Posts tagged maternal health

Photo by Lynsey Addario/VII
A woman waits to be transported to the MSF hospital to have her second c-section in Bo, Sierra Leone.
A doctor blogs from the same hospital about a different patient: “She had delivered this baby at home over 36 hours before. The baby was doing well but she had not delivered the placenta and had started hemorrhaging. She had to walk an hour and a half to the nearest clinic to get an ambulance to take her to the hospital. When she arrived she was only semi-conscious, covered in blood, and her hemoglobin was only 3.1.” Read blog- http://msf.me/19GFsSo

Photo by Lynsey Addario/VII

A woman waits to be transported to the MSF hospital to have her second c-section in Bo, Sierra Leone.

A doctor blogs from the same hospital about a different patient: “She had delivered this baby at home over 36 hours before. The baby was doing well but she had not delivered the placenta and had started hemorrhaging. She had to walk an hour and a half to the nearest clinic to get an ambulance to take her to the hospital. When she arrived she was only semi-conscious, covered in blood, and her hemoglobin was only 3.1.” Read blog- http://msf.me/19GFsSo

Photo by Anna Surinyach
An MSF midwife examines a patient. Most maternal deaths in South Sudan’s Western Equatoria State are due to postpartum hemorrhages; women living in isolated rural communities are often unable to reach a health center when complications arise.  Read more

Photo by Anna Surinyach

An MSF midwife examines a patient. Most maternal deaths in South Sudan’s Western Equatoria State are due to postpartum hemorrhages; women living in isolated rural communities are often unable to reach a health center when complications arise.  Read more

Iran: Helping Women Survive in One of Tehran’s Toughest Neighborhoods
Photo by Mohsen Sheikholesl
Doctors Without Borders has been providing medical assistance to drug addicts, prostitutes and street children in Tehran’s Darvazeh Ghar neighborhood. See more photos: http://bit.ly/130aNPH

Iran: Helping Women Survive in One of Tehran’s Toughest Neighborhoods

Photo by Mohsen Sheikholesl

Doctors Without Borders has been providing medical assistance to drug addicts, prostitutes and street children in Tehran’s Darvazeh Ghar neighborhood. See more photos: http://bit.ly/130aNPH

Safe Delivery: Reducing maternal mortality in Sierra Leone and BurundiEnsuring pregnant women have timely access to emergency obstetric care has reduced maternal deaths by as much as 74 percent in parts of two African countries 
The comprehensive emergency obstetric services at MSF hospitals in Bo and Kabezi is provided 24 hours a day, seven days a week. All services are free of charge. The total annual operating costs of the programs are equivalent to just under two dollars per person in Bo and $4.15 per person in Kabezi.
MSF’s data indicate that maternal mortality in Burundi’s Kabezi district has fallen to 208 per 100,000 live births, compared to a national average of 800 per 100,000 live births, a 74 percent decrease. In Sierra Leone, MSF figures for the same year indicate that maternal mortality in Bo district has decreased to 351 per 100,000 live births, compared to 890 per 100,000 in the rest of the country, a 61 percent reduction. MSF is the only emergency obstetric care provider in Kabezi and Bo.
Sierra Leone and Burundi both suffer from extremely high maternal mortality rates due to lack of access to quality antenatal and obstetric care, which are linked to shortages of qualified health staff, a lack of medical facilities, and health systems that have been shattered by years of civil war.
“Giving birth in Sierra Leone is often a life-threatening endeavor for many women,” said Betty Raney, an obstetrician with MSF in Sierra Leone. “In my 25 years as an obstetrician, I have never seen such a level of severity among the patients. Had they not had any access to care, many of them would die.”
Using the United Nations Millennium Development Goal (MDG) of reducing maternal mortality by 75 percent by 2015 as a point of reference, MSF’s estimates indicate that the maternal mortality ratio in Kabezi is already below the MDG level. MSF is confident that the mortality ratio will have dropped by 75 percent in Bo by 2015.

Safe Delivery: Reducing maternal mortality in Sierra Leone and Burundi
Ensuring pregnant women have timely access to emergency obstetric care has reduced maternal deaths by as much as 74 percent in parts of two African countries 

The comprehensive emergency obstetric services at MSF hospitals in Bo and Kabezi is provided 24 hours a day, seven days a week. All services are free of charge. The total annual operating costs of the programs are equivalent to just under two dollars per person in Bo and $4.15 per person in Kabezi.

MSF’s data indicate that maternal mortality in Burundi’s Kabezi district has fallen to 208 per 100,000 live births, compared to a national average of 800 per 100,000 live births, a 74 percent decrease. In Sierra Leone, MSF figures for the same year indicate that maternal mortality in Bo district has decreased to 351 per 100,000 live births, compared to 890 per 100,000 in the rest of the country, a 61 percent reduction. MSF is the only emergency obstetric care provider in Kabezi and Bo.

Sierra Leone and Burundi both suffer from extremely high maternal mortality rates due to lack of access to quality antenatal and obstetric care, which are linked to shortages of qualified health staff, a lack of medical facilities, and health systems that have been shattered by years of civil war.

“Giving birth in Sierra Leone is often a life-threatening endeavor for many women,” said Betty Raney, an obstetrician with MSF in Sierra Leone. “In my 25 years as an obstetrician, I have never seen such a level of severity among the patients. Had they not had any access to care, many of them would die.”

Using the United Nations Millennium Development Goal (MDG) of reducing maternal mortality by 75 percent by 2015 as a point of reference, MSF’s estimates indicate that the maternal mortality ratio in Kabezi is already below the MDG level. MSF is confident that the mortality ratio will have dropped by 75 percent in Bo by 2015.

Photo: Mateso Emilienne, 25, was picked up by MSF ambulance the previous day from Gatumba Health Center. Her baby was delivered via Caesarean section. Burundi 2012 © Sarah Elliott
Low-Cost Health Interventions Drastically Reducing Maternal Mortality in Sierra Leone and Burundi
Medical data gathered in 2011 from MSF projects in Bo, Sierra Leone, and Kabezi,Burundi indicate that the introduction of ambulance referral systems, together with the provision of emergency obstetric services, can significantly reduce the risk of women dying from pregnancy-related complications.
“You do not need state-of-the-art facilities or equipment to save many women’s lives,” said Vincent Lambert, MSF’s medical advisor for Burundi. “MSF’s experience can serve as an encouraging example for donors, governments and other NGOs considering investing in the improvement of access to emergency obstetric care in countries with high maternal mortality rates.”
The research, published in the paper, “Safe Delivery: Reducing maternal mortality in Sierra Leone and Burundi,” is the first of its kind to quantify the impact of such a model of care on maternal mortality in an African setting.

Photo: Mateso Emilienne, 25, was picked up by MSF ambulance the previous day from Gatumba Health Center. Her baby was delivered via Caesarean section. Burundi 2012 © Sarah Elliott

Low-Cost Health Interventions Drastically Reducing Maternal Mortality in Sierra Leone and Burundi


Medical data gathered in 2011 from MSF projects in Bo, Sierra Leone, and Kabezi,Burundi indicate that the introduction of ambulance referral systems, together with the provision of emergency obstetric services, can significantly reduce the risk of women dying from pregnancy-related complications.

“You do not need state-of-the-art facilities or equipment to save many women’s lives,” said Vincent Lambert, MSF’s medical advisor for Burundi. “MSF’s experience can serve as an encouraging example for donors, governments and other NGOs considering investing in the improvement of access to emergency obstetric care in countries with high maternal mortality rates.”

The research, published in the paper, “Safe Delivery: Reducing maternal mortality in Sierra Leone and Burundi,” is the first of its kind to quantify the impact of such a model of care on maternal mortality in an African setting.

An Escalating Health Crisis in South Sudan

Above: Two-year-old Lastman Muthko was brought to the MSF field hospital in Doro camp earlier this morning by his mother Mariam [left]. He is suffering from severe malaria and has had difficulty breathing.

Since November 2011, MSF has been operating emergency programs in South Sudan for tens of thousands of refugees who fled violence in Sudan’s South Kordofan and Blue Nile States. MSF has field hospitals in five refugee camps in Unity and Upper Nile states in South Sudan (Batil, Doro, Jamam, Yida, and Gendrassa). However, resources in the camps are stretched extremely thin, and the humanitarian crisis is only worsening as more refugees arrive. Heavy rains have exacerbated the situation, flooding camps and leaving refugees—many of whom have already endured the journey from Sudan on foot—vulnerable to diseases like diarrhea, malaria, and cholera.Photo:South Sudan 2012 © Nichole Sobecki

An Escalating Health Crisis in South Sudan

Above: Two-year-old Lastman Muthko was brought to the MSF field hospital in Doro camp earlier this morning by his mother Mariam [left]. He is suffering from severe malaria and has had difficulty breathing.

Since November 2011, MSF has been operating emergency programs in South Sudan for tens of thousands of refugees who fled violence in Sudan’s South Kordofan and Blue Nile States. MSF has field hospitals in five refugee camps in Unity and Upper Nile states in South Sudan (Batil, Doro, Jamam, Yida, and Gendrassa). However, resources in the camps are stretched extremely thin, and the humanitarian crisis is only worsening as more refugees arrive. Heavy rains have exacerbated the situation, flooding camps and leaving refugees—many of whom have already endured the journey from Sudan on foot—vulnerable to diseases like diarrhea, malaria, and cholera.

Photo:South Sudan 2012 © Nichole Sobecki

It’s a kind of medical utilitarianism: the patients’ needs come before everything. And people appreciate it: at a checkpoint, a man always gave us bananas because we saved his leg. They show us their babies in the street, and they remind us that the birth was difficult but that they’re still there.

Anna Halford, returning from a four-month mission as a project coordinator in DRC, reflects on the work MSF does to help people enduring daily violence.

Despite a volatile security situation, MSF continues to provide free health care in four reference hospitals, 12 health centers, and four health posts in North Kivu, as well as in four reference hospitals, 19 health centers, and five health posts in the province of South Kivu. There are also a number of cholera treatment centers (CTCs), mobile clinics, and emergency response activities.

At the project in Masisi, MSF performed 105,681 medical consultations in 2011. In the Masisi hospital, 7,226 inpatients were admitted for hospital care and 3,947 women gave birth for free.

The Risks of Childbirth in Somalia

Doctor Hamida Shakib Mohamed just helped deliver a healthy boy weighing 3.6 kilograms [about 8 pounds]. It’s a good thing the mother made it to this health center; it was a difficult labor and she needed the assistance of a skilled birth attendant using a vacuum device to complete the delivery. She lives in a village about 110 kilometers [about 68 miles] north of here, but her father insisted she make the trip. He appreciates the MSF–supported services here after his wife was treated for post-partum hemorrhaging just a few months ago. “We give the right care," says Dr. Hamida, "so people come to us.”

Last December, MSF expanded its medical services in Galcayo North to include maternity and obstetric care. The number of deliveries has since boomed to about 200 per month, with many mothers coming from increasingly far away. Dr. Hamida is happy about that. She’s Somali, educated in Mogadishu in the 1980s, but holds a foreign passport and has lived abroad for most of the past two decades. “Now that my children are grown,” she says “I’m free and I want to give my energy to the Somali community.” She couldn’t be more needed.A baby rests in the inpatient post-natal department of MSF’s Galcayo South hospital.
Somalia 2011 © Siegfried Modola

The Risks of Childbirth in Somalia

Doctor Hamida Shakib Mohamed just helped deliver a healthy boy weighing 3.6 kilograms [about 8 pounds]. It’s a good thing the mother made it to this health center; it was a difficult labor and she needed the assistance of a skilled birth attendant using a vacuum device to complete the delivery. She lives in a village about 110 kilometers [about 68 miles] north of here, but her father insisted she make the trip. He appreciates the MSF–supported services here after his wife was treated for post-partum hemorrhaging just a few months ago. “We give the right care," says Dr. Hamida, "so people come to us.

Last December, MSF expanded its medical services in Galcayo North to include maternity and obstetric care. The number of deliveries has since boomed to about 200 per month, with many mothers coming from increasingly far away. Dr. Hamida is happy about that. She’s Somali, educated in Mogadishu in the 1980s, but holds a foreign passport and has lived abroad for most of the past two decades. “Now that my children are grown,” she says “I’m free and I want to give my energy to the Somali community.” She couldn’t be more needed.

A baby rests in the inpatient post-natal department of MSF’s Galcayo South hospital.
Somalia 2011 © Siegfried Modola

Somebody Help: The Forgotten Population in North Darfur

In the remote Jebel Si area of North Darfur, MSF runs a hospital, five health posts, and a mobile clinic. These are the only health facilities in the area, and they serve a permanent population of 100,000, as well as about 10,000 seasonal nomads. The majority of MSF’s patients in Jebel Si are women and children.

But now a series of obstacles threaten to seriously hamper MSF’s ability to deliver medical assistance. Vital medical and logistical supplies have been prevented from reaching the area, work permits have not been granted, and physical access to the region has become increasingly difficult.

As a result of these obstacles, MSF has been forced to scale down its activities dramatically. Unless urgent steps are taken to rectify the situation, the people of Jebel Si will be faced with the reality of a future without essential health care.Photo: An MSF staff member checks a child for malnutrition in Jebel Si, where obstacles threaten the continued operation of MSF’s health posts, the only such facilities in the area.
Sudan 2012 © MSF

Somebody Help: The Forgotten Population in North Darfur

In the remote Jebel Si area of North Darfur, MSF runs a hospital, five health posts, and a mobile clinic. These are the only health facilities in the area, and they serve a permanent population of 100,000, as well as about 10,000 seasonal nomads. The majority of MSF’s patients in Jebel Si are women and children.

But now a series of obstacles threaten to seriously hamper MSF’s ability to deliver medical assistance. Vital medical and logistical supplies have been prevented from reaching the area, work permits have not been granted, and physical access to the region has become increasingly difficult.

As a result of these obstacles, MSF has been forced to scale down its activities dramatically. Unless urgent steps are taken to rectify the situation, the people of Jebel Si will be faced with the reality of a future without essential health care.

Photo: An MSF staff member checks a child for malnutrition in Jebel Si, where obstacles threaten the continued operation of MSF’s health posts, the only such facilities in the area.
Sudan 2012 © MSF

On this Mother’s Day, let’s remember that 1,000 women still tragically die every day in childbirth or from pregnancy-related complications that are preventable with skilled clinicians, drugs and equipment. Maternal death is an ongoing crisis, but it is an avoidable crisis and it deserves our attention.
Kara Blackburn, from Brisbane, Australia, is a registered nurse/midwife who joined Doctors Without Borders in 2006. She has practiced midwifery for 14 years. In her current role as medical advisor for women’s health, based in Sydney, Blackburn supports a number of Doctors Without Borders women’s health projects globally.

Read the rest of her article from WomensENews.org
By Foot, Bike, Car, or Canoe: Patient and Staff Stories of Malaria in DRC


“My name is Zamukunda. I tested positive for malaria at the health center. This morning I delivered my first child, a boy who weighed 1.6 kg [3.5 pounds]. My labor began very late last night, which was a surprise because I was still far from my delivery date. I was in a lot of pain and was bleeding, which made me worry, so I left the house with my mother and we walked for two hours to reach this health center.

My baby was born at two in the morning. He was not breathing very well and I was continuing to bleed so MSF decided to transfer us in their car from Kashuga to the main hospital in Mweso. We picked up another woman and her child who was very sick with malaria. The trip took only an hour since there has not been much rain. Now I am in the intensive care unit at the hospital with my baby, who is on oxygen. So far we are doing okay.”

Zamukunda’s son was born at seven months. She did not know how malaria would affect her pregnancy or her baby. The high fevers caused by the disease can provoke contractions and lead to premature delivery. Zamukunda and her son are receiving treatment at MSF’s Mweso hospital.Photo: DRC 2012 © Sandra Smiley
Patients receiving malaria treatment in an MSF-supported hospital in Katanga province.

By Foot, Bike, Car, or Canoe: Patient and Staff Stories of Malaria in DRC

“My name is Zamukunda. I tested positive for malaria at the health center. This morning I delivered my first child, a boy who weighed 1.6 kg [3.5 pounds]. My labor began very late last night, which was a surprise because I was still far from my delivery date. I was in a lot of pain and was bleeding, which made me worry, so I left the house with my mother and we walked for two hours to reach this health center.

My baby was born at two in the morning. He was not breathing very well and I was continuing to bleed so MSF decided to transfer us in their car from Kashuga to the main hospital in Mweso. We picked up another woman and her child who was very sick with malaria. The trip took only an hour since there has not been much rain. Now I am in the intensive care unit at the hospital with my baby, who is on oxygen. So far we are doing okay.

Zamukunda’s son was born at seven months. She did not know how malaria would affect her pregnancy or her baby. The high fevers caused by the disease can provoke contractions and lead to premature delivery. Zamukunda and her son are receiving treatment at MSF’s Mweso hospital.

Photo: DRC 2012 © Sandra Smiley Patients receiving malaria treatment in an MSF-supported hospital in Katanga province.

Better Treatment for HIV-Positive Pregnant Women

The World Health Organization recently issued new guidelines to prevent mother-to-child transmission of HIV. The recommendations include getting more women on treatment sooner and staying on it for life. The guidelines have the support of Doctors Without Borders.

Read more on this article from Voice of America.


Photo: MSF / Brendan Bannon
MSF HIV specialist Dr. Eamonn Vitt examines an HIV positive Ugandan woman who’s 7 months pregnant. (Nov. 2009)

Better Treatment for HIV-Positive Pregnant Women

The World Health Organization recently issued new guidelines to prevent mother-to-child transmission of HIV. The recommendations include getting more women on treatment sooner and staying on it for life. The guidelines have the support of Doctors Without Borders. Read more on this article from Voice of America. Photo: MSF / Brendan Bannon
MSF HIV specialist Dr. Eamonn Vitt examines an HIV positive Ugandan woman who’s 7 months pregnant. (Nov. 2009)

HIV in infants born to HIV-positive mothers is a big problem in the developing world. There are around 2 million HIV-positive children in developing countries, whereas in the United Kingdom, for example, there are just 70. So, we’ve almost got rid of this problem in the West, but in the developing world it’s a big problem.
Dr. Nathan Ford, MSF Medical Aid Coordinator, in an interview on Voice of America about better treatment for HIV-positive pregnant women.
Afghanistan: Medical Care Suspended in Khost After Attack on MSF Hospital

MSF today suspended medical activities in its recently opened maternity hospital in Khost Province in eastern Afghanistan, after an explosion inside the hospital compound this morning. Seven people were injured in the blast, including one child.
	“The suspension will continue until we receive assurances from the actors controlling the areas that medical activities can take place unhindered, and that the security of patients, medical staff, and health facilities will be respected, as previously agreed,” said Renzo Fricke, country representative for MSF in Afghanistan.
	Patients currently under MSF’s care will be referred to the maternity ward in Khost Provincial Hospital. No new patients will be admitted to the MSF facility for the time being.Photo: Afghanistan 2012 © Hilde Cortier/MSF
Inside MSF’s maternity hospital in Khost, where staff had delivered more than 600 babies since it opened a month ago.

Afghanistan: Medical Care Suspended in Khost After Attack on MSF Hospital

MSF today suspended medical activities in its recently opened maternity hospital in Khost Province in eastern Afghanistan, after an explosion inside the hospital compound this morning. Seven people were injured in the blast, including one child.

“The suspension will continue until we receive assurances from the actors controlling the areas that medical activities can take place unhindered, and that the security of patients, medical staff, and health facilities will be respected, as previously agreed,” said Renzo Fricke, country representative for MSF in Afghanistan.

Patients currently under MSF’s care will be referred to the maternity ward in Khost Provincial Hospital. No new patients will be admitted to the MSF facility for the time being.

Photo: Afghanistan 2012 © Hilde Cortier/MSF
Inside MSF’s maternity hospital in Khost, where staff had delivered more than 600 babies since it opened a month ago.

The Avoidable Crisis of Maternal DeathMSF makes it a priority to provide lifesaving, emergency obstetric care in both acute and chronic humanitarian crises. MSF teams strive to address the five main causes of maternal death: hemorrhage, sepsis, unsafe abortion, hypertensive disorders, and obstructed labour.

	In a conflict or crisis, pregnant women are even more vulnerable because health services have collapsed, are inadequate, or are totally non-existent. But these women need access to quality emergency obstetric care whether they live in a conflict zone, in a refugee camp, or under plastic sheeting after a devastating earthquake.

	In fact, they need the same help that all pregnant women facing a complication need: access to appropriate medical assistance—skilled medical staff, drugs, and equipment—to save their life and the life of their baby.

	Conflict, epidemics, natural disasters, or the complete breakdown of a country’s health system are crises faced by MSF’s millions of patients around the world every day. But a maternal death: that’s the avoidable crisis.

Infographic by Will Owen

The Avoidable Crisis of Maternal Death

MSF makes it a priority to provide lifesaving, emergency obstetric care in both acute and chronic humanitarian crises. MSF teams strive to address the five main causes of maternal death: hemorrhage, sepsis, unsafe abortion, hypertensive disorders, and obstructed labour.

In a conflict or crisis, pregnant women are even more vulnerable because health services have collapsed, are inadequate, or are totally non-existent. But these women need access to quality emergency obstetric care whether they live in a conflict zone, in a refugee camp, or under plastic sheeting after a devastating earthquake.

In fact, they need the same help that all pregnant women facing a complication need: access to appropriate medical assistance—skilled medical staff, drugs, and equipment—to save their life and the life of their baby.

Conflict, epidemics, natural disasters, or the complete breakdown of a country’s health system are crises faced by MSF’s millions of patients around the world every day. But a maternal death: that’s the avoidable crisis.

Infographic by Will Owen