Spring 2015: Because tomorrow needs her

Dear Friends,

In this issue of Alert, we want to highlight a new campaign, “Because Tomorrow Needs Her,” which is designed to focus attention on women’s health.

Women and children make up the majority of patients in MSF facilities worldwide; in many cases, saving a mother’s life amounts to saving two lives, because children who lose their mothers are statistically less likely to survive. That’s a challenge, however, because women often have less access to health care than men do, with profound consequences.

We know, for instance, that 15 percent of all pregnancies will be “complicated,” and that pregnant women with complications, and their babies, are much more likely to die if they cannot access emergency obstetric care. There has been progress, but at present, 800 women still die from pregnancy-related complications every day.

The difference between life and death can be explained almost entirely by the access to high-quality secondary-level health care. When I worked in Afghanistan at the MSF maternity hospital in Khost, my days often began at dawn, when families finally felt safe to travel on highly insecure roads. Women presented near death, having spent the preceding night bleeding or laboring unsuccessfully at home. In the two years since MSF opened this hospital, not a single woman who arrived alive has died. (And, in fact, Caesarean sections make up roughly one-third of all the surgeries our teams carry out in war zones.)

Health care providers and governments can take some relatively simple steps to improve the situation for women and their children—better ambulances and referral systems, waiting houses near hospitals for pregnant women, prenatal care and vaccination programs for young children

But in some places, it’s difficult to get these initiatives implemented, and there are other issues at play as well. Some patients can’t afford transport, for example. I met women in the Congo who walked for days to reach our hospital or who camped out in nearby forests in anticipation of needing care.

“Because Tomorrow Needs Her”—a book, a multimedia presentation, and more—tells these stories while also focusing on sexual violence, the need for prenatal and antenatal care, the effort to prevent the transmission of HIV from mothers to their children, and much more. We are printing the book’s introduction here. I hope you will read it, and then share my anger at the injustices many women face, while appreciating their strength and their dedication to their families.

Related to this, we have a field journal from Sierra Leone about working with pregnant women with Ebola. And we also have a piece about MSF’s years-long effort to develop a modernized health information system that can help us catalog and improve our medical practices. As innovative as some of our projects are, our data collection methods are often rather antiquated. I can’t tell you how many hours I’ve spent transcribing paper logs onto Excel spreadsheets, or how many times Headquarters requested that I search for some piece of missing data.

Built using open-source software, and constructed after detailed consultation with those working in the field as well as HQ, this is an exciting and much-needed initiative, an important adjunct to delivering direct medical care to the most vulnerable and encouraging broader medical attention for the most difficult populations to reach.


Deane Marchbein

President, MSF-USA Board of Directors