the streets for tins and plastic.

The two Western women in the film should be statistically better off, but face their own problems. The USA has one of the worst infant mortality rates in the world – and the child born to Starr, from San Francisco, California, will be one of a staggering 1.6 million children currently homeless in the US. Describing herself as “poor, white trash”, without San Francisco’s Homeless Prenatal Programme, Starr would have no hope of clothing or eating enough to feed her newborn child. Statistically, her baby has a life expectancy of 78 years, but a one in three chance of becoming obese.

“I found the Third World right here in America,” says Martha Ryan, the Program’s Director. The problem of homeless families in the US is growing rapidly, she adds. “We began with 517 babies. Now there are 35,000 families to help.”

Finally, in the UK, where more than one in four families are led by a single parent, the film follows single mum Lisa, 22 as she prepares for the birth of her second child. Lisa’s son Finlay has the highest life expectancy of all four babies and could live to be 100. Meanwhile, Lisa’s problems are more practical than life-threatening. She is determined to escape a life on benefits, but faces childcare costs of £1400 a month for Finlay and her two-year-old, Grace.

Of all four women, Lisa is the happiest. “People might have more, but at the end of the day, I’m happy with what I’ve got,” says Lisa. “All I want is a roof, children and a job… I don’t live above my means, I’m just happy.”

Asked what she is looking forward to about the new baby Lisa says: “Someone to love and someone to love me back as much.” Meanwhile, in diamond rich Sierra Leone, Hawa hopes that by having many children, one might grow up to help her out of poverty.

Four Born Every Second airs tonight 10:35pm on BBC One as part of the Why Poverty? series