Fistula in Nigeria

Dr. Ana Langer and Brenda Drake, Chair of EngenderHealth’s Board of Directors, recently travelled to Nigeria, where the organization leads efforts to treat and prevent fistula. This Day, a leading Nigerian newspaper, covered Dr. Langer’s visit and the progress made in restoring the lives of women suffering from the condition. Check out the article.

Video: Accelerating Equality for Women and Girls around the World

On Thursday, December 3rd, EngenderHealth co-hosted a lively event at the Paley Center in New York with Equality Now and Ashoka featuring each organization's leader in conversation with Nicholas Kristof and Sheryl WuDunn, authors of Half the Sky. The speakers and audience members engaged in a stimulating discussion on many dimensions of womens health, rights, and welfare, with moderating by Maria Hinojosa of NOW on PBS. Watch the video and learn more about a range of subjects, from media representations of women and girls to the decline of the footbinding tradition in China.

The video is in two parts, each one approximately an hour long. Part 1 of the video includes discussion among the panelists, and Part 2 features the panelists responding to questions from the audience. Both will play in the video player above, or you can watch them directly on YouTube: Part 1 and Part 2.

For more information, please visit the following web sites:

• Equality Now
• Ashoka
• EngenderHealth
• Half the Sky
• EngenderHealth's Reader's Companion for Half the Sky

Calling all Champions for Maternal Health: Contribute Your Ideas Now!

The Maternal Health Task Force at EngenderHealth and Ashoka’s Changemakers just launched an exciting global competition to identify young individuals with innovative solutions to improve maternal health, Healthy Mothers, Strong World: The Next Generation of Ideas for Maternal Health.

The competition will select 16 young leaders from around the world to develop their ideas during 9-month mentorships with seasoned Ashoka Fellows working in the maternal health field. Also, three organizations will be awarded with $5,000 in prizes to attend the global Maternal Health Change Summit to be held in India in August 2010.

Submit your ideas now, or nominate an inspiring young champion, at www.changemakers.com/maternalhealth or email connect@changemakers.com.

Experts Meeting to Address Obstetric Fistula in Rwanda

KIGALI, RWANDA—Leading experts and physicians working in the reproductive and maternal health field will convene in Kigali December 7–8, 2009, to identify challenges and solutions to a pressing and preventable health concern in Rwanda—obstetric fistula. Hosted by the Ministry of Health, in collaboration with the Rwanda Medical Association and the U.S. Agency for International Development-supported Fistula Care Project (managed by EngenderHealth), the meeting will engage policymakers, health officials, medical staff, and community leaders to set achievable goals for preventing fistula and improving Rwandan women’s health.

Fistula affects an estimated 2–4 million women globally, including in Rwanda. It is a devastating gynecological injury usually caused by prolonged labor without medical intervention or cesarean section. As a result, women with fistula have chronic leakage of urine and/or feces. In most cases, fistula can be repaired through surgery, and it is almost always preventable—with timely, high-quality obstetric care as well as family planning.

At the meeting, national and international experts will strategize on how to best to integrate family planning with maternal health services to prevent fistula and improve the health and lives of Rwandan women. Leading physicians will be available to offer their expertise and comment on the issues, including:

• Dr. Isaiah Ndong, Vice President for Programs, EngenderHealth
• Dr. Joseph Ruminjo, Clinical Director of Fistula Care, EngenderHealth
• Dr. Theobald Hategekimana, Director, University Central Hospital of Kigali
• Dr Serigne Magueye Gueye, Fistula Master Trainer, Cheikh Anta Diop University/Grand Yoff General Hospital, Senegal

The meeting will be held at the Serena Hotel in Kigali. Members of the media are invited to attend the opening ceremony on December 7 and the morning session on December 8. Please contact Kellen Kebikomi by telephone at 250-25257-0912 or by email at kkebikomi@engenderhealth.org to confirm your attendance.

About Fistula Care
The Fistula Care project is a five-year cooperative agreement funded by USAID and managed by EngenderHealth. The project works to address the enormous backlog of women awaiting life-altering fistula repair, ensuring they receive timely and quality care from trained providers. At the same time, we work to remove barriers to emergency obstetric care that lead to fistula in the first place, so that women in labor get to the right place with the right services at the right time. The project is supporting a network of facilities offering a continuum of services, from emergency obstetric care, referrals, and family planning, to complex fistula repairs and advanced surgical training. Visit www.fistulacare.org for more information or contact us at: fistulacare@engenderhealth.org.

About EngenderHealth
EngenderHealth is a leading international reproductive health organization working to improve the quality of health care in the world’s poorest communities. EngenderHealth empowers people to make informed choices about contraception, trains health providers to make motherhood safer, promotes gender equity, enhances the quality of HIV and AIDS services, and advocates for positive policy change. The nonprofit organization works in partnership with governments, institutions, communities, and health care professionals in more than 20 countries around the world. For more than 65 years, EngenderHealth has reached more than 100 million people to help them realize a better life. For more information, visit www.engenderhealth.org.

(From the EngenderHealth press release)

New Series of HIV and AIDS Program Briefs

This World AIDS Day, EngenderHealth announces a new series of HIV and AIDS program briefs highlighting promising practices and lessons learned from our work. The briefs explore hallmarks of our programs, including strengthening health systems, developing human resources, engaging communities, and advocating for supportive policies. In nine countries, EngenderHealth partners with local clinics and community-based organizations to provide comprehensive HIV and AIDS prevention, care, and treatment services.

The first in the series is a set of five briefs on the AIDS, Population, and Health Integrated Assistance (APHIA II) Nyanza Project, which is based in Nyanza, Kenya. APHIA II is a holistic project to improve and expand HIV prevention, treatment, care, and support services, along with integrated reproductive health, maternal health, family planning, malaria, tuberculosis, and child health services.

The briefs in this series are:

• Implementation Strategy of the APHIA II Nyanza Project (PDF, 416KB)
  
• Improving Health Facility–Based Services in Nyanza Province, Kenya: The APHIA II Nyanza Project (PDF, 372KB)
• Implementing a Community Strategy within the APHIA II Nyanza Project (PDF, 328KB)
• Community-Based Care and Support within the APHIA II Nyanza Project (PDF, 380KB)
• Strengthening the Kenya Health Management Information System (HMIS) for Monitoring and Evaluation of the APHIA II Nyanza Project (PDF, 372KB)

APHIA II Nyanza is supported by the U.S. Agency for International Development and is managed by EngenderHealth, in collaboration with Kenya’s Ministry of Health. Other partners include: the Academy for Educational Development (AED), the Christian Health Association of Kenya, Inter Diocesan Christian Community Services, and PATH.

For more information about the APHIA II Nyanza Project and EngenderHealth’s HIV and AIDS programs, please visit www.engenderhealth.org/aphia or contact Sharone Beatty at: sbeatty@engenderhealth.org.

World AIDS Day Community Statement

EngenderHealth is among the organizations signing the World AIDS Day Community Statement, which recognizes the advances that have been made in the response to HIV and AIDS, as well as the challenges ahead. Download the full statement. (PDF, 3.0mb)

First Lady of Tanzania Visits EngenderHealth-Supported Clinic

In November 2009, the First Lady of Tanzania, Mama Salma Kikwete, visited Madaba Health Centre, a facility in the Ruvuma Region in southwestern Tanzania that is supported by EngenderHealth and that serves 50,000 people. The First Lady was there as part of a national campaign to reduce maternal and neonatal mortality, and she spoke about the importance of avoiding early pregnancy, improving maternal health care, and openly discussing HIV and preventing its spread.

EngenderHealth, through a U.S. Agency for International Development–supported ACQUIRE Project Associate Award, is helping to equip facilities in the Ruvuma Region with obstetric wards and is improving the quality and use of family planning services by training health care staff, strengthening supervisors’ skills, and raising awareness in communities. Over the past year, more than 400 clients received long-acting or permanent methods of contraception at Madaba, and nearly 9,000 clients received these methods in the region overall. EngenderHealth, through funding from the President’s Emergency Plan for AIDS Relief (PEPFAR), also trains health care professionals to provide counseling and testing for HIV and AIDS, other reproductive health services, and life-skills coaching to youth.

Last year, EngenderHealth assisted 38 facilities throughout Tanzania in improving the quality of their maternal health and family planning services.

Learn more about EngenderHealth’s work in Tanzania.

New Comprehensive Web Site Dedicated to Maternal Health

NEW YORK, NY—November 30, 2009—Today marks the launch of the Maternal Health Task Force’s new web site, which brings together experts, activists, policy makers, students, and others in one virtual place to move the maternal health agenda forward. The site will be the leading online platform for those committed to improving maternal health, offering individuals and organizations from around the world a place to discover resources, to collaborate with others, and to discuss successful strategies.

Discover
Featuring the first search engine solely focused on maternal health data and information, the web site has an ever-growing library of more than 1,300 journal articles, research and program reports, conference presentations, toolkits, and other materials. One of three interactive maps illustrates maternal health work being carried out by organizations around the world; this feature currently highlights organizations in six countries and is expected to map many more.

Collaborate
On the Partner Channel, organizations can post updates on their maternal health projects, and visitors can learn more about what these organizations are doing. Visitors can also use the Partner Channel to engage with experts from allied fields like HIV and human rights. The Collaborate section includes an interactive calendar highlighting more than 300 upcoming events in 2009 and 2010.

Discuss
The web site is highly interactive; visitors can join live chat sessions, participate in and hold discussions on the e-Forum page, add their expertise to the Wiki page, and take part in online polls on key issues. There is also a video blog where visitors can comment on, rate, and discuss videos related to maternal health. Thus far, the Maternal Health Task Force has 500 members, and many of our partners and members are already engaged in dialogue and contributing content.

Explore the web site and become a member by registering at www.maternalhealthtaskforce.org. For more information, please contact Raji Mohanam at 212-561-8522 or rmohanam@engenderhealth.org.

About the Maternal Health Task Force
The Maternal Health Task Force at EngenderHealth contributes to shaping collective efforts to improve maternal health worldwide. Supported by the Bill & Melinda Gates Foundation and initiated in late 2008, the Task Force serves as a catalyst to address one of the most neglected areas in global health. Recognizing that real progress requires better coordination and increased global attention, the Maternal Health Task Force brings together existing maternal health expertise and engages new organizations to facilitate global coordination of maternal health programs around three thematic areas: research and evidence, programs and evaluation, and advocacy and policy.

About EngenderHealth
EngenderHealth is a leading international reproductive health organization working to improve the quality of health care in the world’s poorest communities. EngenderHealth empowers people to make informed choices about contraception, trains health providers to make motherhood safer, promotes gender equity, enhances the quality of HIV and AIDS services, and advocates for positive policy change. The nonprofit organization works in partnership with governments, institutions, communities, and health care professionals in more than 20 countries around the world. For more than 65 years, EngenderHealth has reached more than 100 million people to help them realize a better life. For more information, visit www.engenderhealth.org.

(From EngenderHealth's press release.)

EngenderHealth Staff Member Joins Global Network of Men Leaders

On November 24, United Nations Secretary-General Ban Ki-Moon launched his Network of Men Leaders at the official observance of the 10th anniversary of the International Day for the Elimination of Violence against Women. In addition to EngenderHealth's own Senior Technical Advisor Andrew Levack, members include Desmond Tutu, Paulo Coelho, and José Luis Rodríguez Zapatero (the prime minister of Spain). The Network will provide a platform for world leaders to advocate for and provide guidance and direction to end violence against women. Learn more.

Bringing Back Dignity: Fistula Survivors in Ethiopia

Three newly-posted videos tell the stories of Tihun, Yeserash, and Abebu -- three young women from Ethiopia who have survived obstetric fistula. The women and their family members give insight into the difficulties of life with fistula, the joys of being repaired, and the lessons learned from their experiences. These videos are excerpts from the film "Bringing Back Dignity," produced under the ACQUIRE Project funded by USAID.

Despite the double tragedy of losing her baby and developing a fistula, Tihun has been blessed with a supportive husband who did not leave her when she was ill. Her husband Aweke explains that everyone urged him to leave his wife with beliefs that he would contract her condition, but he would not do so. Both Tihun and Aweke have learned valuable lessons from Tihun's fistula. Aweke regrets not being careful to use protection that would prevent an early pregnancy. Tihun vows that if she ever has a daughter she will not marry her off, and instead will let her go to school and then choose her own husband.

Yeserash and her father, Simeneh, express the hardships of obstetric fistula as well as the lessons learned from their experience. Simeneh's father regrets marrying off his daughter at the young age of 12 or 13 and vows that he will not do the same with his other daughters. He wishes other people would learn from his "painful mistake", urging them not to arrange early marriages and to allow their daughters to consent to marriage. Yeserash is now fully recovered and has since had a health baby boy.

Abebu, a 20-year-old fistula survivor, describes the hardships of living with a fistula and how her life has been transformed by repair. Abebu was married at the age of 15 and developed her fistula after four days of prolonged labor. When her leaking began, her husband stole her property and threw her out and her parents shunned her. Now that she is cured, Abebu is glad to be able to mingle with friends and participate in community events.

These videos recount hardships and celebrate achievements related to the participant's daily struggles with pregnancy, loss, and relationships, as well as their search for safety, acceptance, and dignity. Our hope is that viewers will come away with greater compassion, as well as an understanding of what causes fistula, how women can be repaired, and why community members, the health sector, and policymakers all have critical roles to play in prevention.

Save the Date: Accelerating Equality for Women and Girls Around the World

If you live in the New York City area, please join us on Thursday, December 3, for this important event. "Accelerating Equality for Women and Girls around the World: A Conversation with Media, Activists, Entrereneurs, and You" will include:

• Nicholas Kristof and Sheryl WuDunn, authors of Half the Sky
• Taina Bien-Aime, Equality Now
• Bill Drayton, Ashoka
• Ana Langer, EngenderHealth

The event will be moderated by Maria Hinojosa, Senior Correspondent, NOW on PBS.

This event is free and open to all, but space is limited. To attend, you must RSVP to rsvp@engenderhealth.org. For more information, read the online invitation, or call 212-561-8456.

EngenderHealth's Carrie Ngongo Receives Special Recognition in New York Times Contest

Congratulations to EngenderHealth's Carrie Ngongo! Carrie, Senior Program Associate with Fistula Care, received an honorable mention in New York Times columnist Nicholas Kristof's Half the Sky contest.

Carrie’s reflection on motherhood and the inspiring work to help women with fistula get treatment was selected from more than 700 entries.

You can help EngenderHealth make motherhood safer around the world! Join us.

And don't miss EngenderHealth's Reader's Companion for Half the Sky!

EngenderHealth's Fistula Care Project Highlighted at the Huffington Post

Hanna Ingber Win, the World Editor of the Huffington Post, writes about obstetric fistula today as part of her series on mothers in Ethiopia. As part of her research, Hanna talked to Karen Beattie, project director of EngenderHealth's global Fistula Care Project (funded by USAID), who is featured in the column. Read the full column.

Dr. Ana Langer Blogs at the Huffington Post About Our New Commitment to Action

EngenderHealth’s President, Dr. Ana Langer, blogs in today's Huffington Post about our commitment to action announced by President Clinton at last week's Clinton Global Initiative. Excerpt:

You wouldn't expect a plenary session at the Clinton Global Initiative called "Moving From Crisis to Opportunity - Financing an Equitable Future," featuring the CEO of JP Morgan Chase & Co., to be the natural venue for launching a major initiative on maternal health.

But that's exactly what happened Friday morning in New York, when former President Bill Clinton unveiled a new program and CGI Commitment to Action called Young Champions for Maternal Health.

A partnership between the Maternal Health Task Force at EngenderHealth (the organization I lead) and Ashoka, a pioneer in social entrepreneurship, Young Champions is the first international fellowship program to focus exclusively on maternal health. The strategy: Build the next generation of passionate and committed innovators in this field by offering a nine-month work study that will conclude with each fellow designing a concrete solution to protect women's reproductive health. EngenderHealth and Ashoka will jointly promote these solutions to the broader global health community.

As a 25-year veteran in the health field, I couldn't have been more gratified to see this innovative program take the stage, literally, at a major forum on the world's financial systems. It validated what those of us on the front lines of global health know to be true: To truly move beyond financial crises and do so in a sustainable and equitable way, we must invest in the health and well-being of mothers, particularly in the developing world.

Read more at: http://www.huffingtonpost.com/dr-ana-langer/smart-global-investment-s_b_300082.html

Read the full entry.

Inspired by Half the Sky? Check out our new Reader's Companion!

Inspired by Half the Sky? EngenderHealth’s online Reader's Companion to Nicholas Kristof and Sheryl WuDunn’s best-selling book will deepen your understanding of women's health and rights and the change that is happening around the world, every minute, every day. Hear the voices of those working on the front lines of global health and development, and of the women and men who are beating impossible odds and improving lives in their communities.

EngenderHealth is named in Half the Sky as an organization doing important work to support women in developing countries. Chapter-by-chapter, the Companion offers diverse perspectives, interviews, facts, and stories that expand on the topics in the book, drawing on EngenderHealth's expertise and program experiences around the world.

Learn more about what you can do to turn oppression into opportunity for women and girls everywhere!

When Planning a Pregnancy Can Save a Woman's Life

EngenderHealth's president, Dr. Ana Langer, authored an op-ed in the Huffington Post today:

"A new UNICEF report released last week is the latest in a series of drumbeats for a concerted, large-scale campaign to save the lives of mothers and newborns worldwide, far too many of whom are dying today from entirely preventable causes. With Congress back in session, a first order of business should be to approve a spending increase for maternal health and family planning in the FY10 Foreign Operations Bill.

"At stake are the more than half a million of expectant and new mothers who die each year, 99% of them in developing countries where maternal care is scarce. That's more than one woman every minute. Yet the number of maternal deaths has remained virtually unchanged for the past two decades. This is unconscionable, and it's why the Group of Eight leaders recently agreed that the world must do more to ensure that mothers everywhere can deliver their babies safely. Here in the U.S., we can do our part by doing more to fund life-saving efforts.

"When most of us think of childbirth, it triggers an image of a mother in a comfortable delivery room, holding the baby she'd dreamed of. Birth is a triumph, in part because pregnancy is never without some degree of risk. But in countries where women have a 1 in 8 lifetime chance of dying from pregnancy or giving birth, it can be tantamount to Russian roulette."

Read the rest of the column at the Huffington Post.

Spotlight on Ghana: President Obama Visits EngenderHealth Training Site

Richard Killian, Chief of Party for Quality Health Partners (managed by EngenderHealth) sits with colleagues at an information booth during President and Mrs. Obama’s visit to La General Hospital.

President Obama greets Richard Killian and other EngenderHealth staff at the information booth.

During his visit to Ghana, President Obama traveled to La General Hospital in Accra, where EngenderHealth trains health providers from across the country to provide high-quality family planning services. While at the hospital, the President and the First Lady stopped by an information booth, met a few of our staff who spoke about the importance of family planning, and learned more about our programs across the country.

EngenderHealth has worked in Ghana for more than 20 years to expand contraceptive use, improve health outcomes, and make lasting positive changes in the Ghanaian public health system. Currently, EngenderHealth collaborates with the local government to reduce maternal deaths, by ensuring that clients can prevent unwanted pregnancies and can choose from a wide range of family planning services, including long-acting and permanent methods. Other initiatives include expanding prevention and treatment services for HIV and reducing related stigma. Indeed, we work with all levels of the health system—from doctors to midwives to policymakers—to improve the quality of health care.

During his visit, President Obama spoke passionately about the need to address poor maternal health. “Part of the reason this is so important is throughout Africa the rates of both infant mortality, but also maternal mortality, [are] still far too high—I mean by a factor of a multiple of 10s compared to many other parts of the world,” the President said. The kinds of programs that provide strong prenatal and maternal care, he said, “are very important.” President Obama’s comments, along with proposed funding increases in next year’s budget, signal his commitment to global maternal and child health, as well as to reproductive health and family planning.

Meeting several mothers and their babies at the clinic, President Obama noted, “This is the highlight of the trip.”

Read more information about EngenderHealth’s activities in Ghana.

Fragile, Threatened, and Still Urgently Needed: Family Planning Programs in Sub-Saharan Africa

EngenderHealth staff Dr. Roy Jacobstein, Lynn Bakamjian, John M. Pile, and Jane Wickstrom published a commentary on the fragility of family planning programs in Africa in the current issue of Studies in Family Planning.

Congress Moves to Boost Funding for Global Health Priorities

Recent actions in Congress show growing momentum and support for maternal and child health and family planning, with historic funding increases proposed by both the House of Representatives and the Senate. Equally significant, the Senate Appropriations Committee passed an amendment offered by Senator Frank R. Lautenberg (D-NJ) to legislatively eliminate the Global Gag Rule.

Both the House and Senate called for increased funding for global health in the foreign aid budget for fiscal year (FY) 2010. The House already passed a bill allocating $528 million for maternal and child programs and $648.5 million for family planning, an increase of $100 million for family planning over enacted levels in FY2009.

On the Senate side, a spending bill approved by the Senate Appropriations Committee now awaits a vote by the full Senate. It calls for $628.5 million for family planning and reproductive health programs—$83.5 million above the FY2009 level and $35 million above President Obama’s request. In addition, a total of $555 million for child survival and maternal health was allocated—$31.5 million above President Obama’s request and $60 million above the FY2009 level.

Senator Lautenberg’s amendment to the spending bill would stop the 25-year-long back-and-forth over the Global Gag Rule, with successive presidents instituting and then repealing the policy. Lautenberg proposed an amendment that would prevent a future president from reinstating the policy by executive order.

“It is time to end the dangerous and harmful Global Gag Rule permanently. Health care providers across the globe should be able to care for the health of women and families, without ideological obstacles blocking the way. This amendment will strengthen America’s position as an international leader for women’s rights,” said Lautenberg.

Both houses of Congress are on August recess, but when returning in September, the Senate will be taking up appropriations for foreign aid. Write your senators today and ask them to vote yes and show their support for these global health priorities.

Following the Senate vote, both the bills will go to conference, and the allocations will be finalized. EngenderHealth will keep you informed of new developments.

EngenderHealth Announces New Board Leadership and Appointments

August 11, 2009, NEW YORK—EngenderHealth is pleased to announce new appointments on our Board of Directors. Brenda J. Drake, a Board member since 2003, is now Chair, taking the helm from Stasia Obremskey—who is stepping down from the Board. Dr. George F. Brown, a director since 2006, will serve as Chair of the Executive Committee, and Francine Coeytaux, who formerly held this position, is now Vice Chair of the Board. EngenderHealth also welcomes two new members: Dr. Julio Frenk and Dr. Supanya Lamsam.

Brenda J. Drake is Director of the Public Health Trust in Oakland, California. Ms. Drake practiced corporate law for 15 years before entering the philanthropic sector and joining the Richard & Rhoda Goldman Fund. During her 10 years at the Fund, she developed and implemented programs in population, reproductive health and rights, services for the elderly, low-income community organizing, and social justice for incarcerated men, women, and youth. Ms. Drake also served as Interim Executive Director for the Museum of the African Diaspora in San Francisco. Ms. Drake is a graduate of Stanford University and the University of California, Berkeley, School of Law.

Dr. George F. Brown, Senior Consultant in Reproductive Health for The William and Flora Hewlett Foundation, was Vice President, International Programs, at the Population Council for more than two decades. Dr. Brown expanded the Council’s work to more than 50 countries. Under his leadership, new research programs were created in gender and development, HIV and AIDS, and maternal mortality. He also served as Special Advisor in Population to the President of the Canadian International Development Agency and as Director, Health Equity, for the Rockefeller Foundation. Dr. Brown received his medical degree from the University of Toronto and a Master’s in Public Health from Harvard University.

The two new Board members, Dr. Julio Frenk and Dr. Supanya Lamsam, also bring extensive expertise in global health. “We are thrilled to have these two new, internationally recognized leaders joining our dedicated Board,” said Ana Langer. “I am personally very much looking forward to working with them.”

Dr. Julio Frenk is the new Dean of the Harvard School of Public Health. He served as Mexico’s Minister of Health from 2000 to 2006, leading a ground-breaking and internationally recognized effort to transform the national insurance and public health system. During his 25-year career, Dr. Frenk has been a Senior Fellow of the Bill and Melinda Gates Foundation’s Global Health Program and held executive positions at the World Health Organization and the Mexican Health Foundation. Dr. Frenk holds a medical degree from the National Autonomous University of Mexico, as well as a Master’s in Public Health and a joint doctorate in Medical Care Organization and Sociology from the University of Michigan.

Dr. Supanya Lamsam is a biomedically trained scientist with 20 years of experience in HIV and AIDS policy, fundraising, program management, and evaluation. As the Founding Executive Director of the Thailand Business Coalition on AIDS, she co-created an innovative program to provide financial incentives to reward companies that implement HIV and AIDS prevention and nondiscrimination programs. She also held senior positions at the International HIV/AIDS Alliance and the Population and Community Development Association in Thailand. Dr. Lamsam has a Ph.D. in molecular parasitology and a B.Sc. in Biology from the Imperial College of Science, Technology, and Medicine in the United Kingdom.

G8 Leaders Commit to Improving Maternal and Child Health

The Group of 8 (G8) leaders stepped up their commitment to reducing maternal and child deaths at last month’s summit in Italy. Their final declaration calls for a global consensus on maternal, newborn, and child health, citing the importance of community leadership and engagement in these health areas, of the removal of barriers to all women’s and children’s access to services, of skilled health workers, and of accountability for results. EngenderHealth joins the public health community in welcoming this new pledge and calls on world leaders to ensure that they follow their words with action.

Mobilizing around Long-Acting and Permanent Methods

On June 23, the RESPOND Project and the U.S. Agency for International Development launched a “Community of Practice” on long-acting and permanent methods of contraception. Held at the National Press Club in Washington, D.C., the event brought together 75 representatives from a wide range of agencies, organizations, foundations, and pharmaceutical companies. Participants shared the latest data on methods, as well as their experiences in implementing programs. Moving forward, the Community of Practice will provide a forum for various individuals to work together, address common issues, and identify sound approaches. For more information, please contact info@respond-project.org.

EngenderHealth and RH Reality Check

EngenderHealth is profiled in the latest e-newsletter from RH Reality Check with our new corporate video. A big thanks to them!

PBS's FRONTLINE/World and Obstetric Fistula in Sierra Leone

PBS's FRONTLINE/World recently published a video by Jenny Chu—Sierra Leone: Yeabu's Homecoming—about obstetric fistula in Sierra Leone, and listed EngenderHealth among organizations working on the issue (see the Links section). The 14-minute video focuses in part on Mercy Ships, one of the partners working with EngenderHealth on the global Fistula Care Project (managed by EngenderHealth).

For more information about this work, see the Sierra Leone country profiles at EngenderHealth.org and FistulaCare.org.

(Photo care of and copyrighted by WGBH/PBS.)

Video: Fistula Care Launches Activities at Fourth Guinean Hospital

(Video in French without subtitles.)

Every year, EngenderHealth organizes a national “Fistula Day” in Guinea to raise awareness of fistula among communities and key decision makers. Held this year on May 21, it marked the official launch of Fistula Care activities at a fourth site in Guinea, Labé Regional Hospital, the main hospital of the country’s central mountain region.

The opening ceremony, held at the amphitheater of the local training center, was well-attended by dignitaries from across the country, including the Governor and the Mayor of Labé, the Mayor of Kissidougou, officials from the Ministries of Health, Social Affairs, and Decentralization, and representatives of the U.S. Ambassador to Guinea and the Mission Director of the U.S. Agency for International Development (USAID), which supports Fistula Care. The Peace Corps, United Nations Population Fund, World Health Organization, OIC International, civil society organizations, the private sector, and the media were also represented.

To begin the proceedings, Labé Mayor El Hadj Amadou Thiam presented EngenderHealth with a key to the city. Accepting on behalf of the organization, the Vice President for Programs, Dr. Isaiah Ndong, later reflected that “this facility offers hope and the chance for a new life to women living with fistula throughout the Labé region.”

The Governor of Labé, the representative from USAID, and Ministry staff voiced their appreciation for the Fistula Care project. “One characteristic of the project is its big-picture consideration of all of fistula’s causes and its relevant strategy for sustainability, engaging technical departments from different partner Ministries and the community beneficiaries themselves,” said Dr. Cherif Sylla, General Secretary of the Ministry of Health and Public Hygiene.

A local youth group led a chant of the slogan “let’s fight together against fistula,” adding a spirited energy to the event. And three fistula survivors whose lives have been transformed by surgical repair shared emotional testimonies, including one who brought her infant, whom she gave birth to following a successful fistula repair.

Hundreds of peer educators invited the crowd to participate in a vibrant procession to the Labé Regional Hospital, where the General Secretary of the Ministry of Health and Dr. Ndong jointly cut the ribbon to celebrate the start of fistula repair services.

Fistula repairs at Labé began in early June. The hospital builds on the successful model Fistula Care developed at other sites in Guinea: Kissidougou District Hospital, Ignace Deen University Teaching Hospital, and Jean Paul II Hospital in Conakry. The Fistula Care project supports surgical repair, prevention, and reintegration into society for repaired women and creates partnerships between health facilities, communities, and local governments. Read more about Fistula Care’s activities in Guinea.

All For Good / Video Volunteers Promotion

If you have seen our YouTube channel, you know that we have put together some videos over the last few years. But there is a lot more to say. In particular, we need your help explaining why Americans should care about international family planning. We think it’s important, but if you have any video skills at all, we want to know what YOU think. That's where the YouTube Video Volunteers project comes in.

Just make videos of any kind, upload them to YouTube as “public”, then e-mail your video links to video@engenderhealth.org with the text “YouTube Video Volunteers” in the subject line. As long as your video is on-topic and meets YouTube’s guidelines, we'll make you an honorary member for a year! If we like the video, we'll add it to our favorites and will highlight the link on our web site.

For more information, visit www.engenderhealth.org/afg. Thank you!

EngenderHealth and the YouTube Video Volunteers

In partnership with AllForGood.org, United We Serve, and others, YouTube has launched the Video Volunteers channel -- and EngenderHealth is at the forefront. The project's launch video from the Vlog Brothers names us first, and we are both excited and honored by this.

About EngenderHealth: An Introduction to Our Work Around the World

Are you new to EngenderHealth? Or do you need help explaining what we do? Watch our new YouTube video for a good introduction to our work around the world, and please share it with friends!

Reflections on Mother's Day and Obstetric Fistula

Carrie Ngongo is the Program Coordinator for the Fistula Care Project, which is managed by EngenderHealth.

This is my first Mother’s Day as a mother: I am blessed to have a delightful baby girl who is growing, learning, and thriving. Becoming a mother has certainly given me a great deal of appreciation for all mothers. I’ve also found myself thinking about women who have not been so fortunate on their road to motherhood and who instead have faced great difficulty and loss along the way.

In March I had the opportunity to meet a group of inspiring women in Niger who had all been through traumatic labors. Each of these women had been eager to bring a baby into the world. They felt the joy of kicking in their wombs, and they talked to their growing babies as they went about their days, just as I did. Yet while I was in the care of an experienced doctor and delivered at a hospital in a major city, most of these women were in rural areas without the help of a skilled health provider. They labored and labored, but something wasn’t right: Their babies were not passing through the birth canal. By the time they were brought to a hospital for emergency care, it was too late. Their babies were dead.

This would have been loss enough, yet it didn’t stop there: They soon discovered that they were leaking urine, the result of obstetric fistula. They couldn’t control the flow, even if they tried not to drink much or used cloth to soak up the mess.

For some, their husbands and family members stood by them in spite of their smell, but many experienced rejection and isolation from those closest to them. Not only had they lost their babies, but they’d lost their health and their personal relationships too.

Fortunately, each of these women had found out that there was hope for them. Fistula can be repaired in most cases, and the women heard that surgical repair is available at Lamordé Hospital in Niamey. Lamordé is one of the hospitals supported by the Fistula Care Project, which EngenderHealth leads with funding from the U.S. Agency for International Development.

	Fistula survivors in Niger

At Lamordé Hospital there were 17 women who were hoping for healing. Lamordé has a structure set aside for women awaiting fistula repair surgery. It’s a plain building jammed full of simple bed frames, without power for fans or air-conditioning in the sub-Saharan heat. There’s space just next to it for women to cook or find shade to rest. Some of the women have been here for more than a month, waiting to be hospitalized for the treatment.

At first glance, providing fistula repair surgery seems straightforward. A trained surgical team in an equipped hospital is all you need—but it’s not so simple. In much of Africa, there are too few doctors to serve large, dispersed populations. Motivated surgeons need time to be trained and to advance their skills, especially because of the complexity of repair and the reality that no two fistulas are the same. One fistula surgeon in a hospital is often not enough, because that doctor may be called away. Moreover, fistula repair is never an emergency, and understaffed and overburdened hospitals can easily prioritize a thousand other important things.

As I talked with the women, I was amazed by their patience and endurance. These women have already been through plenty. How can we reduce the time they wait for surgery?

This was one of the subjects I discussed with the hospital staff who make fistula repair possible, including social workers, nurses, record keepers, and surgeons. We agreed that the Fistula Care Project will continue to train surgical teams and equip the hospital, so that client backlogs diminish over time. Together, we’re working on innovative solutions like supporting field trips for trained surgeons to travel between hospitals in order to pool their efforts, and encouraging hospitals to improve communication and record keeping in order to improve the quality of their services.

All 17 women whom I met in Niger have now had their lives transformed by fistula repair surgery. They are recovering, looking forward to returning to their homes and rebuilding their lives. Many hope to try to have a child again. Thanks to fistula repair surgery, they too may be mothers celebrating healthy babies on a Mother’s Day in the future.

Real men don’t cry – or do they?

The MenEngage Symposium in Rio, as well as EngenderHealth, were highlighted in a new article from IRIN, the news and analysis service of the UN Office for the Coordination of Humanitarian Affairs:

"Men don't cry. Men take risks. Men don't ask for help. Men are strong. Men have many sexual partners. These stereotypes of masculinity are contributing to the spread of HIV throughout the world, experts warned at a recent symposium on men and boys."

Read the full article online, and also check our our blogging from the event.

Promoting safe sex among Uganda's truck drivers

Our vice president of programs, Dr. Isaiah Ndong, was a recent guest writer for the Guardian:

"The greater number of truck drivers that will use the new road through Katine could pose increased risks of sexually transmitted infections in the area. It is vital drivers are encouraged to lead healthy lifestyles, argues Isaiah Ndong, from the charity EngenderHealth."

Read the full article here.

Live from MenEngage Rio: Men, Masculinities, Globalization, Development and Social Justice

Posted by Theresa Castillo

On the surface, there was a great deal of academic talk about “patriarchal masculinities” and the “masculinity of hegemony” at the “Men, Masculinities, Globalization, Development and Social Justice” session today (April 4). But for me it was another opportunity to think about the ways in which stereotypes are created and perpetuated in our daily lives.

One speaker, Juan Guillermo Figueroa from Colegio de Mexico, likened the way we socialize men through sports and competition as the “gym academy.” Men are allowed to hug and kiss each other on the field, but are discouraged to display any emotion outside of this sports context. This example highlights the importance of building spaces for men and communities to address such gender norms.

The MAP program has several strategies in place that tackle these deep-rooted behaviors and advance the global movement for social justice by empowering both men and women. We need to build on such successful programs. With more than 450 people, representing 80 countries, the Rio call for action commands a unified voice to help us move forward in our work and remain mindful. The possibility for change is very much in our hands.

Live from MenEngage Rio: Gender and Masculinities in Post-Conflict Settings

Posted by Theresa Castillo

Throughout the day, the one salient theme echoed by many of the presenters was the concept of privilege—reminding me that it is impossible to talk about gender without referencing power and who holds it.

For those of us who develop gender programs, we must be aware of the social, political, and economic dynamics that exist within a community. Several research documents explore these complicated dynamics and we should rely upon them to inform our work.

In the session “Gender and Masculinities in Post-Conflict Settings,” presenters described the extreme violence that young men and boys experience daily in the most poverty- stricken areas. The stories they told were overwhelming. While the research presented was moving, informative, and demonstrated the great demand for targeted services, there was no guidance given for implementing programs focused on men and boys in these settings.

Traditionally, there has been a dearth of guiding documents in this area. However, recently MAP has made great efforts to address these issues, through its work to engage men and boys in post-conflict and emergency settings.

Our curriculum provides a space for health and social service providers to discuss and plan for these different circumstances, considering the cultural, social, and political contexts that impact gender-based violence and the HIV epidemic.

This session has made me more hopeful that in the future we can share our best practices and come up with effective strategies to help this community of young men and boys.

Live from MenEngage Rio: How the Privileges of Patriarchy Can Work Against Men

Posted by Eric Ramírez-Ferrero

On day four of the conference, the workshop that clearly stood out for me was, “Gender and Masculinity in Post-Conflict Settings.” In it, we examined experiences of men in war-torn societies, including post-genocide Rwanda, northern Uganda and eastern Congo, East Timor and Gaza.

One speaker used an interesting phrase, “gender against men,” to describe how strict notions of manhood are a liability to those men who fall outside of the limits it sets, men who don’t live up to the expectations inherent in “being a man.”

In post-conflict settings, such men might include those who have been the victims of sexual violence. The speaker from Uganda showed a moving video documenting the experience of one Congolese man (his identity was protected) who candidly described the horror of being held prisoner by the forces fighting in eastern Congo: Over a period of days, he was repeatedly gang-raped by soldiers. Though the physical trauma was beyond daunting, this man also knew that his perpetrators’ intention was to humiliate him, to diminish him, to demonstrate their power over him by putting him “in his place”—as a “woman.”

This sounded disturbingly familiar. We know that, ultimately, rape is about power, even when both the perpetrator and victim are men. As an anthropologist, I also found it fascinating how gender definitions are used to make sense of those who have power and those who don’t. It’s not merely academic - it plays out daily in the most devastating ways: In these and other post-conflict settings, men who aren’t willing to fight—to take up that traditionally “male” role –are feminized and subject to the same reign of terrors as women.

Unfortunately, the humiliation of male victims of sexual violence is further compounded when they seek counseling and care. The limited systems available (in this case United Nations missions) to support survivors of rape are closed to men. Indeed, support workers’ own definition of rape has excluded men as possible victims, and even those who did “get it” conceded that, “We have programs for women at-risk and for those who traumatized by sexual violence, but we have nothing for men.”

The same speaker explained that this is in part a result of what he called “patriarchal feminism” – a one-sided concept wherein only women are vulnerable. He went on to say that this is quite damaging for women, too, because it limits them to the role of victims rather than as agents of change. He seemed to be saying that many efforts to promote women’s equality actually reinforce traditional visions of womanhood and manhood (thus the “patriarchy”).

I agree with the speaker that, inadvertently, some “empowerment” efforts may reinforce rather than change norms. But the term “patriarchal feminism” sounds like plain old patriarchy to me, because there is no doubt that pervasive and age-old ideals of what women and men should be and do really DO oppress women! Yet this workshop made clear that we all need to be more conscientious of and concerned by how the meanings of “manhood” affect men, too. Clearly, they continue to benefit men in power, but they render other men even more vulnerable and sometimes invisible—and in the worst cases, beyond the safety net of services and support.

Live from MenEngage Rio: Overcoming resistance to male involvement in health services

Posted by Eric Ramírez-Ferrero

One of the recurring themes at global symposium is the resistance to male involvement in reproductive and sexual health services that we’ve encountered around the world—resistance among individuals, in communities, and from governments. And it occurred to me yet again that this resistance may be due to simple lack of imagination: When people haven’t “seen” male involvement in practice, it’s hard to fathom what programs for men could look like. What resources are required to get men involved? What expertise is needed to start effective programs? And how would such programs affect current efforts that aim to improve women’s health and lives?

On Wednesday, I attended a training session on “Engaging Men and Boys in Clinic and Social Service Settings” in which we examined the nuts and bolts of programming and started to answer some of these questions.

The training, conducted in part by EngenderHealth’s own Manisha Mehta, started with a great activity where we were each put “in charge” of providing a health service focused on either men, or on couples, and asked to think about what our client, or clients, might need: Would it be counseling, clinical care (such as testing or treatment), health education, or would broader social marketing efforts be best? It got the room thinking about what we can easily offer from means within our reach.

My assignment was: “You are a nurse speaking with a couple in which one person is living with HIV, and the other does not have HIV. They want to know about their options for avoiding pregnancy and transmitting HIV.” (I decided this couple would need both health education and counseling—perhaps slightly more counseling.)

This activity led to enthusiastic conversations and demonstrated a diversity of what male involvement programming can look like, the huge range of services that are possible, that many services can be offered at low or no cost, and—perhaps best of all—that they actually could be integrated alongside existing services for women. In fact, there was a consensus that for reasons of ethics, equity, and sustainability, an integrated approach (rather than offering separate men’s services) really makes the most sense in settings like Tanzania, where there are is already a shortage of health services.

Next, we were divided into groups and given a case study. My group examined why young people in general—those between the ages of 15 and 24—and young men in particular are reluctant to use health services, even when they are designed to be “youth-friendly.”

We also had a larger discussion of why men are reluctant to use services ostensibly designed for them—so-called “male-friendly” services. We cited many reasons, but ultimately it seems like it’s a vicious cycle: Men don’t seek services, so health clinics become geared towards women, which means that they become “women’s” places, and then men won’t go to get care because clinics are “for women.” There’s also the reality that many health clinics aren’t open during hours that men have time to go.

I was lucky that my group included a senior member from Tanzania’s Ministry of Health. We talked very concretely about how CHAMPION and the Ministry could collaborate to provide male- and couple-friendly services. It was so encouraging to see the Ministry representative’s enthusiasm for integrating services—everything from prostrate cancer screenings, to counseling for sexual anxiety and dysfunction, to better vasectomy services, and improved treatment for sexually transmitted infections—as a start!

As importantly, we discussed how we might offer counseling to men—in a site outside of a clinic—that can help them examine and start to change behaviors (like having multiple sexual partners at the same time) that make them more likely to spread HIV.

This conversation cemented a key point of the training workshop: Male-friendly services cannot exist in a vacuum. Instead, they need to be an integral part of a continuum of care for whole families. This is what will make a difference in the lives of men, women and children.

Maternal Health Task Force is now officially on-line

We're happy to announce the launch of the Maternal Health Task Force web site! In the words of Ann K. Blanc, the project's director...

I’m happy to let you know that the Maternal Health Task Force is now officially on-line! We launched our website late yesterday at www.maternalhealthtaskforce.org. You’ll note that it’s a very simple site at this stage – we will be expanding its capacity and extending its reach significantly as the information systems and knowledge management strategies for the project take shape. Stay tuned… much more to come!

It is primarily a blog at this point, but will be growing in the near future.

The Kerry-Lugar amendment passed by unanimous consent!

The Kerry-Lugar amendment just passed in the Senate by unanimous consent! Thank you to everyone who sent your Senators a letter supporting the Kerry-Lugar Amendment. Our collective efforts paid off.

With your help, we can continue to make sure our leaders stay committed to global health. If you have not already done so, please join our 3FOR1 campaign at http://www.3FOR1.org in support of international family planning—watch the video, send the letter to President Obama, and spread the word. Thank you!

Live from MenEngage Rio: Men, sexual health, and homophobia

Posted by Flavian Rhode

This afternoon I attended a workshop addressing homophobia and discrimination. It wasn’t at all what I expected. Instead, I found myself thinking in new ways about the implications of the rigid definitions and expectations of “male” and “female.”

I learned that in some places in South Asia, you’re considered gay only if you are the “receiver” in a sexual relationship with another man. If you are not the “receiver” (how would anyone ever find out?!) you’ll never be thought of as gay—even if you have no interest in ever having a sexual relationship with a woman!

In Namibia, where I live and work, some people look at a man who is gay and think that actually he wants to be a woman. It’s the easiest way for them to make sense of it, even though it really makes no sense at all.

This got me thinking about my work with young men and young women and how, on the one hand, we are always trying to do a better job of including people who identify themselves as lesbian, gay, and transgendered. Yet on the other hand, our work is about helping people—all people—express themselves in healthy ways, to give them the strength to never engage in behaviors that would ever cause harm to another, and that they also the skills to protect themselves if needed. If you talk to all men about their sexual health, does it really matter what kind of sex they’re having?

Live from MenEngage Rio: Inclusion of minority populations

Posted by Theresa Castillo

Today, breakout sessions offered a chance to really explore importance of inclusion, which basically means making programs as inclusive of minority populations as possible. This means including indigenous populations, migrants, refugees, the transgendered, commercial sex workers, and other marginalized groups. Usually, these groups are left out of conversations about improving health, improving communities, and creating a better life for everyone.

In our MAP work, we are aware of these vulnerable populations and include them in our outreach. One example is our new MARPs work in Ethiopia which directs HIV prevention efforts to the most at- risk, yet hard-to-reach, populations, including commercial sex workers. Achieving a gender-equitable world means that all people can enjoy human rights, including the right to health care. Moving forward, we need to continue expanding our reach so that as men become partners in the global call for gender equality, these groups remain an integral part of the conversation.

Live from MenEngage Rio: Day Two

Posted by Eric Ramírez-Ferrero

The morning of day two I viewed the Symposium’s photo exhibit entitled, “The World’s Most Influential Men,” which highlights positive male role models for boys (and girls, too!) from 20 countries. Even more than the photos, I was moved by the accompanying captions. In particular, a beautiful portrait of a father and son from Ethiopia was tagged with the quote, “To the world you may be one person, but to one person you may be the world.”

Another photo was a powerful reminder that men’s roles are not limited to fatherhood but span the entire community—from brothers and uncles, to teachers, coaches, to local government leaders: One man’s beliefs and acts really do impact an extended network of people.

At CHAMPION, we had a similar idea. Our formative research revealed that most Tanzanians thought that gender equitable men did not exist. We thought it was critical to show that they did exist, that all over Tanzania there are men working for the health of their families and communities. We created a photo and story calendar of male “champions” from around the nation, and mounted an exhibit at our recent project launch.

The most provocative session of the day for me was the “Dialogue with Women’s Rights Movements,” which began with personal reflections by the speakers about how they came to their work (how have all of us ended up in this room together?) and later turned to recent press coverage of a disturbing trend in Brazil: the high incidence of rape and molestation of young girls and women. Where is the public outrage from men? they asked. There are gender-equitable men in all of our communities, and among our leaders. But where is their leadership at times like this? Where are their voices?

The photos and speakers in this and other sessions affirmed the importance of gender-equitable men speaking out – of our need to both see and hear them: Men who truly believe in the possibility of a transformed world have a responsibility to be visible, and to challenge other men’s sexist and damaging behaviors.

Global Health Funding At Risk: Take Action Now!

Click here NOW to contact your senators.

As you know, we have been urging President Obama and the U.S. Congress to commit $1 billion to international family planning programs in 2010--which would be part of the Federal International Affairs Budget. The House and Senate budget committees have now approved a 2010 budget with significantly less funding for international affairs than in President Obama's original budget proposal, which called for $53.8 billion. The House committee proposes spending 10% less on international affairs than President Obama's budget, and the Senate committee calls for a 7.4% reduction.

The International Affairs Budget supports critical global development and health initiatives that save children's lives, prevent the spread of HIV and malaria, and provide women and couples with lifesaving family planning that lets them plan their futures and offers opportunities to escape the cycle of poverty. We need to ensure Congress fully funds these vital international programs. The global financial crisis has only worsened conditions for the world's most vulnerable people, and our support now can significantly impact their lives.

Senators John Kerry (D-MA) and Richard Lugar (R-IN) have introduced an amendment in the Senate to restore President Obama's original request level for the International Affairs Budget. It is very important that you e-mail a letter to your Senators and urge them to co-sponsor and vote for the Kerry-Lugar Amendment and oppose any other reductions in funding. You can also call the Senate switchboard at (202) 224-3121 and ask to speak your Senator's office.

The time to act is now. Make sure your voice is heard! Go to www.engenderhealth.org/s2010 and send the message to your senators.

If I Had a Billion Dollars...

(This post by Dr. Isaiah Ndong, M.D., M.P.H., is Vice President for Programs at EngenderHealth, recently appeared on Reproductive Health Reality Check.)

If I had a billion dollars, I know exactly how I would spend it: improving women's access to family planning in the world's poorest communities.

Some might think this is an unusual choice. But throughout my 29-year career as a doctor and public health professional working in developing countries, I have seen first-hand how contraception can change women's lives-allowing them and their families to survive, thrive, and plan for better futures.

We need to remember - amidst daily reports about a troubled economy here in the United States - that many of those living on the other side of the world confront daily emergencies of their own: poverty, malnutrition, HIV and AIDS, lack of health care, civil strife, and depleted environmental resources.

There's no doubt that $1 billion is a lot of money. But for what amounts to just .03% of President Obama's proposed federal budget, a $1 billion investment in family planning can help mitigate all of these challenges at once.

Family planning as a global health and development priority does not get the attention it deserves, particularly the direct connection between population and poverty. The chances that you can achieve a better life for your family are diminished when you are struggling just to feed and support your children. But with smaller families, parents can afford more for each child-providing better food, shelter, education, and health care-and can save more. This greatly improves their chances of breaking the cycle of poverty.

With better access to family planning come opportunities to improve social, political, and environmental conditions. When women and couples can decide when to have children, their opportunities outside the home can also expand, and they may contribute more to their communities socially and economically. There is less competition for food, jobs, and housing and more equitable and less harmful use of natural resources. For families in rural areas, this could reduce the need to seek a better life in urban areas, where the daily influx of new migrants strains already limited infrastructure.

Yet right now, millions of women and couples who wish to limit or space their births have no way to access the contraception that would let them do so. Over the last several years, U.S. support for family planning programs has dwindled while the need for it has increased, and few donors have stepped in to fill this gap. So a good portion of a $1 billion investment is needed just to rebuild these programs to the levels they were at several years ago. And across Africa and Asia, high levels of unmet need for contraception are likely to only grow as the largest youth generation in the world's history comes of reproductive age.

These are all compelling reasons to support family planning, but the bottom line for me is that it is a right, and not having access to it is a price paid in women's lives. Maternal mortality continues to devastate families - with more than 500,000 women dying during pregnancy or childbirth every year. Up to one-third of these deaths could be prevented if women had access to contraception. And, family planning reduces deaths from AIDS; it is the most effective way of preventing mother-to-child transmission of HIV.

the coming weeks, President Obama will be making allocations for the fiscal year 2010 federal budget. Please join me in calling on him to raise the United States commitment to international family planning programs to $1 billion in 2010-less than a penny per day per American.

It's sure to be one of our wisest investments.

Visit www.3for1.org or www.engenderhealth.org to send President Obama a letter and join our campaign.

Live from MenEngage Rio: How do we focus on well-being?

Posted by Theresa Castillo

In today’s plenary session, “Including Men and Masculinities in Gender Equality Policies,” one of the speakers said something that really struck me. Annikenn Huitfeldt, the Minister of Gender Equality and Children in Norway, posed the question, “How do we move from discussing “being well” to focusing on well-being?” She challenged us to think about all of the factors that comprise a person’s well-being, and that lead to a family’s well-being.

In the context of male engagement, one aspect of well-being for many men is being able to be fully involved in family life, yet laws and policies don’t always support this. To support well-being for everyone—men, women, and families—national policies are needed in many, many countries that grant men paternity leave, that allow men to be present in labor and delivery rooms, even for something as simple has making sure that there are family diaper stations in public restrooms.

Ms. Huitfeldt’s speech illustrated perfectly the need to work at all levels to bring about change, and affirmed for me that in the Men As Partners program, we’re definitely on the right track.

Live from MenEngage Rio: Gender Equality as a Human Right

Posted by Theresa Castillo

The opening session here at MenEngage reminded me that I was witnessing a historic moment: The focus on engaging men and boys to achieve gender equity has emerged as a top priority for both human rights and public health activists and advocates in recent years.

The Symposium, and the support it is receiving from UN agencies, is a testament to this positive change. The conversation is no longer about why it is important to involve men; instead, we are now talking about how to scale up current partnerships, advocacy efforts and effective programming. It is an inspiring time to be in this field.

In the coming week, I hope we have a chance to examine the shared responsibility among both men and women for bringing about change—it is not only men who hold traditional attitudes about gender role. Women, too, may reinforce such stereotypes. Seemingly innocent comments like "take it like a man" are really reminders that boys and men should hide their emotions or else they could be viewed as being too "feminine"—too weak. Every unchallenged stereotype becomes a step back in achieving gender equality and social justice. We can all change this as individuals, which leads to community change, which leads to.... As I said, it's an inspiring time to be in this field.

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Theresa P. Castillo has worked domestically and internationally in the fields of sexual and reproductive health, adolescent mental health and health disparities for over 14 years. She received her A.B. in psychology and pre-medicine from University of Chicago. Her graduate training includes a Masters degree in Public Health Education with a focus on women’s health, violence prevention, and cultural competency among immigrant/ refugee populations from Columbia University. She is a Certified Health Education Specialist, Returned U.S. Peace Corps Volunteer and was an Emerging Leaders fellow for the U.S. Department of Health and Human Services. Currently, Theresa is a Senior Program Associate for EngenderHealth with the Men As Partners® Program. She lives in New York.

Live from MenEngage Rio: Opening ceremony

Posted by Flavian Rhode

The magnitude of what I am a part of hit me square in the face listening to the introductory remarks during of the Global Symposium for Engaging Men and Boys in beautiful Rio de Janeiro. For the first time, I was in a room surrounded by people who really get what my work is about, people who are passionate, driven and committed to making gender equity a worldwide reality.

The Symposium is helping us learn from one another and reinforcing that we’re all together on this journey. But more than that, once again I realize that the smallest act can lead to positive change. It takes but one person....what have I done to make a change today?....what about you?....Ciao.

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Flavian Rhode is currently working with EngenderHealth's Men As Partners® program in Namibia, assisting local organizations in incorporating male engagement activities into their programs. Mr. Rhode was formerly head of ChildLine. He also has experience in counseling, particularly couples counseling and relationships. Mr. Rhode has tertiary postgraduate qualifications in psychology and the performing arts. He is currently enrolled at the University of Stellenbosch, where he is pursuing a Masters degree in Public Health.

Live from MenEngage Rio: Empty Chairs No More?

Posted by Eric Ramírez-Ferrero

The Global Symposium on Engaging Men and Boys in Achieving Gender Equity kicked off at 6 p.m. on March 30, with leaders of UNICEF, UNAIDS, WHO and UNIFEM among those welcoming participants from more than 70 countries.

The mood was celebratory-the fact that more than 450 of us had gathered for the first global event for activists and practitioners supportive of male involvement was a reason to cheer! But there was also a cautionary tone: let's be realistic.we have a long way to go.

One veteran of the women's rights movement, Kim Bolduc, UN Resident Coordinator for Brazil, offered an image that stuck in my mind: Historically, when women gathered in global forums to act on issues related to gender equity and, ultimately, the well-being of women and families, there were often empty chairs. These empty chairs represented missing men, whose presence and commitment could have profoundly impacted and expedited progress on a range of sexual and reproductive health issues. I found this a mournful and regretful metaphor for opportunities lost.

Nevertheless, a spirit of hope pervaded and the speakers repeatedly lauded the efforts of individuals, organizations and governments for recognizing a basic idea - one which has informed EngenderHealth's own Men As Partners Program for more than 12 years: The beliefs and actions of men are intimately linked to the social well-being and public health of men, women and children.

Here in Rio, the chairs are full. Over the course of this week, the Symposium will examine how positive male involvement can lead to better health, indeed to a better life, for everyone. It's an issue I think about daily, and it reaffirms for me our decision to make CHAMPION about families. Our byline is "Men as facilitators of family health." We are building on men's capacity for leadership to act on behalf of their partners and families-the people who matter to them the most-while working to sensitize them, communities and policy makers that gender equality has health benefits for us all.

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Eric Ramírez-Ferrero was born in New York City in 1963 of Cuban immigrant parents. He was raised in New York and in Enid, Oklahoma. He received his A.B. in biology and anthropology from Bennington College in 1985. His graduate training includes an M.P.H. in population, family and reproductive health from the Bloomberg School of Public Health of Johns Hopkins University, and an A.M. and Ph.D. in anthropology from Stanford University, where he specialized in critical medical anthropology and feminist theory. His doctoral dissertation, Troubled Fields: Men, Emotions and the Crisis in American Farming (Columbia University Press, 2005), is a feminist analysis of men’s health in light of the ongoing economic restructuring of rural communities in the United States. Ramírez-Ferrero has taught at Oklahoma State University and the University of Tulsa. He has worked domestically and internationally in the promotion of reproductive and sexual health for the Area Health Education Centers Program, Planned Parenthood, and Family Health International. He is currently chief of party for EngenderHealth in Tanzania, leading CHAMPION—a project to promote positive male involvement in the prevention of HIV and other adverse reproductive health outcomes. He lives in Dar es Salaam.

Ten Thousand Women with Fistula Receive Life-Changing Surgery

Dear colleagues and friends,

EngenderHealth and the U.S. Agency for International Development (USAID) today celebrate a milestone in global maternal health: A total of 10,000 women have received fistula repair surgery with U.S. support since 2005. Fistula, a devastating childbirth injury affecting millions of women in developing countries, can be surgically repaired up to 90% of the time, but most of those with the condition lack access to a skilled surgeon or health center, making treatment out of reach.

Four years ago, USAID launched a global effort to both treat and prevent fistula. To date, through initiatives such as the EngenderHealth-led Fistula Care Project, and in collaboration with local governments, regional health care organizations, and faith-based organizations, medical teams in 12 countries and 25 health facilities across Africa and Asia have been trained and equipped to provide surgery for fistula.

It is these trained medical professionals, as well as their supporting institutions, whose dedication has made it possible for 10,000 women to regain dignity and hope through fistula repair surgery. We honor the tireless efforts of the surgical teams as we mark this maternal health milestone.

Obstetric fistula is an injury caused by prolonged obstructed labor, when the head of the baby cannot pass safely through the woman's birth canal. The baby often dies as a result, and the woman is left with an abnormal opening in the birth canal and chronic incontinence. If left untreated, fistula can lead to skin ulcerations and infections, kidney disease, social isolation, and even death.

The hopeful part of the story is that in addition to most cases being reparable, fistula is almost entirely preventable. This is why the Fistula Care Project is working to improve access to emergency obstetric care and cesarean section for women who develop complications during delivery. Together with skilled attendance at all births and the availability of voluntary family planning, this could make fistula as rare in the developing world as it is in the industrialized world. The Fistula Care Project is working to engage all levels of society to raise awareness about fistula and its underlying causes, including early pregnancy, poverty, and a lack of education and empowerment for women and girls.

As the largest USAID-supported effort to both treat and prevent fistula, the Fistula Care Project will keep you apprised of our work to transform the lives of thousands more women and girls around the world--work that is possible thanks to your partnership. To learn more, please visit our web site at www.fistulacare.org.



Gratefully yours,

Karen J. Beattie
Project Director
Fistula Care Project





The Fistula Care Project is a five-year cooperative agreement funded by USAID and managed by EngenderHealth. The project works to address the enormous backlog of women awaiting life-altering fistula repair, ensuring that they receive timely and quality care from trained providers. At the same time, it works to remove barriers to emergency obstetric care that lead to fistula in the first place, so that women in labor get to the right place with the right services at the right time. The project is supporting a network of facilities offering a continuum of services, from emergency obstetric care, referrals, and family planning to complex fistula repairs and advanced surgical training. Visit www.fistulacare.org for more information or contact fistulacare@engenderhealth.org.

The American people, through USAID, have provided economic and humanitarian assistance worldwide for nearly 50 years. For more information about USAID and its programs, visit www.usaid.gov.