The Truth About… Life And Death on BBC World Service

The start and end of life can present particular challenges for all of us, whether we're talking about conceiving, surviving those crucial first few days or grappling with the end of life and, even how to define when exactly the body dies. But different places find different solutions, so it's been fascinating to see how people deal with some very difficult situations.Claudia Hammond, Presenter
Date: 21.05.2014     Last updated: 21.05.2014 at 11.30
Category: World Service
From fertility and premature birth, to death and bereavement, Claudia Hammond reports from South Africa, India, UK, Bosnia, Cyprus, and Israel on the very latest scientific understanding of the fundamentals of living. In this special global six-part series, she explores pioneering work to find new solutions and innovations for problems that arise at the beginning and end of life, and hears the moving personal stories of those affected.

In a follow up to last year’s critically acclaimed series The Truth About… Mental Health, Claudia Hammond returns this June with a new six-part series examining some of the important global issues at the start and end of our lives.

Starting on Wednesday 25 June, Claudia, presenter of the BBC World Service’s Health Check programme, examines the cultural differences and ethical debates that influence our attitudes to life and death.

Claudia Hammond says: “The start and end of life can present particular challenges for all of us, whether we're talking about conceiving, surviving those crucial first few days or grappling with the end of life and, even how to define when exactly the body dies. But different places find different solutions, so it's been fascinating to see how people deal with some very difficult situations. These are issues facing World Service listeners around the world every day and I’m pleased to be returning with a second series of The Truth About… where I tackle life and death from a global perspective.”

Commissioning Editor, Steve Titherington, says: “Issues of life and death affect the whole world. This is a time when the understanding of the physiology of both the start and end of life is being understood as never before. We explore how that will impact globally on understanding of what it is to be alive and to die, and the impact that has on society and on each of us as an individual.”

Over the six weeks, The Truth About… Life and Death looks at a range of issues and themes:

Episode One: Fertility on a Shoestring

BBC World Service, Wednesday 25 June, 1930-2000 BST

In the first episode, Claudia looks at fertility, which for many is a hidden problem that occurs before life has even begun. Claudia meets Nosiphiwo, who was ostracised by her husband’s family in South Africa after years of trying, in vain, for a baby. Stories like Nosiphiwo’s, of social stigma and even physical abuse and destitution, are common in low-income countries, where most of the millions of infertile women in the world reside. While programmes tackle the causes of infertility, such as preventing and treating sexually transmitted infections, calls to provide affordable fertility services have been overlooked by agencies which tend to focus on the problem of over population.

Claudia visits Tygerberg Hospital in Cape Town where fertility treatment is being offered at a fraction of the cost of private clinics. She meets the programme director, Dr Matsaseng, who is pioneering differing ways to keep costs down. These include using cheaper medications in smaller amounts, to taking on the jobs of several staff himself, texting and supporting patients through each stage of their cycle to coordinate their treatments. The next step is to find a way to take low-cost fertility treatment to rural areas. Fertility treatment needs a laboratory and the Belgium based ‘Walking Egg Project’, a shoe-box sized portable laboratory for performing IVF, could provide the answer. By the start of 2014, sixteen babies had been born in Belgium using this system, and the team in South Africa now hope to trial it at the hospital.

Episode Two: Prematurity

BBC World Service, Wednesday 2 July, 1930-2000 BST

The second episode focuses on premature birth. Every year there are an estimated 15 million babies born prematurely and their chances of survival depends very much on the world that they are brought in to. Reporting from India, BBC Urdu Correspondent, Suhail Haleem visits the Goa Medical college. In the past three years they have managed to increase the survival rates in babes born too soon, dramatically reducing child mortality at the hospital. Suhail meets the mothers, doctors and nurses of the intensive care unit to discover how by focusing on high levels of hygiene, they have been successful.

Meanwhile Claudia Hammond explores some of the ethical issues of keeping very small babies alive, including the increased risk of some disabilities. Professor Neil Marlow from University College London, has followed a group of premature babies for nearly twenty years and has chartered the long term consequences of being born too soon.

Episode Three: Babies’ Minds

BBC World Service, Wednesday 9 July, 1930-2000 BST

The third episode focuses on the development of a baby’s brain. Each day, around the world, several hundred thousand new babies are born, into what’s been described as “one great blooming, buzzing confusion” (William James, 1890, Principles of Psychology). Claudia explores some of the incredible new discoveries about what influences the developing mind of these tiny new-borns, during their all-important first year of life. It used to be thought that before children had language, they couldn’t think or have ideas. We now know that from birth, they’re active learners. Babies can, it seems, not just smile and giggle but they really do get the joke, and Claudia watches scientists try to make them laugh in the lab. Claudia also hears about new research which shows how babies will actively pick the toy that’s just right for them and their stage of development. However, the tiny baby brain is vulnerable, and Claudia hears about important work in the Gambia that’s exploring how nutrition affects the way that babies think.

Episode Four: What’s Killing Us?

BBC World Service, Wednesday 16 July, 1930-2000 BST

The fourth episode focuses on the causes of mortality around the world. The truth here is that when it comes to global figures it’s not known what people die of because more than half of the deaths in the world aren’t registered. Yet all public health programmes rely on mortality data to decide where to put resources, so this lack of data can distort funding. Even when data is collected, the cause of death can be incorrect and cultural factors can affect the way the forms are filled in. This isn’t a new problem as Claudia discovers when she meets the Royal Society’s Head of Library and Archive, Keith Moore, she hears that in the sixteenth century causes of death included grief, fright and even wind.

BBC Urdu Correspondent, Suhail Haleem reports from India on the attempts there to create a comprehensive register for the first time. The Million Deaths Study, which began in 1998, is monitoring nearly 14 million people in 2.4 million nationally representative households in India. Any deaths that occur in these households during this period will be assigned a probable cause. Researchers carry out a “verbal autopsy”. This is where researchers visit families who have lost a loved one and ask them about the symptoms to try to ascertain what they really died from. The study has generated some interesting and controversial results that have important implications for healthcare in India.

Episode Five: When are we dead?

BBC World Service, Wednesday 23 July, 1930-2000 BST

The penultimate episode focuses on the ethical and philosophical issues surrounding the end of life. Huge advances in technology now mean it’s possible to keep people alive longer, blurring the boundary between life and death. This intensifies the dilemmas for doctors, patients and their families. Different countries and religions have reacted in a variety of ways, from preserving life at all costs to euthanasia.

Claudia visits Jerusalem in Israel to ask how the religions there, shaped over many centuries, have adapted to modern medicine when it comes to the end of life. She discovers how Arial Sharon’s final years, spent on a ventilator to keep him alive, illustrate the pivotal role of religion. Jewish Law forbids any act which could hasten a person’s death. So, unlike many countries around the world, Israeli Law prohibits the withdrawal of life support, such as a ventilator, from patients who are dying. But the law also prevents ventilators being withdrawn from patients who are not dying, who have been saved by modern medicine yet depend on a ventilator to breathe. With unique access, Claudia visits Herzog hospital on the outskirts of Jerusalem, where patients lie in beds, kept alive on ventilators. Many are unconscious but some are aware of their surroundings. She hears from the families of patients, some of whom have been there for many years.

It is only lawful to turn a ventilator off in Israel when a patient is confirmed dead. Yet fierce religious debate continues around how death is actually defined. While ‘brain stem death’ criteria are usually used, even in Israel, there are sections of the ultra-orthodox Jewish community who argue that the final heart beat is the critical moment, with huge implications for end of life care.

Episode Six: Bereavement without a Body

BBC World Service, Wednesday 30 July, 1930-2000 BST

For a loved one to die is devastating. To lose those closest to us in war or conflict and not to know where they are or how they died, compounds the grief and hugely complicates the bereavement process. Families can’t mourn fully because they’re unable to lay their loved one to rest. In the concluding episode, Claudia reports from Bosnia where thousands of families have missing relatives and from Cyprus, where hundreds of Greek and Turkish Cypriot families still wait for news that the bodies of their missing have been found.

In Nicosia in Cyprus she meets Maria, still waiting for news of her mother, father, sister and brother, all killed and still missing since 1974. And she visits the grave of a father of three young children, who was taken from his job at a bank, murdered and dumped down a dry well in 1964, his body only returned to his family for burial after an agonising 45 year wait.

A huge complication for bereaved families waiting for news is when graves are moved not just once but sometimes twice and even three or four times, in an attempt by perpetrators to hide their crimes. In Bosnia Herzegovina, the former Grand Mufti, the Muslim leader, tells Claudia about the agonising choices made by grieving families about funerals and burial, when only partial remains of their loved ones are recovered.

Claudia hears from Greek and Turkish Cypriots about the new drive to find the graves of their missing. The clock is ticking in Cyprus and there are fears that unless there’s a dramatic escalation in the location of hidden graves, the lives of grieving relatives will be over, without them ever having known the truth. One woman crucial to the process is Sevgul Uludag, a one-woman humanitarian mission who's spent the past 12 years finding the missing. She carries two mobile phones, so members of the Greek and Turkish Cypriot communities can call her, in confidence, with news of where bodies might be buried.

SW