EngenderHealth Receives Award from Manhattan Young Democrats

On March 21, EngenderHealth received an award from the Manhattan Young Democrats (MYD) for our work to improve the quality of reproductive health care around the world. EngenderHealth President Pamela Barnes accepted the award on behalf of the organization at Engendering Progress, MYD’s third annual event honoring women leaders, activists, and entrepreneurs.

MYD is an all-volunteer organization committed to educating and activating young progressives for social change. Also in attendance at the event was Hollaback!, a movement dedicated to ending street harassment using mobile technology, and Catalyst, a nonprofit organization expanding opportunities for women and business.

True Heroes of the Congo

When Dr. Christophe Kimona treated a young mother for her fistula recently, he repaired more than just her body—she said he restored her spirit.

“I am motivated by compassion for women who have no other sources of support,” Dr. Kimona said. “It is satisfying to aid my fellow countrymen and women.”

His colleagues agree that “it is the work of the heart.”  Dr. Kimona, Dr. Mukwege, Dr. Amisi, Dr. Nembunzu, Dr. Ahuka, Dr. Manga, Dr. Mubikayi, Dr. Tchangou, Dr. Denon, Dr. Aime-Manga—these are the names of some of the dedicated surgeons who are healing women living with obstetric fistula in the Democratic Republic of the Congo (DRC). They are few in number.

Patients come to them in despair, many having been abandoned by their husbands or family and sometimes having lost their will to live. Many have endured years of isolation because of their fistula, a devastating condition in which a hole develops between the birthing canal and the bladder or rectum, causing chronic incontinence. Fistula can result from prolonged or obstructed labor when women lack access to emergency obstetric care.  In the Eastern Congo, a region plagued by years of conflict, fistula has also been caused by sexual violence. 

Yet, in the face of the most difficult circumstances, these surgeons, together with their teams of nurses, anesthetists, social workers, and administrators, find a way every day to restore dignity and hope for women.

These are the individuals whom U.S. Secretary of State Hillary Rodham Clinton calls “true heroes” in the Congo—a selfless breed of surgeons, nurses, and other staff who dedicate themselves to giving women with fistula a second chance at a fulfilling, productive life.
 

A Community of Practice

Last week, for the third year in a row, these surgeons came together with staff from the Ministry of Health and others who provide care and advocate for women with fistula to review progress in providing these services in the Congo. Coinciding with International Women’s Day, the March 8-9 meeting was hosted by Fistula Care (managed by EngenderHealth and funded by USAID) and Panzi Hospital, a facility supported by the project in Bukavu, South Kivu Province of Eastern Congo. 

On March 8, Secretary Clinton sent a message to the participants, commending them for their dedication: “Facing difficult challenges every single day, the surgeons and health care providers at this meeting are truly heroes, committed to supporting Congolese women and girls by providing the high-quality fistula services that are desperately needed to restore health, dignity, and lives.”

The community of practice (CoP) included fistula surgeons, nurses, anesthesiologists, social workers, and administrators, many of whom are women and all of whom work in fistula repair and prevention. Also present were local partners, Ministry of Health representatives, and global players such as the United Nations Population Fund, World Health Organization, and U.S. Agency for International Development.

Fistula Prevention, Surgeon Training, and a National Strategy for Fistula

Participants discussed the successes and obstacles of working in an environment where access to resources for surgical care is challenging. The surgeons emphasized time and again the importance of increasing access to quality emergency obstetric services to prevent fistula from happening in the first place. Mme Lucie Zikudieka from PROSANI, a USAID-funded integrated health project, reviewed with participants the recent national revision to the partograph and the plans for its introduction. The tool is used to monitor and manage women in labor and delivery to ensure that appropriate actions are taken if complications arise. 

Professor Serigne Magueye Gueye, an eminent Senegalese urologist, led a discussion on training fistula surgeons and introduced a recently completed, internationally recognized Competency-based Training Manual for Fistula Surgery. Participants agreed on the need for a formalized training strategy for fistula surgery as part of a national strategy to address obstetric fistula, which participants also reviewed.  Women’s health advocates have long fought for a high-level plan, which would establish policies to increase access to quality fistula services.

In all, the annual CoP meetings have provided a space for surgeons, practitioners, and policy makers to work together toward a unified vision for addressing obstetric fistula. Dr. Denis Mukwege, Founder and Director of Panzi Hospital, made an impassioned plea to the Ministry of Health to urgently finalize and implement the strategy. Every day of delay means more women continue to experience this devastating condition.  Fistula Care will work with the Ministry and other key stakeholders to advance the strategy within the next few months. For more information, visit www.fistulacare.org.

EngenderHealth’s Postabortion Care Work Wins Spot in Top 50 Ideas for Women & Girls

EngenderHealth’s postabortion care work has earned a spot on Women Deliver’s Top 50 most inspiring ideas and solutions for women and girls around the world.

Launched in honor of International Women’s Day, the competition saw hundreds of submissions from 103 countries. More than 6,000 individuals voted for their favorite ideas and solutions. Thank you to all of our supporters who voted for us and made this happen!

Our Work in Postabortion Care

For nearly two decades, EngenderHealth has partnered with developing country Ministries of Health to strengthen and modernize health systems to provide effective postabortion care. Abortion is severely restricted throughout most of the developing world, where more than half of all induced abortions are unsafe. Performed by unskilled people, often in unsanitary environments, such abortions account for roughly 46,500 deaths per year.

EngenderHealth’s programs have trained more than 15,000 clinicians—from community-based health workers to physicians—to use low-tech, lifesaving tools, such as manual vacuum aspirators and misoprostol, for treatment of complications from abortion. Healthcare providers are trained to provide counseling for family planning and referrals for other reproductive health services to improve women’s health over the long term. With timely care from a trained provider, this program prevents the needless deaths of thousands of women from unsafe abortion.

For more on our postabortion care work, visit our website.

On the Hill: Recent Legislative Actions for Women’s Reproductive Health and Rights

The U.S. Senate last month addressed a number of issues affecting the health and rights of women and girls, including a bill against child marriage passed by the Senate Foreign Relations Committee, a vote by the Senate Judiciary Committee to renew the landmark Violence Against Women Act (VAWA), as well as a new campaign by Democratic Senators, One Million Strong for Women, in response to recent political attacks on women’s health and rights.

Senate Foreign Relations Committee Passes Child Marriage Bill

The Senate Foreign Relations Committee passed a bill seeking to protect girls in developing countries by ending child marriage. Introduced by Senators Dick Durbin (D-IL) and Olympia Snow (R-ME), the International Protecting Girls by Preventing Child Marriage Act (S.414) would require the U.S. government to develop a strategy toward ending the practice and authorize the President to provide assistance to reduce child marriage. In late 2012, a similar bill passed unanimously in the Senate but was blocked in the House of Representatives.

Senate Judiciary Committee Approves Landmark Domestic Violence Bill

The Senate Judiciary Committee voted to reauthorize the U.S. Violence Against Women Act (VAWA), a landmark and historically bipartisan bill first signed by President Bill Clinton in 1994. The bill (S.1925) seeks to improve law enforcement’s capacity to respond to reports of domestic violence and sexual assault and to improve protections for victims. In 2000 and 2005, the bill was reauthorized with bipartisan support. But this year, for first time, the bill received a party-line vote of 10-8 in committee. The legislation is now on the calendar for consideration by the full Senate.

Congressional Democrats Launch “One Million Strong for Women” Campaign

In a collective response to recent attacks on women’s health and rights, including abortion rights, contraception, and Planned Parenthood, 16 Democratic senators and representatives have launched One Million Strong for Women, a campaign that reaffirms their commitment to protecting women’s health and rights. To date, nearly 270,000 people have signed the campaign in support of the cause.

Is CEDAW Making a Difference in Women’s Rights and Equality?

Question: What does the United States have in common with Iran, Somalia, Sudan, South Sudan, Palau, and Tonga? 

Answer: None has committed to the United Nations Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)—the most comprehensive global treaty affirming the human rights of women.

This month, an international committee will convene in Geneva, Switzerland, to review country-level progress in implementing the landmark convention. Slated for February 13–March 2, the 51st Session of the Committee on the Elimination of Discrimination against Women will review reports on women’s rights submitted by nations that have ratified CEDAW, a periodic exercise to assess whether CEDAW is helping to advance women’s rights and where improvements could be made.

To date, the United States remains the only developed country in the world that has not ratified the treaty, in spite of having assisted in drafting the document in the 1970s. Proponents of CEDAW point to the treaty’s successes in advancing women’s rights globally—including in Bangladesh, where CEDAW was used to attain gender equality in schools, and in Mexico, where treaty language was used in a law prohibiting gender-based violence that was later passed.

Skeptics in the U.S. Congress have questioned the vagueness of the treaty language, looking to attach qualifications known as “reservations, understandings, and declarations” (RUDs), including the understanding that ratification would not create a right to abortion or compel the government to extend maternity leave.

Looking Back on CEDAW in the United States

After taking office in 2009, President Barack Obama included CEDAW in his list of five priority multilateral treaties, calling it an “important priority.” No advances have been made toward ratification to date. Becoming an official party to CEDAW would require the president’s signature, along with at least two-thirds support (67 votes) within the U.S. Senate.

On two previous occasions, the Senate Foreign Relations Committee voted favorably for the treaty with bipartisan support—in 1994 (13-5) under President Bill Clinton and in 2002 (12-7) under President George W. Bush. But since its adoption by the United Nations in 1979, CEDAW has never been brought before the full Senate for a vote. In 1980, President Jimmy Carter had also signed the treaty, but without the Senate support needed for official ratification.

The most recent legislative action on the issue was a bill introduced in the U.S. House by Rep. Lynn Woolsey (D-CA) about one year ago, promoting Senate support for the treaty. No further action was taken after it was referred to the House Foreign Affairs subcommittee on Africa, Global Health, and Human Rights. Previously, in November 2010, Sen. Dick Durbin (D-IL) chaired the first Senate hearing on the issue since 2002, but came short of bringing the issue before the full Senate.

…And the Shorty Awards Winner for Best #Charity in Social Media is _____________

Help us fill in this blank with @EngenderHealth!

We’ve been nominated for a 2012 Shorty Award for Best #Charity in Social Media. Every year, the Shorty Awards honors the best producers of short content on social media. Learn more about these awards here. 

We’ve enjoyed sharing our work and passion for reproductive health in the form of 140-character text bytes. Now, we’re asking YOU to craft one for us!

Please take 1 minute to cast a vote and give a reason:

“I nominate @EngenderHealth for a Shorty Award in #charity because... <fill in the blank>”

After you’re done, pass the word on! Shorty Awards makes it easy to tweet it, share it, forward it. Check out some other free promotional tools on our profile page.

Many thanks from EngenderHealth!

EngenderHealth on the Move

International conferences are always on our agenda. But this winter has been particularly busy so far, with staff attending the International Conference on Family Planning in Dakar, Senegal, and the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Addis Ababa, Ethiopia. Since our field staff cannot pack you in their suitcases and take you with them—they’re just not that strong!—we asked them to tell you a little about their experiences now that they are back home. 

 

2011 International Conference on Family Planning, Dakar: JAWEER BROWN (Technical Advisor, Family Planning)

What were some of your favorite moments from the conference, and why?

One of my personal highlights from the conference was a presentation by a young activist living with HIV. He really moved me and set the stage for my experience in Dakar. Against the backdrop of a large tent and competing with the rumblings of an enthusiastic audience, the activist reminded us of the human face behind the words family planning, HIV, systems strengthening, development, and all the jargon we use in our work. He represented the lives of so many we refer to as “client,” ”population,” or ”user.” With a palpable candor and passion, he pressed us to adhere to our commitments to make real change and embodied the purpose of our work: to meet the urgent sexual and reproductive health needs of young people like him.

Were there any takeaways from discussions surrounding the issue of HIV risk and hormonal injections?

Going into the conference, we knew the facts surrounding this important issue. An important takeaway that emerged on this topic, however, is the fact that we may never have conclusive evidence about a link between hormonal contraceptives and HIV risk. Strong leadership, therefore, is vital for proceeding within this uncertainty. This will involve investing more resources and attention to expand the contraceptive choices available to women and increase access to a wide method mix, including long-acting and permanent methods of family planning.

What other research highlights received special attention from conference participants?

I am a tech geek in disguise, and I really enjoyed a presentation on new contraceptive technologies. Two innovations in particular caught my eye: the microbicide/hormonal contraceptive ring, and the development of a topical gel contraceptive. 

What were some major contributions EngenderHealth made at the conference?

EngenderHealth contributed a great deal to the Implementing Best Practices (IBP) sessions, which were another major highlight of my experience in Dakar. The format of these sessions was unique.  Rather than Powerpoint presentations followed by a question-and-answer period, the sessions were broken up into roundtables, allowing for open dialogue in small groups of 8–10 people. It was a rare opportunity to sit down with colleagues and experts from around the world and take a bird’s eye view at what we do and how we do it.

2011 International Conference on AIDS and STIs in Africa, Addis Ababa: MARK BARONE (Senior Medical Associate)

What were some of your favorite moments from the conference, and why?

A favorite moment from the conference was a presentation that my colleague Dr. Quentin Awori delivered on our randomized controlled trial of the Shang Ring versus conventional male circumcision in Kenya and Zambia. Dr. Awori works in Homa Bay, Kenya, and is a co-investigator on the study. He is an up-and-coming young researcher, which made it even more gratifying to see our work presented by him. The presentation generated a lot of discussion and offered great hope that a device will simplify male circumcision and allow for more rapid scale-up.

I also particularly enjoyed the opportunity that the conference presented to connect with many of the people that I know who are working in the field of HIV and to meet new people. Conferences like this provide a venue to learn not only from the actual conference sessions, but also to talk with others and get a better sense of what is going on more broadly in the field  and to create opportunities for future collaborations.

What other research highlights received special attention from conference participants?

Voluntary medical male circumcision received a great deal of attention during ICASA, including a number of special sessions and many oral and poster presentations. I hope that emphasis on this proven HIV prevention intervention will spur along some of the programs in Sub-Saharan Africa that have been lagging a bit.

What work did EngenderHealth present, and how did it fit into the overall conference narrative and themes?

EngenderHealth was well represented at the conference, with oral and poster presentations that highlighted our work in voluntary medical male circumcision for HIV prevention, gender, and our work with most-at-risk populations (MARPs). We also had a booth in the exhibition area highlighting our HIV-related work, with a special focus on our work with MARPs in Ethiopia.

Teaming Up for Respectful Maternity Care

Pregnancy and childbirth are momentous events in the lives of women and families everywhere. But too often, a woman's experience with her health care providers results in lasting damage and emotional trauma, rather than comfort and trust.

This is why EngenderHealth is partnering with the White Ribbon Alliance to promote Respectful Maternity Care, a campaign to raise awareness of the disrespectful treatment that many women experience in seeking and receiving maternity care.

To learn more, read our guest blog on the White Ribbon Alliance website.

Repro Health in Review: 11 Highlights of 2011

We saw a number of significant moments in global reproductive health during 2011 -- from historic court rulings to scientific breakthroughs to the launch of a new UN agency dedicated to women's equality and empowerment. Check out our digital timeline of 2011 highlights! Or scroll down for a complete list.

Repro Health in Review: 11 Highlights of 2011 on Dipity.

October 31: The world’s 7 billionth baby joins the global community.

October 4: A study published in Lancet Infectious Diseases (October issue) suggests a possible link between hormonal contraceptives and HIV.

August 10: The UN CEDAW issues an historic ruling that governments have a human rights obligation to guarantee access to maternal health services.

August 1:  The Obama Administration issues new standards requiring health insurance plans to cover women's contraceptives without co-payments.

July 6: In a 2-1 decision, a New York appeals court ruled that the “anti-prostitution pledge” violates the First Amendment by forcing funding recipients to take on the government’s viewpoint as if it were their own.

May 17: The World Health Organization expands its list of essential medicines to include misoprostol, a lifesaving drug that prevents postpartum hemorrhage, a leading cause of maternal death.

May 12: A study by National Institute of Allergy and Infectious Diseases reveals that early treatment for HIV patients can significantly reduce chances of transmission.

April 15: The U.S. Congress passes the FY2011 Continuing Resolution, ending a budgetary impasse that sparked a nationwide debate about women’s reproductive health and rights.

March 3: Two Ugandan families take maternal health rights into their own hands by bringing a lawsuit against their government for the needless deaths of two mothers in a North Uganda clinic.

February 1: A 2010 Demographic Health Survey in Bangladesh reveals a significant 40% decline in maternal mortality in less than a decade. Learn about EngenderHealth’s role in improving maternal health in Bangladesh.

February 24: Secretary General launches UN Women, signifying a historic step to marshal resources and mandates for greater impact in gender equality and women’s empowerment.

January 6: 600 UK women reported unwanted pregnancies while using the Implanon contraceptive implant, creating a pregnancy scare among clients. Read our commentary on the role of training for implants.

Snapshots: Eliza of Tanzania

In Arusha, Tanzania, Eliza talks with a patient at the Ngarenaro Health Clinic. Learn more about EngenderHealth’s work to improve clinical quality.

Photo credit: Mark Tuschman