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Last Updated: Friday, 21 April 2006, 09:35 GMT 10:35 UK
Bounlid's baby
The World Health Organization is following six women around the world to compare their experiences of pregnancy and motherhood. Here, Bounlid from Laos describes life with her baby Lang, who is one-year-old.

Damiana Mamani:
Bolivia

Samah Mohamed :
Egypt


Hiwot Abraham:
Ethiopia
Renu Sharma:
India

Bounlid:
Laos

Claire Roche:
UK

Bounlid is 27. She lives in the Vientiane province in Laos with her husband and children. Her daughter Lang is her fifth child.

"She is very healthy. She has the usual coughs and colds we all get in winter though. It gets cold here, especially at night. I wish we had more bedclothes for the children.

"There are not many toys in our house, but her sisters and brother manage to make exciting things for Lang from fruits and leaves."

WHO/Jim Holmes
'This year has been wonderful'

Boulid told the WHO: "I still breastfeed Lang whenever she likes. She also eats rice and vegetables.

"Unfortunately our well is empty at the moment because it is the dry season, so we have to walk one mile to our local well for water.

"We bought Lang some new shoes for her first birthday. She is tottering about now and loves her new-found freedom.

"She never stops moving."

She added: "We are not sure if we will have any more children. I am taking pills to stop me getting pregnant."

Bounlid added: "It's been two years since anyone came to vaccinate children in our village.

"Lang has not had any vaccinations, although we probably would agree if a vaccination team were to visit."


Nine months old

Lang is ill. She has a sore throat at the moment which her mother says is making her cry a lot.

Bounlid with her baby
'We have another mouth to feed'

"I think she's lost a bit of weight. She probably weighs around 8kg, although we have never weighed her properly.

Bounlid said her daughter was now crawling, and can walk - with a little assistance.

She said: "Lang loves her new-found independence. She has started to make noises, but nothing we can understand yet."

Bounlid said she felt fairly well, but has a nagging cough which seems to be exacerbated by the fire in her house.

Nets

She is the breadwinner for the family as her husband cannot work due to a trapped nerve, which is causing him to have trouble walking. He now stays at home to look after the children.

He also regularly suffers from bouts of malaria, which prevent him from working for days at a time.

Bounlid said they all sleep under mosquito nets. But she added: "We haven't had the nets dipped in insecticide for a long time, plus they are riddled with holes - so I don't know how effective they are."

In Laos, 82% of under-fives sleep under nets, but just 15% are treated with insecticide.

The family are able to get their water from a well.

"We boil the water before drinking it or using it to prepare food.

"In the dry season we get our water from a tap about 1km from our house."


At six months

Bounlid is back at work, as well as caring for Lang.

"Lang and I are in good health. She now weighs 6.5kg and seems to get heavier every day!

"I am still breastfeeding Lang whenever she wants to be fed. I have no idea how many times a day I feed her - why would I count?"

She added: "Just one week ago, Lang started eating a little rice as well. I think she's copying her brothers and sisters.

"I haven't taken Lang to the local clinic - we can't afford it.

"There are supposed to be twice-yearly visits to our village by a mobile health clinic, but nobody has come to the village recently.

"I hope they come soon because I would like Lang to be immunised like her brothers and sisters."

Bounlid
'I don't expect any rest'
Bounlid added: "I am now back at work cutting bamboo and making fences.

"Soon our village will be connected to the electricity network and we'll be able to work in the evening as well as during the day.

"We've worked out that this could increase our earnings by half again to US$4.5 a day.

"Lang's brothers and sisters take care of her while I work. That are really good with her.

"If I'm out in the forest, I sometimes don't return home for hours at a time."

In Laos, 40% of children under five years of age are underweight.


Six weeks old

"Both Lang and I are in good health, although I am finding it hard to get my energy back. I'm breastfeeding throughout the day and night and Lang is growing fast.

"I have to start working again and the heat is intense.

"In a few days time I will have to go back to the forest to chop bamboo.

"I'll have to take Lang with me because there is nobody at home to look after her."

Bounlid added: "Our water supply has dried up in the heat. My eldest daughter, Sivilay, who is seven years old, has to collect water from our neighbour's well which is half a kilometre away.

"Unfortunately this means she has to miss some school, but I'm simply too tired to do this myself."

She said: "No health worker has been to visit us. The local health clinic - which is just a few hundred metres away - is always empty, so even if Lang were ill, we probably wouldn't go there".

Bounlid worries about Lang's health, particularly as her second daughter died when she was just six weeks old.

In Laos, one in 11 children die before the age of five, the majority from preventable and treatable conditions such as malaria, pneumonia and measles.


Seven days old

A week after her daughter was born, Bounlid said: "I spent several days trying to think of a name for her and decided on Lang - which means 'foreigner' in our language.

"In my village we never have outsiders visiting, but because of the World Health Organization project there has been a lot of foreign interest in our lives. So I thought this name was appropriate."

She added: "In our culture, a woman who has just given birth spends a number of days by the smoking embers of a fire.

"For the first born child, a mother will spend a month by the fire, but luckily Lang is my fifth child, so I won't have to do this for much longer.

"I really need to get back to basket making. No one in our family is earning money right now."

Copyright - WHO/Antonio Suarez Weise
The family's bed-nets are 'full of holes'

Bounlid added: "My husband doesn't seem very interested in his new daughter. He reminds me that we have many girls already and that he would have preferred a boy."

She said the family had not visited a clinic, but health workers had visited the village to give routine vaccinations to village children. Bounlid was also given some vitamin A.

She added: "I would like to stop having children. We have a big enough family now, but I don't know how to do this and no one has given me any advice."

The WHO says that 26 out of every 1,000 babies die in their first week of life from preventable diseases.


Childbirth

Bounlid said: "My labour lasted around 36 hours. It was incredibly painful and I'm exhausted.

"I gave birth at home, with no medical assistance. I am so relieved my husband Nga was with me.

"Nga cut the umbilical cord with a splinter of bamboo - it has a razor-sharp edge and is naturally very clean. This is a traditional practice where we live."

Her husband washed the floor as soon as Bounlid had given birth, and the house was back to normal within 10 minutes.

Bounlid added: "All that's changed is that we have another mouth to feed."

"I feel worn out. I will have to return to work in the fields again soon.

"We have to start earning money again as I have a family to feed. We only had rice and bananas for dinner today."


Seven months pregnant

Bounlid was unsure about when her baby will be born, but had a feeling it was a girl.

She makes a living making bamboo baskets. They are sold for 1,000 Lao kip each (10 US cents).

She continued to work during her pregnancy.

When she was seven months pregnant, Bounlid said: "It's extremely heavy work - bending, stretching and carrying - and I can only manage a little at a time before I have to take a break."

Bounlid plans to give birth to the baby at home. Her family cannot afford to have a skilled attendant present.

Just 19.4% of births in Laos are assisted by a skilled attendant, such as a midwife, doctor or nurse.

And only 29% of pregnant women have at least one antenatal check up during their pregnancy.


Five months pregnant

Bounlid and her husband Nga have three healthy children, but sadly their second daughter died when she was just six weeks old.

"I've had no antenatal care and I don't expect to have any for the rest of my pregnancy."

Bounlid plans to give birth at home, as she has with her other four children.

She added: "It is too expensive for most people to give birth with a skilled assistant at the clinic which, in any case, has very basic facilities and no telephone or ambulance if there were complications."

Bounlid said she does worry about emergencies.

Lao People's Democratic Republic has one of the highest rates of maternal death in the world.


Where the women live


Photos courtesy of the World Health Organization.


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