NEW YORK, MARCH 2, 2015—In advance of International Women's Day on March 8, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today launched Because Tomorrow Needs Her, a multimedia initiative focused on improving access to women’s health care worldwide.
In videos, photos, and stories of patients and medical workers, Because Tomorrow Needs Her calls attention to the shocking loss of women's lives in many of the countries where MSF works. Every day, approximately 800 women and girls die of preventable complications in pregnancy and childbirth.
"It is unconscionable that in many parts of the world today, women have no access to quality obstetric care, when providing it is not complicated," said Séverine Caluwaerts, an MSF obstetrician/gynecologist. "High impact, yet low-cost interventions by trained health staff can have a dramatic impact on maternal mortality."
To cite one example: In 2012, MSF initiated ambulance referral systems in parts of Burundi and Sierra Leone. These countries have some of the world’s highest rates of maternal mortality and feature very few hospitals or qualified medical workers. However, once women experiencing complications in childbirth could take an ambulance to a hospital with trained staff, where services such as surgery and blood transfusions were available, the maternal mortality rate in the districts dropped by more than 60 percent.
Because Tomorrow Needs Her bears witness to the barriers that women and girls face in seeking essential medical care in many communities where MSF works, whether they are due to poverty, conflict, or cultural norms.
Photographers Martina Bacigalupo, Patrick Farrell, Kate Geraghty, and Sydelle Willow Smith captured images and videos of women in Burundi, Haiti, Malawi, and Papua New Guinea, working with MSF medical teams. Patients and medical workers wrote first-person reflections from the front lines of the crisis—such as villages and clinics in Afghanistan, South Sudan, the Democratic Republic of Congo, and Sierra Leone.
The specific health challenges that women face go far beyond childbirth. Because Tomorrow Needs Her also looks closely at MSF's experience with pre- and post-natal care, obstetric fistula, unsafe abortion, sexual violence, and prevention of mother-to-child transmission of HIV.
Obstetric fistula alone affects untold millions of women and girls and remains largely neglected. A consequence of prolonged, obstructed labor, an obstetric fistula is an opening between the vagina and the bladder or rectum, causing lifelong incontinence if left untreated.
Bacigalupo photographed women before, during, and after surgery for obstetric fistula in Burundi, over the course of several months. Many of the women are isolated by society, forced to live separately or shunned by neighbors because of their incontinence.
"What struck me is the strength with which these women try to preserve their dignity, long before they meet any doctor who tells them it is possible to have a normal life," Bacigalupo said.
Because Tomorrow Needs Her also devotes a chapter to unsafe abortion, which is one of the top five causes of maternal mortality worldwide. Pulitzer Prize-winning photographer Patrick Farrell documented the rise of abortions that are self-inflicted or performed by nonmedical personnel in Haiti, where laws prohibit the procedure and economic barriers prevent access to proper health care services. Such issues are not unique to Haiti, nor are the consequences.
"On a daily basis, MSF staff in hospitals and emergency rooms the world over see women and girls with complications from unsafe abortions …" write Caluwaerts and Catrin Schulte-Hillen, who leads MSF's working group on reproductive health and sexual violence care. "They require immediate medical care, and sometimes surgical interventions and blood transfusions, to save their lives."
In total, MSF operates 131 projects worldwide that provide dedicated emergency obstetric services in areas where other health systems are nonexistent or are severely affected by conflict or neglect.
Bacigalupo and three MSF women's health experts—Caluwaerts, Schulte-Hillen, and Africa Stewart (see bios below), will speak about the project in a March 4 panel discussion at Pace University in New York City. Journalist Nina Strochlic of the Daily Beast will moderate. Admission is free but registration is required at www.pace.edu/tickets. The event, co-sponsored by Pace University's Student Government Association and the Pace University Rotaract Chapter, will also be webcast live at 7:30 p.m. EST at doctorswithoutborders.org/tomorrowneedsherwebcast.
An exhibit of the photographers’ work will be open to the public from March 4 to 10 at Pace University's Schimmel Center.
The full multimedia project, Because Tomorrow Needs Her, can be viewed online at womenshealth.msf.org.
Martina Bacigalupo studied photography at the London College of Communication. She lives in Burundi, where she works as a freelance photographer, often in collaboration with international NGOs. Her work has been published in the New York Times, Sunday Times Magazine, Le Monde, Vanity Fair, Esquire, Liberation, Internazionale, and has been shown in several international venues, including PARIS PHOTO 2013, UNSEEN Amsterdam 2014, and AIPAD New York 2014. She won the Canon Female Photojournalist Award in 2010 and the Fnac Award for photographic creation in 2011.
Dr. Séverine Caluwaerts is a obstetrician-gynecologist and one of the referent gynecologists for MSF. Prior to joining MSF, she spent a year of her residency in South Africa where she cared for a large population of HIV-positive women. She has completed assignments for MSF in Sierra Leone, Democratic Republic of Congo, Niger, Burundi, Pakistan, and Afghanistan. When she is not on mission, she works with HIV-positive pregnant women in Belgium and is involved in teaching medical students and midwives.
Catrin Schulte-Hillen has worked for MSF as a midwife, project coordinator and project manager in conflict and post-conflict contexts in Africa, Latin America, and the Balkans. She is the leader of MSF’s reproductive health and sexual violence care working group. Prior to that, Schulte-Hillen was a program director for MSF-USA and worked for several years as a health advisor and consultant for MSF, the European Commission, and other NGOs. She is a licensed midwife and holds a master of public health degree, a license in applied epidemiology and statistics, and a degree in business administration.
Dr. Africa Stewart is a wife and mother of three who graduated with honors from the Johns Hopkins University. She completed her medical degree and residency in obstetrics and gynecology at Drexel University and Hahnemann Hospital in Philadelphia. Dr. Stewart joined MSF in 2011 and has completed assignments in Sudan, South Sudan, and Nigeria. She is an outspoken supporter of women's rights and specializes in obstetric fistula prevention and repair. She continues to serve her local communities with adolescent outreach and education.