December 10th Advocacy Campaign

Alyne da Silva Pimentel Teixeira, a Brazilian national of African descent, was born on September 29^th 1974.  She was married and had a five year old daughter.  Alyne arrived six months pregnant and complaining of severe nausea at a health center in the state of Rio de Janeiro, Brazil, on November 11th 2002.

She was seen by the attending obstetrician-gynaecologist who prescribed anti-nausea medication , vitamin B12, and local medication for a vaginal infection.  Alyne began her prescriptions immediately. 

The doctor assured Alyne that all was well.  As what was described as merely a precaution, the doctor also scheduled routine blood and urine tests for Alyne on 13th November, two days later.  The doctor chose to then send Alyne home rather than admitting her. Between 11th November and 13th November, Alyne’s condition worsened considerably.

On 13th November Alyne went with her mother to the health centre.  Another doctor examined Alyne and decided to admit her to the maternity ward.  A physical examination and ultrasound could not find a foetal heartbeat. Alyne was informed that she would need to be given medication to induce delivery which began that afternoon.

Nearly 14 hours later, Alyne underwent surgery for removal of placenta and afterbirth.  Following the surgery, Alyne began severe haemorrhaging.  Her condition worsened and she remained at the health centre. Her mother and husband did not visit the health centre that day as they had been assured that Alyne was well. 

Her symptoms continued to worsen yet treatment given was minimal.  Attempts were finally made to transfer Alyne to an intensive care unit beginning sometime in the early afternoon of the 15th.  Only one hospital would take her, but they would not use their ambulance to transfer her.  It took at least eight hours to locate an ambulance and an intensive care unit which could take her. 

Upon arrival, Alyne had to be resuscitated.  She was placed in a makeshift area in the emergency room hallway, as there were no available beds for her. The medical attendants failed to bring Alyne’s medical records to the hospital.  They provided the treating physician at the hospital a brief verbal recount of her symptoms and sent her mother back to the health centre to retrieve the medical records. This took several hours. 

Alyne da Silva Teixeira died at 7:00pm on 16th November 2002, on a makeshift bed in a hallway.  The medical records do not indicate what (if anything) was done for Alyne during the 22 hours that she was in the hallway at the hospital.

But Alyne’s story does not end there.

Her story was heard, and eventually made its way to an international organisation with the resources to seek justice for Alyne and the thousands of women like her at risk.  Her story made its way to one of the human rights bodies at the UN empowered to hand down legally binding decisions. They were as outraged as we are now. 

The committee, after several years of litigation, found in favour of Alyne. Brazil had failed to meet its legal obligations to protect women in childbirth and to ensure appropriate, non-discriminatory health services. 

Although Brazil claimed that her death was not due to complications during pregnancy, that they were not responsible because the doctors were employed by a private institution, and that Alyne’s care was no worse because she was a black woman from a poor household, the Committee did not agree.  Alyne’s death was clearly clinically linked to complications in pregnancy, and the highly decentralised health care system in Brazil does not absolve the government of legal responsibilities.  Her care was indeed worse because she was a black woman from a poor background.  The Committee particularly noted the failings in recognising the emergency complications, the significant delay in performing surgery, the under-resourced health facilities, and the additional delay in transferring her to a tertiary care facility all constitute violations of the state’s obligations under the right to non-discriminatory health care services, particularly for pregnant women.  The Committee also found that Brazil turned a blind eye to systematic discrimination based on race, ethnicity, and socio-economic standing, which contributed to Alyne’s death. 

Brazil is now required to provide financial protection to Alyne’s mother and daughter, who at the time of submitting the claim were living in a precarious situation.  Brazil must ensure women’s right to safe motherhood and affordable access to adequate emergency obstetric care and, of particular interest, provide professional training for health workers in reproductive health care and emergency obstetric services. 

This decision is now legally binding and will apply to all governments who have signed and ratified the Convention on the Elimination of all Forms of Discrimination Against Women. 

Alyne’s story has, quite literally, changed the world.  But now she needs help.  She needs you to tell her story to the whole world, and to tell governments that they must take steps to protect women in childbirth.  She needs a global network of women to share her tale and to see it to its end – not the tragic end which happened on 16th November 2002, but the end where we live in a world that cherishes pregnancy and protects women in childbirth, where governments proactively invest in the training and resources needed to avert preventable deaths.  Your voice is needed to make this happen – and SI is launching this new initiative to help you accomplish just that.