Koohi Goth Hospital: On Obstetric Fistula & Restoring Dignity

“Why do women have to leak for thirty long years before finally finding their way to us?” said Dr. Shershah Syed, President of the Pakistan National Forum on Women’s Health (PNFWH).

While on a visit to Pakistan, we had the opportunity to meet a key partner organization working with Dr. Anita Zaidi and her VITAL Pakistan team. This organization, named Koohi Goth Hospital, was established in 2005 and is a project of the Zafar and Atiya Foundation Charitable Trust. This is a family foundation with generations of physicians who are all heart and soul, and deeply committed to vulnerable and underprivileged communities serving poor women and children.

Originally displayed on the Pakistan National Forum on Women’s Health website.

While touring the Koohi Goth facility and learning more about their work, we had the opportunity to spend some time with the amazing and inspiring Dr. Shershah Syed and his team which included Dr. Saboohi Mehdi and Sarwan Kumar. Dr. Syed shared with us the rich family history that has infused his profession. The foundation’s work is unwavering in its commitment to education and health. One of the most striking features shared was the lack of payment for services provided while at Koohi Goth Hospital, a true indication of their mission to provide care for the poor and under-served at no cost.

Koohi Goth Hospital Tour

At its essence, the fundamental belief in the human dignity of each person they service and that education and health are basic human rights became evident as we walked the corridors of the hospital,  meeting women of all ages that were being trained as community health workers, midwives, technicians etc. Their and training being provided free of cost and in fact students were rewarded with a living area and a stipend/scholarships during their stay. The emphasis on human dignity was most profound as the discussion shifted to stories of women that experienced obstetric fistula. See story below.

Koohi Goth Education and Training

Koohi Goth Hospital offers fistula services and have also incorporated a social integration program to further help the women cope with the depression associated to their experience. In fact, the origins of Koohi Goth Hospital focused on the taboo disease known as the Vesico Vaginal Fistula (VVF), Recto Vaginal Fistula (RVF) among other gyno-related problems. Koohi Goth Hospital continues to actively work towards the elimination of RVF and VVF and the protection women from other labor related complications and gynecologic diseases.

What’s a fistula or an obstetric fistula?

Obstetric fistula is a connection between the vagina and rectum or bladder that is a direct consequence of prolonged or obstructed labor. Women are left incontinent (having no or insufficient voluntary control) of urination or defecation. This condition can be extremely stigmatizing and difficult to live with, leaving these women incapable of leading normal lives.

Why is there an international day to end it?

Because this is a preventable condition that chronically affects some of the most poor and marginalized women in the world, women who live in rural areas where in obstetric care is poor, or non-existent, and skilled labor is difficult to reach. This type of childbirth-related devastation can be fully spared.

Obstetric History Lesson at Koohi Goth Hospital
Obstetric History Lesson at Koohi Goth Hospital

How many women are affected?

According to the World Health Organization, between 50,000 to 100,000 women worldwide develop obstetric fistula each year. However, these estimates are based on scanty data and need to be updated. According to the Fistula Foundation, over one million women suffering from obstetric fistula worldwide. Fistula is most prevalent in sub-Saharan Africa and Asia.

The Koohi Goth facility is a 200-bed healthcare center, with about 70-beds currently functional, and providing Obstetric & Gynecological services at no charge and without any discrimination of race, color, caste, or creed. Located in the outskirts of Karachi and conveniently built only 2 kilometers from the National Highway, the hospital serves as a true oasis for maternal health and women’s health in Pakistan. The facility is staffed 24-hours a day by world and country renown specialists like Dr. Shershah Syed, founder of Pakistan National Forum on Women’s Health, who volunteer their time in order to improve maternal health and save the lives of women and children.

Koohi Goth Hospital Courtyard
Koohi Goth Hospital Courtyard

We want to honor the work of Dr. Syed, his incredible and noble family, and all the staff at Koohi Goth Hospital for the transformative work they are doing every single day. No woman should have to endure the pain, suffering, and social ostracization that follows an obstetric fistula. Working in collaboration, we can save more lives, and help improve the health of women and children who most need it. Thank you!


Families Matter: Global & Contemporary Insights

The International Day of Families provides an opportunity to promote awareness of issues relating to families and to increase knowledge of the social, economic and demographic processes affecting families. The theme for 2015 is: Men in Charge? Gender Equality and Children’s Rights in Contemporary Families. Within the context of the development goals, this theme is timely and spot on! Discussion of future goals to elevate health, gender equality and children’s rights involves engaging more men in charge. This year, as we build on the Millennium Development Goals (MDGs), we have an opportunity to share more stories that celebrate leadership in supporting families with their social and economic successes. Happy International Day of Families from the Children’s Prize!

Below are a couple of examples from the Children’s Prize portfolio illustrating how dynamic leadership makes a positive difference:

Aleyda K. Mejia (center), Children’s Prize Director,  is accompanied by father and daughter during 2014 Pakistan field project visit.
Aleyda K. Mejia (center), Children’s Prize Director, is accompanied by father and daughter during 2014 Pakistan field project visit.

During our visit to Pakistan, in 2014, we met with a father and his daughter and had an opportunity to learn about their incredible story.The young lady to the right will be the youngest midwife trained in the local community of Rehri Goth. Her family lives in a very conservative part of the village, and her father played a critical role in ensuring that she’d pursue her midwifery studies. He stood firm for both himself and his daughter. In tears, he explained how proud he was that his daughter would have this opportunity through Dr. Anita Zaidi's Children's Prize project. Not only will a select group of women in the community receive valuable and life-saving training, but the experience will also provide them with an income.

Women acting out a Drama about birth in Uganda.
Women acting out a Drama about birth in Uganda.

Meet our partner Safe Mothers Safe Babies (aka SAFE)! Located in Uganda, their project includes Save for SAFE Deliveries and Save for SAFE Families, primary ways that Safe Mothers, Safe Babies seeks to help women and their families prepare for birth and health emergencies. In this region of the country, as in many similarly disadvantaged locations, families do not have enough money to pay for transport and medical supplies during birth and medical emergencies. It can take hours, or even days, for them to borrow enough money from relatives and neighbors to save enough to secure transportation. During a health emergency or a complicated delivery, those hours and days can result in significant injuries or death to women, babies, and children.

Saving boxes painted and ready to be sold.
Saving boxes painted and ready to be sold.

To address this issue, the Save for SAFE Deliveries and Save for SAFE Families projects encourage a culture of saving to prepare for the expenses of childbirth and childhood illnesses. Working in partnership with SAFE community groups, we work to normalize the idea that everyone will need to get medical care at some point and that the best thing to do is to prepare for that event. Pregnant women, their partners, and families of young children are educated about maternal, child, and family health. We target the ENTIRE family - incorporating men in the discussion - because they are often the decision-makers and could equally benefit from saving for health emergencies. We normalize this idea by encourage families to purchase a savings box (at cost, about $0.40) and deposit a small amount of money in the box every day. The boxes are made by the community groups using materials that SAFE supplies; the groups chose to use boxes that have to be broken open to access the money as a way to deter spending. Best part of it all? It's works! Women have expressed both joy and gratitude for having saved enough money to cover some of the expenses of motherhood that would have otherwise negatively affected their chances and their newborn baby’s chances of surviving birth.

"On my last born I did everything I was told, because I was told to save, told to call the eRanger [motorcycle ambulance] when I reached the time to go to the health center to deliver, and then I did everything I was told. I felt so happy because before I wasn't comfortable, I was moving on a boda boda [motorcycle taxi]. But now I get my baby well, I take good care, and I get good care because I follow all what I was told to do. I had money to [go] and even to eat something because I saved my money."

SAFE eRanger user and her newborn with eRanger driver
SAFE eRanger user and her newborn with eRanger driver

#ChildrenFirst: Reflections from the UNICEF Annual Meeting 2015

The 2015 UNICEF Annual Meeting was both a celebration and movement to put #ChildrenFirst. Held at the Times Center in NYC on Friday, May 8th, the day-long meeting was filled with inspiring discussions and video clips illustrating the impact UNICEF made in the past year. The auditorium was filled with people from all sort of backgrounds and UNICEF Affiliations including young ambassadors, college students, fellows, board members and supporters. At 9:00 AM, Caryl M. Stern, President and CEO, took the stage and excitedly commenced the event. She reminded us of the UNICEF mission to “advocate for the protection of children's rights, to help meet their basic needs and to expand their opportunities to reach their full potential.”

"The investment in children is paramount to global stability. 14 million children. Each one has a name. Each one has a story. When children's lives are at stake we do not have the luxury to do one or the other. We do both." - @CarylStern

Caryl Stern speaking at UNICEF Annual Meeting
Caryl Stern speaking at UNICEF Annual Meeting

Voices from the Field panel was moderated by Dr. Richard Besser (@DrRichardBesser), Chief Health and Medical Editor of ABC News, and included:

Barabara Bentein (@bbentein), UNICEF Deputy Global Emergency Coordinator

Robert G. Jenkins (@RobertG_Jenkins),@UNICEFJordan Representative

Christine Munduate, @unicefhonduras Representative

Afshan Khan, Director, Office of Emergency Programmes (EMOPS), UNICEF

 

From Left to Right: Moderator Dr. Richard Besser and Panelists Afshan Khan, Barabara Bentein, Robert G. Jenkins, and Christine Munduate.
From Left to Right: Moderator Dr. Richard Besser and Panelists Afshan Khan, Barabara Bentein, Robert G. Jenkins, and Christine Munduate.

The Panel reflected on UNICEF’s past year and quick response to over 294 emergencies in 98 countries. UNICEF sites must constantly fight against corruption, violence, organized crime, dysfunctional governments and significant structural inequities that highly impact the work they do. These barriers to health and socio-economic empowerment are far too common for many organizations or individuals dedicated to global development or, more specifically, improving child health. Despite these barriers to progress, UNICEF has successfully managed to impact millions of families and children through measles vaccinations, feeding the malnourished, providing clean water, and increasing access to formal and informal education. And we must continue to do more, for “we live in an increasingly globalized world. What affects one part of the world will affect another,” as stated by Afshan Khan, UNICEF Director, Office of Emergency Programmes (EMOPS).

The final and highly energized panel at the meeting was all about UNICEF Kid Power. This is an effort to get students in America to stay active through a dual purpose innovative tech solution that simultaneously tackles malnutrition in the developing world. The program focuses on educating children in elementary and secondary schools about malnutrition and encourages healthy competition between schools and groups to get active. Each participant wears a Kid Power Band to track his or her steps and collect points that can be converted into “life-saving nutrition packets for malnourished children in developing countries.”

UNICEF Kid Power Bands
UNICEF Kid Power Bands

The annual meeting served as a reminder of the power of #storytelling. Every panelist, every speaker, every audience member had a story to tell. The stories brought to life children and families, they were made relatable in an effort to connect with those who may have never experienced the harsh realities of an impoverished livelihood. "Children give me hope. Even in the most difficult situations...they give me strength." Cristian Munduate, @unicefhonduras 

Like the work of UNICEF, the Children's Prize also focuses on supporting projects and leadership that improves child health ensuring that more children survive and thrive. Through our community-based work we agree, #ChildrenFirst. If you have a moment, we encourage that you learn more about grassroots leaders whose work ranges from prevention of prenatal complications, to perinatal care packages, access to clean drinking water and Kangaroo Mother Care:

NepalDr. Joanne Katz, Johns Hopkins University Bloomberg School of Public Health 

Kenya, Dr. Abdhalah Ziraba, African Population and Health Research Center (APHRC).

Angola, Lynn Cole,  RISE International

Uganda, Jaqueline Cutts, Safe Mothers Safe Babies (SAFE)

PakistanDr. Anita Zaidi 

 

2015 CP Announcement CP5

 


Midwife Feature: Innovative deployment of community-based portable ultrasounds

ultrasound being done in the home
2014 Winner: Dr. Joanne Katz, Johns Hopkins University

These are women who usually deliver at home or in facilities that cannot take care of these problems. By knowing in advance about these concerns, they can plan to deliver in a facility with the right staff and equipment to help save their lives and those of their infants. As technology becomes more portable and prices lower, it is important to try out life saving equipment to make sure it works as intended and can be effectively used in resource limited settings,” said Dr. Joanne Katz.

Today, May 5, 2015, is recognized for highlighting the work of midwives around the world. On this International Day of Midwives, we’d like to recognize and appreciate the work of our 2014 Winner, Dr. Joanne Katz and her team in rural Nepal. Their work focuses on assessing the feasibility of expanding antenatal care coverage and ultrasound access to low-resource communities through the deployment of Auxiliary Nurse Midwives (ANMs).

Proper care during labor and delivery can reduce the increased likelihood of mortality and morbidity from occurring in the first few hours of life. In addition, a significant number of expecting mothers around the world continue to deliver at home. With intrapartum-related complications being a major cause for neonatal deaths worldwide, this project is focused on training ANMs to identify a set of key factors of intrapartum-related neonatal, fetal and maternal death. Typically, these outcomes are thought to only be identified in a facility setting.

In early 2015, nurse midwives were trained to use portable ultrasounds to uncover common risk factors during home visits. The goal is to examine the sensitivity and specificity with which the nurse midwives are able to detect conditions that may lead to delivery complications as well as compare the early neonatal mortality and stillbirth rates between those who received an ultrasound exam through the study and a separate comparable group.

Thank you, team, for your work in ensuring healthy mothers and children!

Dr. Joanne Katz is Professor and Associate Chair at the Department of International Health of the Johns Hopkins Bloomberg School of Public Health


Innovators of Global Health: Reflections from the 2015 GHIC Conference

The Global Health & Innovation Conference (#GHIC) is one of those events that we look forward to attending every year, and we highly recommend it to all. Hosted by Unite for Sight, GHIC is described as the world's leading and largest global health conference convening thought leaders and changemakers from all sectors of global health, international development, and social entrepreneurship. We couldn’t agree more with this description, and this focus on diversity makes GHIC appealing for our work at the Children’s Prize. There’s opportunity to connect with students and professionals through the numerous talks, workshops, pitches, poster sessions and coordinated networking events. This year, the theme was Focus on Quality: Evidence- and Outcomes-Based Conference and here are some reflections of the experience.

The Honorable Minister of Health of Rwanda, Agnes Binagwaho, M.D. at the 2015 GHIC Conference. Photo credit: Chelsea Ducharme ‏twitter.com/@chelduch

We listened to high profile and engaging speakers at GHIC. We especially enjoyed the compelling keynote address from the Honorable Minister of Health of Rwanda, Agnes Binagwaho, MD. Dr. Binagwaho spoke about the essential principles that have improved health in Rwanda, including how to harness the power from traditional values to create a system of health that meets the people where they are. She focused on the importance of thinking of health as “multisectoral” because the social determinants of health are greatly impacted by sectors other than those within health. She stressed the need to abolish the double standards of health, as she eloquently stated:  “We live in one world, not three.” 

GHIC Conference Tweet

 

During the conference we had an opportunity to listen to Jeffrey Sachs’s inspiring presentation on the current status of the United Nation’s plan to improve the state of the world’s vulnerable population through the post-2015 Sustainable Development Goals and emphasize the need for a new funding mechanism. The need for a Global Fund for Health.

GHIC Conference tweets 2

From the poster session to the pitch presentations, Unite for Sight has provided a successful platform for the exchange of ideas and formation of partnerships. It is an exciting time to be investing in global health and global philanthropy, and conferences such as the #GHIC truly embody this. The transition to a healthier, more sustainable and inclusive world will require the help, dedication and hard work of many. GHIC provided an opportunity to listen and engage with other professionals doing transformative work that will improve health and increase access to opportunities to ensure “Health for All.”

Tweets from GHIC

Leveraging funding to achieve these goals is a major component of global health; it is essential for the creation and implementation of programs that aim to successfully strengthen a health system. With that in mind, the Children’s Prize will be searching for solutions-focused innovative minds with an actionable plan to reduce key health indicators, such as under 5 mortality rates, and increase child survival. One winner will be awarded a $250,000 to implement their project. Are you turning ideas into concrete solutions in the child health space? Then this opportunity is for you! For more details on how to apply, visit childrensprize.org

Shout-Outs to Young Innovators

GHIC Innovation Prize Winner: Lucy Topaloff, from Miraclefeet, pitched the Miraclefeet Brace that offers a treatment for children with clubfoot in developing countries. The organization prides itself on three important identifiers for a sustainable treatment plan:  low-cost, comfortable, and accessible. And we love it too! Congratulations!

Katelyn Chan, from PremieBreathe, spoke about a low-cost (approximately $500) solution to reduce neonatal deaths. PremieBreathe is a respiratory device prototype that warms and humidifies air for infants in respiratory distress.  This is a simple, yet effective, technological solution to a major problem in health for areas that cannot access adequate health care. The Children’s Prize would love to see how this is implemented!

Tweets from GHIC 2

Kunmi Sobowale, from Motherhood Savings Today (MOST) discussed a microfinance intervention to improve birth outcomes and early childhood development. Motherhood is expensive, and to mitigate the costs of some of these health issues introduced by poverty, early childhood savings during the prenatal period can make a world’s difference in the life of a mother. Excellent work, Kunmi!