Ending Maternal Death in the African Diaspora by Kia Caldwell
Alyne’s Death and Transnational Solidarity
to End Maternal Death in the African Diaspora
In August 2011, the U.N. Committee for the Convention to Prevent All Forms of Discrimination against Women (CEDAW) found that the Brazilian State had violated the reproductive health rights of Alyne da Silva Pimentel Teixeira, a 28-year-old Afro-Brazilian woman who died a preventable maternal death. The Committee’s decision followed an eight-year legal battle by the U.S.-based Center for Reproductive Rights on behalf of Alyne’s mother and daughter, who were left without financial support after her death. Alyne died on November 11, 2002, due to complications and medical neglect following a stillbirth that was inadequately treated at a health center. She lived in the Baixada Fluminense, an area of the greater metropolitan region of Rio de Janeiro, that has high rates of poverty and a predominantly Afro-Brazilian population.
Multiple levels of medical neglect and poor quality of care contributed to Alyne’s death, including the fact that her still birth was misdiagnosed and the placenta was not removed when labor was induced. In addition she waited eight hours before being transported to a hospital in an ambulance, and her medical records were never transferred to the hospital where she was admitted. Upon Alyne’s arrival at the hospital, despite exhibiting clinical symptoms of a coma, she was forced to wait in the hospital waiting room for twenty-one hours prior to being treated. The circumstances leading to Alyne’s death highlight gross inadequacies and failures in the quality of maternity and emergency obstetric care provided to poor, African-descendant women in Brazil. Her tragic death also points to the lack of regard for black lives more general in Brazil, as exhibited by the high rates of policy homicides against Afro-Brazilian youth in major cities and death squad activity in the region where Alyne lived.
Brazil has the second-largest African-descendant population outside of Nigeria. In the 2010 census, over 50% of the Brazilian population self-identified as being of African descent, either preta (black) or pardo (brown). However, health issues that disproportionately affect Afro-Brazilians, such as maternal mortality, continue to receive little attention within the medical establishment. In the Southeastern, Southern, and Central-West regions of Brazil, which tend to be more economically developed, rates of maternal mortality have been found to be two to three times-and-a-half times higher for pretas than brancas (white women). In states within Brazil’s less economically developed and predominantly Afro-Brazilian Northeastern region, rates of maternal death have been found to be ten to twenty times higher for pretas than for brancas. Data released by the Brazilian Ministry of Health has also shown that pardas had the highest maternal mortality rates between 2000 and 2003 and accounted for 41.5% of maternal deaths in 2003. In addition, hypertensive illnesses, such as eclampsia and pre-eclampsia, were to found to be higher among pardas and pretas in 2003.
The 2011 decision by the CEDAW Committee was historic, since it was the first time a United Nations human rights committee decided on a maternal mortality case. The fact that this case focused on a poor, African-descendant woman was also important, since it recognized the way racial and economic inequalities shape women’s birth experiences and may also lead to maternal death. The CEDAW Committee called for the Brazilian government to provide financial compensation to Alyne’s mother and daughter and to improve Brazilian women’s access to safe and high-quality maternal health services. Due to community pressure, particularly by black women activists and other feminist health activists, Alyne’s mother was awarded a settlement of R$ 131,000 (approximately US $70,000) by the Brazilian government on March 17, 2014, over two years after the CEDAW Committee’s decision. In addition, a civil case is still pending in the Brazilian courts. Several symbolic forms of reparation have also taken place, including renaming the intensive care unit and community space of a maternity facility and hospital in the region where Alyne lived after her in April 2014.
Although a small measure of justice has been achieved regarding Alyne da Silva Pimentel’s death, much work remains to be done to ensure that similar deaths cease to take place on an everyday basis in Brazil. I first learned of Alyne’s death a few years ago and, as a black woman and a researcher who is committed to challenging health inequities, I have been attempting to call attention to the unjust treatment she received, as well as the larger issues that make Afro-Brazilian women vulnerable to maternal death.
Alyne’s avoidable death exemplifies the struggles for dignity, wellbeing, and survival that women face in African diaspora communities globally. Through the work of Black women’s organizations and networks in Brazil, such as ACMUN (Black Women’s Cultural Association), Maria Mulher, Criola and the Articulation of Black Brazilian Women, as well as other feminist allies, efforts to achieve reproductive justice for Afro-Brazilian women have moved forward. But there is still a very long way to go. By reaching across national borders and supporting each other’s struggles, Black women in the diaspora will be able to ensure that our sisters, friends, and daughters are able to have health pregnancy and birthing experiences. As we celebrate International Women’s Month, let us commit to being part of the larger struggle to ensure the health and survival of Black women, children, and communities.
For more info, or to support reproductive justice for African descended women in Brazil:
Center for Reproductive Rights - http://www.reproductiverights.org
ACMUN (Black Women’s Cultural Association) - http://acmun.org.br
Criola - http://criola.org.br/criola/
Geledés - http://www.geledes.org.br
Maria Mulher - http://www.mariamulher.org.br
Rede Feminista de Saúde - http://redesaude.org.br/comunica/
Kia Lilly Caldwell is an anthropologist and an associate professor of African, African-American, and Diaspora Studies at the University of North Carolina at Chapel Hill. She has conducted research on gender, race, black feminism, and health in Brazil for the past twenty years. Her research also focuses on HIV/AIDS in U.S. African-American communities and human rights in the African diaspora. Her book, Negras in Brazil: Re-envisioning Black Women, Citizenship, and the Politics of Identity, was published by Rutgers University Press in 2007. She is currently completing a book titled, Gender, Race, and Health Equity in Brazil: Intersectional Perspectives on Policy and Practice.