Health in Focus: International Medical Corps Helping Women and Children Around the World

With  many global health issues being discussed on the news recently, it’s easy to get caught up in the hype from the latest hot topic to another. While issues such as H1N1 attract the headlines worldwide, many more fundamental health problems, such as dysentery and malaria, continue to cause more damage, especially to the most vulnerable of our population – women and children.  Fortunately, organizations such as the International Medical Corps (IMC) are working everyday around the world with local communities to fight these basic illnesses.  With 90 percent of IMC’s donations going directly to their field work, the organization is not only at the forefront of emergency medical relief during crisis situations, but is also helping local communities become self-reliant through capacity building and training programs.

We interviewed Stephanie Bowen of IMC to learn more about their work.

What are the specific areas of women’s health that International Medical Corps focuses on?

A woman in Afghanistan holds her newborn baby at Rabia Balkhi Hospital, the largest full-service women’s hospital in Afghanistan, where International Medical Corps runs an in-service midwife training program.

The health and well-being of women and children is one of International Medical Corps’ top program priorities and is integral to everything we do.  This is partly because women and children suffer so greatly in emergencies and are the most vulnerable in ongoing crises.  Of the millions affected by war and natural disaster each year, 80 percent are women and children.  That means when International Medical Corps deploys an emergency response, we work to prioritize women and children so that their health is not further compromised during the disaster.  We focus on delivering all the basic maternal and child healthcare services, including lifesaving antenatal and postnatal care. These services are often provided in remote settings with high levels of cultural sensitivity, whether in the deserts of Chad or the mountains of Pakistan.

But our work does not end when the crisis ends.  This is where the second part of our mission, “From Relief to Self-Reliance,” comes in. We simultaneously work to rebuild and increase the capacity of the local healthcare system so that it can provide care for women and children long into the future.  We make this possible through training and education programs that teach local people to vaccinate infants and young children against disease, provide emergency obstetric care to a mother in labor, and prevent the three big, but easily preventable child killers – acute respiratory infections, malaria and diarrhea.  Nutrition is also a central focus – particularly in food-insecure areas – among lactating women and children.  International Medical Corps treats malnutrition and provides supplemental food, and teaches mothers proper child feeding practices and how to identify the early signs of malnutrition before it becomes severe.

By putting women and children at the core of our programs, we are not only improving the health of hundreds of thousands of people around the world, but we are helping create stable, confident societies that can chart their own future.

What are the most serious health issues affecting women and children in the countries where you operate?

Every minute, a woman dies due to complications during pregnancy and childbirth.  In Sub-Saharan Africa, a woman faces a 1 in 22 chance of dying because of pregnancy-related reasons during her lifetime.  To compare, the same risk for a woman in an industrialized country is 1 in 8,000.  That means, for many of the world’s women, having a child can be a very dangerous fact of life, something that we rarely think about here in the United States.

The difference is largely because in Africa, where the majority of maternal deaths occur, more than 50 percent of women are without a skilled attendant during delivery.  This is no coincidence as the majority of maternal deaths occur during, or within 24 hours after, delivery.  A skilled attendant is able to not only perform a clean delivery, but also handle serious, life-threatening complications that can arise during childbirth.  Having someone who can perform a cesarean section, stop heavy bleeding and other procedures can make a life-or-death difference for a mother and her baby.

In the Democratic Republic of Congo (DRC) , for instance, where we have worked for the last decade serving nearly two million Congolese, International Medical Corps trains health workers in the complicated procedure to repair fistula, a severe gynecological rupture that can occur during delivery or violent cases of rape and that can be fatal if left untreated.  International Medical Corps is also building a Reproductive Health Complex in the most volatile part of eastern DRC that, when fully constructed, will serve approximately 48,000 women of childbearing age.

In South Sudan, we built a medical training school that offers an 18-month training program for midwives and a 30-month program for nurses.  There are currently 45 students enrolled from six out of the 10 states in South Sudan. Upon graduation, they will be able to return to their home communities and provide safe deliveries to mothers and babies.  The hospital adjacent to the school serves 145,000 locals and 25,000 displaced persons with 350 prenatal care visits per month and up to 60 deliveries per month.

What sets International Medical Corps apart from other health or aid-related organizations, such as Doctors without Borders, UNICEF, etc?

Our focus is on training and building self-reliance in the communities in which we work.  International Medical Corps not only responds to emergencies, like many other organizations do, but we stay and help the country transition from emergency to development so they can become self-reliant.  Each and every one of our programs has an emphasis on training.  We have both a bottoms-up and top-down approach. We work with all levels of a country’s healthcare system, from community health workers in remote villages to the Ministry of Health.  Our programs are designed to do exactly what our mission says – to provide immediate relief that saves lives and build self-reliance to help create healthy futures.

A mother and her baby wait outside one of International Medical Corps’ hospitals in eastern Chad, where thousands of refugees from Darfur have access to comprehensive health services.

Do you see a common problem concerning how issues concerning women and children are dealt with in certain countries, or does it differ depending on the location?

While specific issues arise within each country and context, there is no doubt that refugee and internally displaced women and children are more vulnerable and often lack access to services such as reproductive health, nutrition and immunizations that they so desperately need. Amid disaster and conflict, where the most basic needs like food, shelter and clean water are not being met, it can often be an uphill battle moving women’s health to the top of the list of priorities. And certainly another problem we see worldwide, particularly in conflict settings, is sexual violence. This is frequently an outgrowth – if not an actual weapon – of war in many of the areas where we work.

What are some operational challenges you face in the field?

One huge challenge for women is transportation.  It can be very difficult for women to access health services and challenging for us to deliver them. Many of the places where we work are extremely remote, accessible only by poor (or non-existent) roads, which are made more treacherous by harsh weather conditions or violent activity.  Women often have to travel long distances to receive health care. In some very isolated places we have to devise creative ways to get women to and from our clinics.  It is often too far for a woman to walk from her home to our clinic.  For example, in Darfur, we use donkey ambulances – donkey-pulled carts – to transport women quickly to and from our clinics.

Another challenge is a lack of human resources.  Because we work in many harsh environments, it is difficult to find health providers willing to stay in these areas. Often health providers who are trained will migrate to larger cities or outside of the country in pursuit of higher salaries or easier working environments. International Medical Corps has addressed this by building local capacity through training of community health workers and community midwives.  These health providers are more likely to continue working in these difficult places as they have a commitment to improving the health of their own communities. In March 2008, International Medical Corps graduated 30 community midwives from its 20-month training program targeting remote areas of Khost Proince and northern Paktika Province. All of those trained remained in their communities one year later. Seventeen continue to provide services in community clinics supported by local or international non-governmental organizations or the Ministry of Health while the rest, due to security constraints, are not able to practice in a clinic but retain the skills within the community.

Can you provide some basic statistics for our readers related to the extent of the medical needs of women and children around the world?

The fact that a woman dies every minute because of factors relating to her pregnancy really shows the gravity of the issue of maternal health.

We are impressed that around 90% of your funds go directly to your work. How do you manage that?

We are committed to the people we serve and have always strived to make sure that the vast majority of funds raised goes directly to our programs in the field. Just as we have to be innovative in our life-saving work around the world, we also have to be innovative in making our dollars go as far as possible – especially in these tough economic times. Because of the support we receive from government and corporate donors, and donations of supplies and medicines, we are able to leverage every dollar given by private individuals 20 times over. That allows us to reach many more people who are suffering and need our help.

A teen mother holds her baby outside one of International Medical Corps’ clinics in eastern Democratic Republic of Congo. Ravaged by decades of civil war, the country is home to some of the most horrific cases of gender-based violence in the world.

How would you encourage our readers to get involved? On a local level? What are some online resources that we can go to for more information on such issues?

A quick, easy way to get involved is to donate to our women’s health programs around the world.  I know the current economic conditions make us all much more conservative with our money, but even the tiniest bit makes a huge difference and can save a life.  On our website, you can find gifts for as small as $5, which provides a midwife with everything she needs to perform a safe, normal delivery.  For $10, you can deliver health services to one mother and her baby, including pre- and post-natal care, routine checkups, immunizations, and safe delivery services.  For a higher amount, like $600, you can transport $10,000 worth of lifesaving medicines and equipment to remote clinics that serve thousands of women and children.  These are just a few examples of ways that you can contribute and each and every one, no matter the size, is an important contribution to the work that we do and women around the world.

Another idea is to make these gifts in honor of your loved ones this holiday season.  Rather than a scarf or a material gift, you can visit our holiday gift catalog and make a contribution in their honor.  We have a lot to choose from, like food for a malnourished child or clean water for a family.  For whichever one you choose, we have a custom card – electronic or mail – that you can fill out and send to your loved one.  It’s a gift that really embodies the true meaning of giving.

You can also visit a campaign that Oprah recently launched in partnership with us.  Visit oprah.com/forallwomen and learn different ways that you can get involved.  Our website also offers great resources: you can sign up to receive our newsletter, or join our Facebook Cause, “Save Lives and Build Healthy Futures,” and invite your friends to become members.

www.imcworldwide.org

Photos Courtesy International Medical Corp.