Ten years ago, I started my journey at a rural hospital in southern Cambodia. It quickly became clear that maternal health is about far more than numbers; it’s about real women facing real struggles during pregnancy and childbirth.
Even today, many women deal with severe complications like severe bleeding and high blood pressure during delivery. In low-resource areas, these issues can quickly escalate. Women often travel long distances to reach hospitals, sometimes showing up in critical condition due to delays in transport or lack of early medical care. It’s a problem that extends beyond Cambodia.
I still remember a life-changing case from my early days. A young woman, seven months pregnant, came in after a motorcycle crash. Blood was everywhere. She looked terrified and faint. Her baby’s heartbeat was faint, but she was losing blood fast.
We had limited resources—a volunteer doctor, a local anesthesiologist, and myself. No 24/7 surgical team meant we had to act quickly. We performed an emergency cesarean section and discovered severe complications. Thankfully, we chose to save her uterus, and with the right care, both mother and baby survived.
That experience taught me that saving lives goes beyond following protocols. It requires quick thinking, teamwork, and courage in critical moments.
Globally, obstetric hemorrhage continues to be a leading cause of maternal death, with around one-third of such deaths in Cambodia. Despite improvements in recent years, the maternal death rate in Cambodia still hovers around 154 deaths per 100,000 live births—far above the Sustainable Development Goal target of 70 by 2030.
The reality is stark: rural hospitals often lack blood supplies and the trained staff needed to handle emergencies. In wealthier countries, full medical teams and ample resources can make a difference. But in Cambodia, it often falls to just a few medical professionals to save lives under dire circumstances.
Disparities in healthcare persist, even with national reforms aimed at improving maternal health. Rural hospitals still struggle with shortages in basic medical supplies and skilled personnel. Many facilities lack clear protocols for emergencies, and geographical barriers make getting timely care difficult. In many cases, hospitals only learn about approaching emergencies when patients arrive.
My team realized the importance of restructuring care in 2015. We gathered hospital staff to discuss challenges openly and developed standard operating procedures (SOPs) and emergency protocols. These were translated into Khmer and adapted for our specific context. Slowly, this led to better organization and confidence among the staff.
Equally important is mentorship. Training through hands-on practice not only builds skills but also boosts staff morale. Experienced volunteers taught specific techniques, filling gaps in training until local staff could take over.
By keeping detailed logs of each delivery and complication, we tracked our progress. Within a year, severe postpartum hemorrhage cases dropped significantly without any external funding, thanks to our organized system.
Building trust with patients is crucial. Many women hesitate to seek care due to costs or previous negative experiences. Education helped improve their understanding of the importance of timely medical intervention. Simple actions, like explaining procedures and allowing family members to stay nearby, also contribute to trust. When women feel secure, they are more likely to seek help sooner, potentially saving lives.
Our experiences illustrate that improving maternal health isn’t solely about big funding. Effective leadership, mentorship, and adaptable systems can make significant changes. This structured approach has not only benefited our rural hospital but can be applied in other low-resource settings throughout Cambodia.
Maternal health is fundamentally about justice. Every mother’s life matters. Change happens through connection, understanding, and compassion, one birth at a time. By focusing on clear protocols and mentorship, even the most fragile healthcare systems can improve. Small, practical interventions can have a profound impact, demonstrating that change is possible, even under challenging circumstances.
For more insights on maternal health and ongoing efforts to improve care in low-resource settings, check out the WHO’s maternal mortality fact sheet.
