The Soviet occupation of Afghanistan in 1979 resulted in millions of Afghans seeking refuge in neighboring countries, specifically Pakistan and Iran. Today, Afghans account for the greatest number of displaced persons in the world. With over 1.6 million registered Afghans located in the country, Pakistan is struggling to accommodate the unmet health needs of local women.

The World Health Organization describes war as “the most serious threat of all to health.” Unfortunately, this seems to be true in many refugee camps located in Pakistan, where reproductive health needs remain untreated. During the first wave of refugees, communicable diseases, such as malaria, were among the greatest concerns for the population. Nowadays, the focus has shifted to address the growing demands of Afghan women in regards to maternal health.

After conducting a needs assessment, the International Rescue Committee (IRC) concluded that there has been a lack in reproductive health services in refugee camps. The primary area of concern continues to be the surplus of high-risk pregnancies. Malnutrition, poverty and under-use of prenatal services all contribute to the endangerment of a mother and her baby.

However, these are not the only factors that cause Afghan refugees to remain a vulnerable population.

Due to many cultural constraints, women can only receive clinical care and health education from other women. This proves troublesome in many camps where female physicians are limited. The IRC also found that although 80 percent of pregnant women attend between one and three prenatal appointments, only half of them were accompanied by a trained health professional during labor.

Inadequate access to transportation tends to hinder women’s ability to seek health services in the case of an emergency, thus forcing many Afghan refugees to give birth at home without any medical supervision. In the few cases where an Afghan woman may be able to reach a local hospital, a male relative must accompany her–but that cannot always be guaranteed.

Fortunately, there have been recent solutions to this ongoing health crisis.

Government-run health care facilities, or Basic Health Units (BHUs), are growing in popularity in the outskirts of the country. Although some BHUs have already been established, they have rarely been seen in remote towns such as Chamkani, located in Peshawar. However, in 2012, the Chamkani project started operations, establishing seven BHUs in various parts of Peshawar.

The United Nations High Commissioner for Refugees (UNHCR) created the Refugee Affected and Hosting Area program to strengthen these government-run health centers, improve infrastructure and rehabilitate the environment of over 40 rural cities by various projects.

According to UNHCR, the Chamkani project has built a multitude of labor rooms, recovery rooms and waiting areas in the seven new BHUs. They have also provided more medical equipment and training to traditional midwives.

Local interviews suggest that Afghan refugees in Chamkani feel more comfortable because a health clinic is nearby, meaning they will not have to wait for a male to escort them. The Chamkani project also considers the financial situation of many refugees. The women only have to pay five rupees for an ultrasound examination, a procedure that would be exponentially more expensive at a hospital.

While Afghan refugee women still continue to endure hardships during pregnancies, the BHUs have greatly improved their lives and provided them better medical treatment in a timely manner. As Winston Churchill said, “Healthy citizens are the greatest asset any country can have.”

— Leeda Jewayni

Sources: UNHCR,, RHRC
Photo: Pakistan Today

Every Woman Every Child is working to save the lives of 16 million women and children by 2015. Focusing on addressing the major challenges facing women and children all over the globe, Every Woman Every Child works to enhance financing, strengthen policy and improve service on the ground for women and children in need.

Launched by U.N. Secretary-General Ban Ki-moon during the United Nations Millennium Development Goals Summit in 2010, the initiative would mean saving the lives of 16 million women and children, preventing 33 million unwanted pregnancies, ending growth stunting in 88 million children and protecting 120 million children from pneumonia.

Improving the health of women and children is critical to nearly every area of human development and progress. Research shows that the health of women and children is the foundation of creating healthy societies.

According to Women and Health Alliance International, every year half a million women die during pregnancy or because of problems during childbirth. While the mother’s death is horrible enough in itself, the structure of the entire family is damaged to a point of collapse.

Economies cannot grow and social stability cannot increase without first building up public health services. The Every Woman Every Child initiative recognizes that all factors have an important contribution to make in the movement, from the private sector to civil society.

At the 2010 launch more than $40 billion was pledged to the cause. However, more help is necessary to reach the 2015 goal. The secretary-general is asking the international community for additional commitments not just fiscally, but in the form of policy and human service delivery on the ground.

Secretary-General Ban Ki-moon described his enthusiasm for the project, stating,“Every Woman Every Child. This focus is long overdue. With the launch of the Global Strategy for Women’s and Children’s Health, we have an opportunity to improve the health of hundreds of millions of women and children around the world, and in so doing to improve the lives of all people.”

— Caroline Logan

Sources: Every Woman Every Child, UN Foundation, WAHA
Photo: Peace and Security

menstruation in uganda
Menstruation is a major reason for young girls in Uganda to miss school. Reasons for their absence stems from the stigma associated with “that time of the month,” a lack of sanitary napkins and the limited facilities available to students. Attending school while on their period forces girls to put their health at risk and chance being the subject of humiliation.

In an interview with a Guardian reporter, 16-year-old Lydia from Kampala, Uganda expressed why going to school during her period is difficult. She explained that some of the toilets did not have doors, so that if someone walked in, they would see her. Her school also has only four toilets for 2,000 students.  The toilets’ inability to flush or have water complicates the issue further, making menstruation in Uganda a problem in multiple ways.

In a recent study by SNV, officials report that girls miss between 8 to 24 days of school per year while menstruating.

Some girls attempt to prevent their clothing from being ruined by trying to absorb the blood with old cloth or old t-shirts, but these methods are not particularly successful. In another interview, Auma Milly commented that disposable pads are very expensive and are often not available in the more rural regions. Consequently, she felt embarrassed when she went to school and would soil her clothes so often that she chose not to attend.

In an attempt to address the problem regarding women’s sanitary needs, organizations including Save the Children, WaterAid, the Institute of Reproductive Health and local NGO Caritas Lira have begun to raise awareness and assist the cause.  Representatives from WaterAid commented on the importance of deconstructing the taboo regarding women’s health. The founder of 50 Cents. Period. described the battle as giving girls the basic right to hygiene. SNV and Caritas Lira have gone to schools in order to teach girls how to make reusable, affordable pads. Additionally, female Ugandan government officials have begun advocating for reduced taxes on sanitary napkins and improved facilities so that menstruation does not interfere with education.

– Jordyn Horowitz


Sources: The Guardian, The Guardian 2, UWASNET, 50 Cents Period, UWASNET, , SNV
Photo: A Global Village


Arunachalam Muruganantham is leading a sanitary pad revolution in rural India, changing women and girls’ sanitary practices. Out of 355 million females in India who menstruate, only 12 percent of them use sanitary napkins. The others use ash, newspapers, old fabric or sand. In India, women are considered untouchables at the time of their menstruation, and they face stigma and ostracism during their periods. They are banned from public places during menstruation, so they stay indoors, oftentimes reusing their dirty rags. Poor menstrual hygiene not only causes 70 percent of all reproductive diseases in India, but also can lead to maternal mortality, a lower rate of females enrolled in schools and fewer women in the workforce.

In 1998, Muruganantham discovered that his wife, Shanthi, chose to use dirty menstruation rages, rather than sanitary napkins, because sanitary napkins were too expensive. He decided to make a sanitary napkin that his wife and other women in rural India could afford to buy.

He surveyed female medical students, studied used sanitary napkins, and fashioned a fake uterus from a soccer ball filled with goat’s blood. Tucking the soccer ball under his clothing with a tube feeding the blood into his underwear, he ran and walked around to experience having a period. During his mission to create a low cost sanitary napkin, his wife, his mother and his village would abandon him. Due to his unique experiments, he was labeled a mad pervert, but Muruganatham did not give up.

By contacting multiple large sanitary pad manufacturing companies, he discovered what sanitary napkins were made of: cellulose from tree bark. However, the machines needed to break the cellulose down and make the cellulose into sanitary pads were extremely expensive.

After years of hard work, Muruganatham invented a low-cost wooden machine that could break down the hard cellulose to make sanitary napkins, increase sanitary napkin use and create thousands of jobs for rural women. One of his manual machines costs 75,000 rupees, and provides employment for approximately 10 individuals. They can produce 200-250 pads a day, selling for around 2.5 rupees each. Although his invention could have brought him enormous profits, he chose not to sell the machines to big companies. He continues to sell the machines mainly to NGOs and women’s self-help groups.

Muruganatham’s family and community are now supporting his endeavors. He is currently expanding his machines to 106 other countries such as Kenya, Nigeria, and the Philippines. His low cost, locally produced sanitary napkins are empowering women and girls in developing countries while giving them the opportunity to contribute to their local economy. These sanitary napkins reduce unsanitary menstruation practices and are beginning to chip away at the cultural taboo of menstruation that forces women to feel unclean and untouchable because of a completely natural bodily function.

Sarah Yan

Sources: Business Week, BBC
Photo: The Globe And Mail

Female genital mutilation (FGM) or female circumcision, has been occurring for hundreds of years in mostly sub-Saharan and northeast African regions. The term “female genital mutilation” encompasses every procedure where partial or total removal of the external female genitalia occurs, as well as any general injury to those organs without a distinct medical purpose.

The practice of FGM is internationally seen as a violation of human rights for women and young girls because it emulates the inequality between genders and represents extreme discrimination against women. On top of this, the following rights are also violated: the right to security, physical integrity, health, freedom from torture and from inhumane treatment–especially when the procedure can result in death.

There are four general classifications of FGM: clitoridectomy, excision, infibulation and an “other” category. Clitoridectomy entails the removal of part of or the entire clitoris and is one of the most common types. Excision is where they remove part of or the entire clitoris and labia minora, and this can be with or without cutting the labia majora. Infibulation includes the reduction of the vaginal opening by cutting and repositioning the labia majora to make a covering, with or without removing the clitoris. The “other” category classifies any other harmful procedures to a woman’s reproductive organs in a non-medical way.

FGM is in no way beneficial to a woman’s health, and in fact, it is harmful in several ways. Short-term effects include hemorrhage, severe pain, tetanus and urine retention. Long-term effects include cysts, recurrent urinary tract and bladder infections, infertility, childbirth complications and newborn deaths. This kind of procedure is mostly done to newborns or girls around 15 years of age that are going through puberty. Today, over 125 million women and girls in the Middle East and Northern Africa have been circumcised. By 2030, it is estimated that a further 86 million young women around the world will experience this procedure as well.

Many officials at UNICEF disagree with the practice of FGM and state it is not necessary in Islamic countries. They say it is a very old practice, traced back to the Egyptian pharaohs, and that the Koran says how humans were created in the perfect way, so changing them is not justified by religion.

Fahma Mohamed, a 17-year-old student that leads the Guardian’s campaign to end FGM, has acquired over 212,000 signatures in her petition against the issue. She has even gotten recognition from the United Nations Secretary General, Ban Ki-moon, who has made it a priority to end FGM because of how it threatens the empowerment of women.

There have been progressive signs in the worldwide campaign to end the practice of female genital mutilation with multiple countries like Kenya, Uganda and Guinea-Bissau adopting laws against it. The girls themselves understand the risks of being circumcised, and mothers who have dealt with the ordeal are fighting more and more to protect their daughters from the same fate. Schools can be directed to address the issue so that the people in these countries can learn about the issue and how to shield their young women from it.

– Kenneth W. Kliesner 

Sources: The Guardian (1), The Guardian (2), World Health Organization
Photo: Girls’ Globe

According to a new study by GE Healthcare, incidences of fatal breast cancer have risen in developing countries.

Bengt Jönsson, Professor in Health Economics at the Stockholm School of Economics, and co-author of the report has said, “Breast cancer is on the rise across developing nations, mainly due to the increase in life expectancy and lifestyle changes such as women having fewer children, as well as hormonal intervention such as post-menopausal hormonal therapy. In these regions mortality rates are compounded by the later stage at which the disease is diagnosed, as well as limited access to treatment, presenting a ‘ticking time bomb’ which health systems and policymakers in these countries need to work hard to defuse.”

While significant headway is being made in the prevention of communicable diseases such as malaria and HIV/AIDS, many developing countries do not have the resources to provide treatment for cancer.

Ignorance and the stigma of breast cancer is also a contributing factor. “There is little information for the people who need to be helped,” said Dr. Fred Okuku, of the Uganda Cancer Institute in Kampala, “Only a few know how to read and write. Many don’t have TV or radio. There is no word for cancer in most Ugandan languages. A woman finds a lump in her breast, and cancer doesn’t cross her mind. It’s not in her vocabulary.”

In the United States, about 20 percent of breast cancer patients die from it, compared with 40 to 60 percent in developing countries. While prevention and self screening measures are well known in the United States, misinformation in the developing world has led to an increased risk. A recent survey in Mexico City highlights this, indicating that many women feel uncomfortable or worried about having a mammogram.

Claire Goodliffe, Global Oncology Director for GE Healthcare, has said, “It is of great concern that women in newly industrialized countries are reluctant to get checked out until it is too late. This report finds a direct link between survival rates in countries and the stage at which breast cancer is diagnosed. It provides further evidence of the need for early detection and treatment, which we welcome given current controversies about the relative harms, benefits, and cost effectiveness of breast cancer screening.”

David Smith

Sources: New York Times

Many of us spent some time in May being thankful for our mothers. Something else that we may not think to be thankful for is the healthy and sanitary conditions mothers were able to give birth in. For women living in developing countries, this is a huge concern for pregnant women. One country, however, has proven to be the worst place to give birth: Chad.

This statistic was identified by the organization, Save the Children, in their annual Mother’s Index. The group uses an index that includes a woman’s risk of death during childbirth or pregnancy. Chad was deemed the worst place for a mother to give birth because 1 in 15 mothers are at high risk of dying while pregnant or in child labor.

A contributing factor to these startling statistics is that women get married and become pregnant at a young age. 50% of girls are mothers by the age of eighteen. These girls are at risk because their bodies are not fully developed enough to safely experience pregnancy and childbirth. Malnutrition is also a concern for mothers in Chad. High levels of poverty make healthy diets unattainable for many mothers.

The second worst country for women to give birth in is Somalia. This country is the highest ranking in not providing proper care during pregnancy, with 74% of women not receiving adequate care. Somalia also is barely behind Chad in terms of the risk of death during pregnancy and childbirth. In Somalia, one in sixteen women are at risk. The newborn child is also at danger when it is born in Somalia. About eighteen newborns die per 1,000 live births.

Other countries that are ranked in worst places to have a child are Niger, Sierra Leone, Liberia, Guinea-Bissau, Central African Republic, Mali, Nigeria and Guinea. In order to improve childbirth conditions in these developing countries, it is necessary to invest in health systems and the training of health employees, midwives and other who may assist in the birth process. With these improvements in healthcare, more women will survive and be able to celebrate Mother’s Day with their children.

– Mary Penn

Source: Devex, Save the Children
Photo: Global Giving

Family Planning & Women Deliver Conference

Among the many issues discussed at the 2013 Women Deliver conference, women’s ability to choose the size of their families was the main topic. Speakers in the conference praised improvements in women’s access to contraceptives in poor countries and made plans on how to continue this success.

Last year at the London Summit on Family Planning, world leaders pledged to contribute $2.6 billion to help 120 million women in developing countries with health services and contraceptives by 2020. The Women Deliver 2013 conference discussed how to utilize these funds so that it benefits women who need access to such services.

Melinda Gates, of the Bill & Melinda Gates Foundation, supported the plans made at the conference by stating, “Putting women at the center of development and delivering solutions that meet their needs will result in huge improvements in health, prosperity and quality of life.”

Attendees of the conference heard testimonials from numerous third would countries successful experiences with family planning services. Representatives from Senegal, the Philippines, the Women Deliver Zambia, Indonesia and Malawi spoke about how they have made improvements in women’s health rights and access to contraceptives.

Given the effectiveness and low-cost of contraceptives, advocates for women’s health hope to encourage other developing countries to follow the example of their peers and introduce women’s health policies. Speakers also stressed a need to sustain these outlooks on family planning and introduce the concept to a broader audience.

When women have access to contraceptives and other health services, their economic and social situation will also improve. As part of the effort to combat global poverty and promote gender equality, family planning is an issue that should be center stage in developing countries.

– Mary Penn

Source: All Africa
Photo: UN Foundation

Obstetric fistulas are an all too common health risk for pregnant women in poor countries who lack access to adequate healthcare. For millions of women in poor, rural communities with little or no access to health services, pregnancy carries a high level of risk.

An obstetric fistula is a hole or passageway between the birth canal and the excretory system, caused by prolonged, obstructed labor without access to proper medical care or a skilled birth attendant. Often fistulas can resort in the death of the baby, and lasting injury for the mother. The fistula causes an almost constant leak of bodily excretions of urine and/or feces, causing major discomfort. In addition to making it very difficult for a woman to carry out her day-to-day work, the condition can result in a woman being ostracized and stigmatized by those around her because of the foul smell she may carry and her inability to conceive again.

Fistulas are dangerous, but they are also both preventable and treatable. According to the Fistula Foundation, obstetric fistula is “the most devastating and serious of all childbirth injuries,” and it occurs because mothers in poor countries must give birth without medical help. Complications from pregnancy and childbirth continue to be among the leading causes of death and disability for women of childbearing age in poor countries.

Obstetric fistulas were largely eliminated in the U.S. in the late 19th and early 20th centuries through improvements in obstetric care and the use of cesarean sections. The first surgical repair for obstetric fistula was developed in 1852 by a doctor in the United States. Now the surgery to repair obstetric fistula costs approximately $450. An estimated 30,000 to 50,000 women a year develop obstetric fistula, according to the Fistula Foundation, but only about 14,000 of those receive treatment.

The prevalence of fistulas in spite of available prevention and treatment points to health system failures in poverty-stricken parts of the world. Good prenatal care, nutrition, the presence of a skilled birth attendant and access to emergency obstetric care can all help prevent obstetric fistulas if accessible to women.

May 23, 2013 was the first International Day to End Obstetric Fistula. More international companies and organizations have begun paying attention to the problem of fistula. Johnson & Johnson in particular has been involved in supporting women suffering from obstetric fistula for more than 20 years through its subsidiary companies, and it recently stepped up its corporate commitment by providing medical supplies to Ethiopia.

– Liza Casabona

Source: The Fistula Foundation,The Huffington Post,Johnson & Johnson
Photo: Aheers Health

Expanding Contraceptive Accessibility
Women Deliver, a global advocacy organization that speaks for improved health and wellbeing for girls and women around the world, held a conference in Malaysia earlier this month called “Women Deliver 2013″. One of the most exciting strategies discussed at the conference involved contraceptive accessibility for women in developing countries. In 2012, global leaders pledged more than $2.6 billion to provide women and girls in developing countries with “voluntary access to contraceptive services, information, and supplies by 2020.”

Speakers at Women Deliver 2013 noted the importance of providing this kind of healthcare for women that have no access to it. Melinda Gates stated, “Putting women at the center of development and delivering solutions that meet their needs will result in huge improvements in health, prosperity, and quality of life.” She added, “When women have access to contraceptives they’re healthier, their children are healthier, and their families thrive.”

Many people do not recognize the significance of this issue, yet an estimated 150 million women worldwide do not have contraceptive accessibility they desire. In developing countries, pregnancy can be very dangerous for women and lead to greater risks of death or injury of both the mother and her children in childbirth. In addition, women in developing countries face a greater risk of death after bearing too many children and often are not allowed the necessary time for healing in between pregnancies. By providing contraception to delay or prevent pregnancies, young women in developing countries can minimize the risks associated with childbirth, care for the other children they have, and even have new opportunities for education or supporting themselves through work.

Leaders from Senegal, Indonesia, and the Philippines, among others, have pledged to expand family planning programs and access. According to UNFPA (the United Nations Population Fund) Executive Director Dr. Babatunde Osotimehin, “These countries show that we can make an impact on women’s access to reproductive health if we rally the necessary political will and financial commitments.” He continues, “Expanding access to contraceptives is one of the simplest and most cost-effective ways to save lives and ensure the health and wellbeing of future generations.”

These strategies and investments could help to foster healthy populations, as well as allow women and girls to spend more time learning and becoming independent, instead of spending years of their lives raising and caring for their children.

– Sarah Rybak

Source: Ghana Business News
Photo: Facebook