0:00:10 > 0:00:14WOMAN MOANS
0:00:18 > 0:00:23Every second of every day, somewhere in the world a woman is
0:00:23 > 0:00:26giving birth, and every year
0:00:26 > 0:00:30130 million babies are born.
0:00:34 > 0:00:38Imagine living without access to water or electricity,
0:00:38 > 0:00:42going to bed hungry every night, never going to school.
0:00:42 > 0:00:48Hundreds of millions of people live like that. It's called poverty.
0:00:48 > 0:00:53Poverty blights people's lives and it can do so right from the outset.
0:00:54 > 0:00:58Poor countries have high infant mortality rates.
0:00:58 > 0:01:02The infant mortality rate is the number of children in every 1,000
0:01:02 > 0:01:04who die before their first birthday.
0:01:04 > 0:01:06In Britain,
0:01:06 > 0:01:09fewer than five babies in every 1,000
0:01:09 > 0:01:11die before their first birthday.
0:01:11 > 0:01:15But in poor countries the figure is much higher.
0:01:15 > 0:01:18Of the 20 worst countries to be born,
0:01:18 > 0:01:2119 of them are in Africa.
0:01:21 > 0:01:25A child in Africa is much more likely to die as an infant
0:01:25 > 0:01:29than a child in Europe, more likely to suffer from malnutrition,
0:01:29 > 0:01:34less likely to go to school, more likely to be a child worker,
0:01:34 > 0:01:36less likely to have access to clean water,
0:01:36 > 0:01:40much more likely to be a loser in the birthright lottery.
0:01:49 > 0:01:52Where there is high infant mortality, we also find high
0:01:52 > 0:01:55rates of maternal mortality, in other words,
0:01:55 > 0:01:59more women die in childbirth in poor countries than in rich ones.
0:02:06 > 0:02:09In an ideal world, every woman would give birth safely
0:02:09 > 0:02:11and be attended by trained medical staff.
0:02:14 > 0:02:17THEY CONFER
0:02:26 > 0:02:30But every day 1,000 women die either pregnant or in childbirth.
0:02:36 > 0:02:41And every year four million babies die before they are 28 days old.
0:02:41 > 0:02:4799% of these infant deaths are in developing countries,
0:02:47 > 0:02:49especially in Africa and Asia.
0:02:49 > 0:02:53And it's the same story with maternal deaths, most of them
0:02:53 > 0:02:55happen in Africa and Asia as well.
0:03:02 > 0:03:04I have now been working 25 years in Africa.
0:03:04 > 0:03:07I have seen this immense suffering of women.
0:03:07 > 0:03:09And nobody seems to be doing much about it,
0:03:09 > 0:03:12it's very difficult to do, because you need trained obstetricians
0:03:12 > 0:03:16to do this kind of work, it's very strenuous,
0:03:16 > 0:03:19it costs a lot of money and you need some dedication.
0:03:26 > 0:03:29We also find poverty in unexpected places.
0:03:29 > 0:03:32The United States might be the richest country in the world,
0:03:32 > 0:03:35but it has plenty of people living in poverty and one
0:03:35 > 0:03:39of the worse infant mortality rates in the developed world.
0:03:39 > 0:03:41You can be poor wherever you live.
0:03:46 > 0:03:49There is no good reason for poverty to exist.
0:03:49 > 0:03:50There is enough money in the world
0:03:50 > 0:03:54and enough resources for everyone to have enough.
0:03:54 > 0:03:58But poverty goes hand-in-hand with inequality, and all over the world
0:03:58 > 0:04:02the gap between rich and poor is getting wider.
0:04:02 > 0:04:05I'm not so sure that most Americans are aware of the extent
0:04:05 > 0:04:07of poverty in America.
0:04:07 > 0:04:12I think that we tend to put our blinders on and I think that
0:04:12 > 0:04:18what we also do is assume that people are in the situation they
0:04:18 > 0:04:21are in because they want to be,
0:04:21 > 0:04:25when poverty is an accident of birth.
0:04:25 > 0:04:29A child does not get to choose which family he or she is born into.
0:04:29 > 0:04:34When you're born into a family that is poor,
0:04:34 > 0:04:39the opportunities that you have are far fewer than those
0:04:39 > 0:04:42who are born into a family that has means.
0:04:44 > 0:04:47One billion people live on less than a dollar a day.
0:04:47 > 0:04:51Does the world need some people to be so poor,
0:04:51 > 0:04:52so that others can be rich?
0:04:55 > 0:04:59Every year, 130 million children are born.
0:04:59 > 0:05:02That's 130 million new stories.
0:05:02 > 0:05:04Welcome to the world.
0:05:22 > 0:05:28Cambodia, in southeast Asia, has a population of 16 million,
0:05:28 > 0:05:30one third of whom live below the poverty level.
0:05:34 > 0:05:37Almost half of the children in Cambodia are malnourished.
0:05:37 > 0:05:41And although living conditions have improved enormously in this country
0:05:41 > 0:05:45in the last 30 years, it still has a great deal of poverty.
0:05:49 > 0:05:51This is Pisey.
0:05:51 > 0:05:53He's 12 years old,
0:05:53 > 0:05:56although he looks smaller because he's malnourished.
0:05:56 > 0:05:59In other words, he doesn't get enough to eat.
0:09:54 > 0:09:57Although Neang doesn't get state benefits to live on,
0:09:57 > 0:10:00she is entitled to free health care in the public hospital
0:10:00 > 0:10:02where she has come to give birth.
0:10:05 > 0:10:09While his mum is in hospital, Pisey has to travel across the city
0:10:09 > 0:10:13and collect the antiretroviral drugs she needs for her HIV.
0:10:20 > 0:10:24MONITOR BLEEPS
0:11:20 > 0:11:23This is Pisey's new sister, Ly Ly.
0:11:32 > 0:11:36With the birth of baby Ly Ly, there is another mouth for Pisey to feed,
0:11:36 > 0:11:39so his chances of going to school are becoming more remote.
0:11:42 > 0:11:46If he's not working, the family has no income at all.
0:12:25 > 0:12:28Ly Ly faces an uncertain future,
0:12:28 > 0:12:31like all children brought up in a slum.
0:12:31 > 0:12:34She's more likely to become malnourished than go to high school.
0:12:34 > 0:12:38Most people in Cambodia have no access to sanitation,
0:12:38 > 0:12:41which means they are more likely to become ill.
0:13:06 > 0:13:11Ly Ly died just two months after coming home.
0:13:11 > 0:13:13We don't know what she died of.
0:13:13 > 0:13:19Neang now works on a construction site and earns three dollars a day.
0:13:21 > 0:13:25With his mother now earning money, Pisey can go to school.
0:13:25 > 0:13:29Perhaps education is the best way for people in poverty
0:13:29 > 0:13:32to improve their lives.
0:13:49 > 0:13:53The United States is the richest country in the world,
0:13:53 > 0:13:57but it also has high levels of inequality and poverty.
0:13:57 > 0:13:59Starr and her family
0:13:59 > 0:14:01are homeless in San Francisco.
0:14:01 > 0:14:05She and her partner, Fernando, lost their jobs in the recession.
0:14:10 > 0:14:14'It's the kind of thing that can happen, I guess, to anybody.
0:14:14 > 0:14:17'You know? Didn't expect it, wouldn't have expected it a year ago,
0:14:17 > 0:14:19'never would have dreamed this was going to happen.'
0:14:26 > 0:14:29We were living in a nice house, we had everything we needed, we
0:14:29 > 0:14:34weren't hurting, our cupboards were full, and so, kind of, here we are.
0:14:34 > 0:14:35Just lost everything.
0:14:38 > 0:14:41The economy has just completely collapsed.
0:14:41 > 0:14:45I couldn't pay my rent, so I bought a motor home for my family,
0:14:45 > 0:14:47with the last little bit of money we had.
0:14:47 > 0:14:50I thought that was the right thing to do.
0:14:50 > 0:14:55Apparently, it's illegal, you know, to live in the RV, so...
0:14:55 > 0:14:58- FERNANDO:- Gaian, stop! You're hurting your brother.
0:14:58 > 0:15:01Don't have a breakdown. Let's chill.
0:15:01 > 0:15:05It's nobody's fault. I don't even think it's my fault.
0:15:05 > 0:15:06This is life.
0:15:08 > 0:15:11I've never lived at the top end of, you know, the class scale,
0:15:11 > 0:15:15or anything like that. I come from poor white trash, you know,
0:15:15 > 0:15:21so I, hell... even with our situation today,
0:15:21 > 0:15:23I'm probably living better than half of my family.
0:15:26 > 0:15:28I'm not trying to get pity from anybody.
0:15:28 > 0:15:31I am trying to get a little bit of a hand up.
0:15:31 > 0:15:33Not a hand-out.
0:15:33 > 0:15:37I just want a little bit of support while I pull myself together.
0:15:39 > 0:15:40In San Francisco,
0:15:40 > 0:15:44there is a charity that works with pregnant homeless women.
0:15:46 > 0:15:51PEOPLE CHATTER
0:15:58 > 0:16:00HPP, or the Homeless Prenatal Program,
0:16:00 > 0:16:03is a family research centre.
0:16:03 > 0:16:07It initially was a program that focused only on women who
0:16:07 > 0:16:11were homeless and pregnant,
0:16:11 > 0:16:14taking advantage of that period of pregnancy to help a woman
0:16:14 > 0:16:19change her life, or do things that would be healthier.
0:16:19 > 0:16:22You like that one? You pick whatever you want.
0:16:22 > 0:16:25- I prefer these. - OK, whatever you like.
0:16:25 > 0:16:29Congratulations. You're having a boy?
0:16:29 > 0:16:32I've been doing this for 22 years now.
0:16:32 > 0:16:36I found the Third World right here in America.
0:16:36 > 0:16:39I couldn't believe that women were homeless and pregnant,
0:16:39 > 0:16:44and bringing children into the world without a home for them to go to.
0:16:45 > 0:16:50In the first year, we worked with 72 women who were homeless
0:16:50 > 0:16:54and pregnant living in the shelter, and 22 years later,
0:16:54 > 0:16:59this last year, we delivered 517 babies to women who were...
0:16:59 > 0:17:04not everybody is homeless, but everybody is at risk for homelessness.
0:17:04 > 0:17:07The common denominator is poverty.
0:17:11 > 0:17:13Well, this is the Hamilton family residence.
0:17:13 > 0:17:18And I guess this is a room for a family of four, slash five,
0:17:18 > 0:17:24if it's a baby, so we get the single bunks, which, you know,
0:17:24 > 0:17:27so there is four beds, and one dresser
0:17:27 > 0:17:30and that's the extent of the furniture.
0:17:30 > 0:17:34I'm grateful for it, even if it is a little reminiscent of a jail cell!
0:17:34 > 0:17:36You know?
0:17:38 > 0:17:421.6 million children are homeless in the USA
0:17:42 > 0:17:45and poverty and inequality are growing problems
0:17:45 > 0:17:48right across America.
0:17:48 > 0:17:50It's not the extreme kind of poverty
0:17:50 > 0:17:52faced by people in Sub-Saharan Africa,
0:17:52 > 0:17:56but it does mean they have fewer chances in life.
0:17:58 > 0:18:03Starr is having her baby in San Francisco General Hospital.
0:18:03 > 0:18:06The staff here are dedicated to providing care
0:18:06 > 0:18:08to people with low incomes.
0:18:08 > 0:18:11Starr and her family are on welfare,
0:18:11 > 0:18:15which means they get 480 a month to live on -
0:18:15 > 0:18:17that's about £300,
0:18:17 > 0:18:20plus a similar amount in food stamps.
0:18:20 > 0:18:24STARR MOANS
0:18:24 > 0:18:28So, I'm just frustrated and emotional...
0:18:28 > 0:18:30and upset.
0:18:30 > 0:18:34I'm not looking forward to the rest of this birth at this point...
0:18:49 > 0:18:52STARR MOANS
0:19:00 > 0:19:02- MEDICAL STAFF:- Good, good push...
0:19:05 > 0:19:08- NURSE:- Strong, steady, steady push...
0:19:08 > 0:19:13Strong, good, steady, big push...
0:19:13 > 0:19:14all the way back.
0:19:14 > 0:19:17Beautiful. Beautiful, Starr.
0:19:17 > 0:19:19- My baby! NURSE:- Take your baby.
0:19:25 > 0:19:27MEDICAL STAFF CONFER
0:19:29 > 0:19:32BABY CRIES
0:19:32 > 0:19:34- NURSE:- Happy birthday!
0:19:34 > 0:19:36Congratulations, Dad.
0:19:36 > 0:19:38BABY CRIES
0:19:38 > 0:19:43STARR: Yeah, I know! Go ahead and get mad!
0:19:43 > 0:19:45- NURSE:- Oh, my goodness.
0:19:46 > 0:19:48STARR: She's so tiny.
0:19:51 > 0:19:53- You got the baby? - I have the baby.
0:19:53 > 0:19:56- We get to go home, are we ready? - All righty!
0:20:00 > 0:20:01- STAFF:- Bye. Have a good one!
0:20:01 > 0:20:03Have a very happy Monday.
0:20:03 > 0:20:07- You, too. Good luck with your beautiful baby.- Thank you.
0:20:11 > 0:20:14Baby Luma has an uncertain future.
0:20:14 > 0:20:19Not only has she been born homeless and below the poverty line,
0:20:19 > 0:20:25she's also been born into one of the most unequal societies in the world.
0:20:25 > 0:20:27Many people would argue
0:20:27 > 0:20:29that ending inequality
0:20:29 > 0:20:32is the best way to end poverty.
0:20:32 > 0:20:35'We're not out of options in life.'
0:20:35 > 0:20:38It gets really frustrating some days,
0:20:38 > 0:20:41and some days, you know, it's hard to deal with.
0:20:41 > 0:20:45But, you know, we're not out of options, we got, you know...
0:20:47 > 0:20:49..some things going on. We'll figure it out.
0:20:56 > 0:20:58Sierra Leone, in west Africa,
0:20:58 > 0:21:02is a country rich in natural resources.
0:21:02 > 0:21:05It is one of the biggest producers of diamonds in the world
0:21:05 > 0:21:09and it has large deposits of iron ore and other minerals.
0:21:09 > 0:21:14The tropical climate makes it fertile and abundant with crops.
0:21:14 > 0:21:17It has some of the best beaches in the whole of Africa.
0:21:17 > 0:21:19Sounds perfect...
0:21:19 > 0:21:23yet the people of Sierra Leone are some of the poorest in the world.
0:21:24 > 0:21:28In small villages like Bengie, they have no running water,
0:21:28 > 0:21:32no electricity and not much in the way of food or access to
0:21:32 > 0:21:35health services and education.
0:21:35 > 0:21:39This is Hawa. She's pregnant and expecting her fifth child.
0:22:21 > 0:22:26A lack of birth control is a big problem for many African countries.
0:22:26 > 0:22:28In Sierra Leone,
0:22:28 > 0:22:31only 17% of women use contraception.
0:22:31 > 0:22:35This compares to 88% of women in Norway.
0:23:56 > 0:24:00Isatu is heavily pregnant and in need of urgent medical attention.
0:24:02 > 0:24:03Where there is poverty,
0:24:03 > 0:24:07you will find high infant and maternal mortality.
0:24:07 > 0:24:10Sierra Leone is one of the worst countries in the world to be born,
0:24:10 > 0:24:13in terms of infant mortality.
0:24:13 > 0:24:15One in every seven children born here
0:24:15 > 0:24:18will die before their first birthday.
0:24:26 > 0:24:29The women in this region are fortunate to have this hospital.
0:24:29 > 0:24:33It's funded and run by Medecins Sans Frontieres, a charity dedicated
0:24:33 > 0:24:39to providing medical care for some of the poorest people in the world.
0:24:39 > 0:24:43This hospital only deals with very critical cases.
0:24:44 > 0:24:49Now we have five of our own clinics and another 25 government clinics,
0:24:49 > 0:24:54our Ministry of Health clinics, which are referring patients to us.
0:24:54 > 0:24:57We only take, in this hospital, we only take patients who have
0:24:57 > 0:25:00complications, we do not do spontaneous deliveries.
0:25:00 > 0:25:02So we have a high Caesarean-section rate.
0:25:02 > 0:25:05So why do women here lose
0:25:05 > 0:25:09so many babies and why do so many children die young?
0:25:09 > 0:25:12Is it because African mothers and children
0:25:12 > 0:25:15are more unhealthy than, say, Europeans?
0:25:15 > 0:25:18I don't think that women have necessarily more difficult
0:25:18 > 0:25:21births than other places,
0:25:21 > 0:25:25I think the problem is their lack of access to medical care.
0:25:28 > 0:25:31There are very few gynaecologists in the country,
0:25:31 > 0:25:37there are very few other doctors that can provide obstetric care,
0:25:37 > 0:25:40there are very few midwives in the country.
0:25:40 > 0:25:43MEDICAL STAFF CONFER
0:25:47 > 0:25:50Most births in Sierra Leone are supervised in villages
0:25:50 > 0:25:55by traditional birth attendants, women with no medical training.
0:25:55 > 0:25:57They can deal with straightforward births,
0:25:57 > 0:26:00but don't know how to deal with emergencies.
0:26:00 > 0:26:04Hawa is being looked after by a traditional birth attendant.
0:26:39 > 0:26:41The government are trying to get
0:26:41 > 0:26:45women to go to clinics and have their babies in a safe environment.
0:27:04 > 0:27:09Hawa is very unusual in that all four of her children have survived.
0:27:11 > 0:27:15The usual experience for most women in Sierra Leone is very different.
0:27:20 > 0:27:22'If I get a mother in that's had six pregnancies
0:27:22 > 0:27:26'and has five live children, that's something that we comment on.
0:27:26 > 0:27:30'That's unusual that she would have all her children living.'
0:27:30 > 0:27:32Ahh!
0:27:32 > 0:27:37Most mothers lose at least one child in childbirth
0:27:37 > 0:27:40or before the age of five.
0:27:40 > 0:27:43It's rare to see a woman who has all her children living.
0:27:46 > 0:27:49We'll try something else. Give me a knife.
0:27:49 > 0:27:51I am sorry to do this, mother.
0:28:00 > 0:28:03Things are improving in Sierra Leone.
0:28:03 > 0:28:06The government recently made health care free for pregnant women
0:28:06 > 0:28:08and under-fives.
0:28:08 > 0:28:12Relatively small amounts of money mean that women can give birth
0:28:12 > 0:28:15safely and children can have better chances in life.
0:28:22 > 0:28:26THEY SING
0:28:42 > 0:28:45Hawa wants an even larger family,
0:28:45 > 0:28:48but her reason for that is a desperate one.
0:29:06 > 0:29:09Subtitles by Red Bee Media Ltd