“Because Tomorrow Needs Her” Explores Multiple Health Challenges Affecting Women

Global women's health multimedia feature

NEW YORK — 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 neighbours 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 non-medical 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.

The full multimedia project, Because Tomorrow Needs Her, can be viewed online at womenshealth.msf.org.