Tag Archives: Maternal Health

ISUOG Outreach is off to Oman!

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ISUOG Outreach is excited to announce that it will be launching Phase I Trip I of its Outreach Program in Muscat, Oman starting Sunday, 5 November. Led by ISUOG Outreach Committee Member, Dr. Titia Cohen-Overbeek and supported of ISUOG Ambassador to the Middle East, Prof. Hisham Mirghani, the team consists of an international group such as Dr. Nimrah Abbasi of Canada, Dr. Valeria Angioni of Estonia and Ms. Pauline Schut from the Netherlands, with ISUOG’s International Development Coordinator Gesu Antonio Baez joining the team to deliver the program. The team will be teaching a group of 30 trainees from across the country in basic ultrasound in obstetrics and gynecology. With the backing and official partnership of the Omani Ministry of Health and GE Healthcare in supporting machines on loan, the ultimate goal of the program is to train key doctors from vital regions of the country to spread ultrasound knowledge and training in order to foster a sustainable environment in OG/GYN ultrasound education. Stay tuned on our blog for updates on the field as they happen! For more information about our program, visit our website for more details.

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Hot weather. Spicy food. Welcome to Outreach in Haiti

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ISUOG Trainer Gail Ghiretti (pictured centre) with fellow ISUOG trainer Dr. Stephane Michel (pictured left in blue) during the practical training session (Photo by L. Hanson)

It’s day three of ISUOG Outreach in Cap-Haitien and the trainees are showing more progress by the day! ISUOG Trainer Gail Ghiretti writes to us from the field in today’s featured blog:

“Hot as in weather and spicy as in food. 

Food is very spicy here and found in the most unusual things …like peanut butter. This is my first visit to Haiti and my first time volunteering with ISUOG. I have worked in various places around the world teaching ultrasound but I must say this group is the most enthusiastic I have seen in awhile. It’s Day 3 and they are still interested in our presentations! And they all participate in hands-on without becoming bored by watching others scan ; they help and encourage each other with a positive attitude.

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ISUOG Trainer Gail Ghitetti delivering a lecture (Photo by L. Hanson)

There’s lots of laughter in my scanning room but unfortunately, I am not sure what they are saying because everyone is speaking French to each other. My high school French teacher would be appalled since – believe it or not – I did get all A’s in class but that was a long time ago. I am learning new words and should be fluent by end of the week.

When someone asks a question, a great response for scanning instructions are responses like such as “gauche” and “droite”. Impressed ? Oui, n’est – ce pas ?

It has been a pleasure working with the trainees and I look forward to working with them in the future. À bientôt !”

Keep following our blog throughout the week for more live updates from Haiti. For more information around our work in Haiti, be sure to visit our website.

 

 

22 trainees and 90 degrees…..Outreach in Haiti continues!

Day Two of the ISUOG Outreach Program in Cap-Haitien continues again today. Reporting straight from the field is Project Led Dr. Lisbet Hanson who recounts the day’s success in today’s blog post:

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The ultrasound dream team (Left to right: Dr. Stephane Michel (Haiti), Dr. Vladimir Lemaire (Haiti), Gail Ghiretti (USA), and Dr. Lisbet Hanson (USA) – Photo by L. Hanson)

“22 Trainees; 4 Trainers; 5 ultrasounds (not always working); 90 degrees Fahrenheit

We hit the ground running early Monday after Opening Ceremonies with the playing of the Haitian National Anthem, a warm welcome from the Hôpital Universitaire Justinien Administrative Director and a benediction by Dr Cyril Leconte, Chef de Service d’OBGYN.

Stéphane, Vladimir and Gail’s excellent lectures have included a variety of basic introduction to ultrasound topics, including ultrasound physics, transducers, knobology, biometry, etc. We are using the standardised ISUOG lecture sets and adding videos and images when we want to emphasise a point. The trainees consist mostly of OBGYN and Family Medicine Residents, but also a few seasoned practitioners. They are not afraid to speak up when they have questions or to debate a point passionately. Some have never touched an ultrasound machine before. Most have had a little exposure in their residency. Dr. Leconte is clearly an impassioned educator. His vision is to develop and incorporate a formal ultrasound-training program into the three-year OBGYN Residency at HUJ.  I am really enjoying the opportunity to finally meet him and get to know the man who applied to ISUOG Outreach for this training opportunity a few years back.  That evening, he gave us a tour of the city and with a little history lesson on the way home; it was very interesting!

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Cap-Haitien (Photo by L. Hanson)

Our lecture hall is above the busy Maternity Ward where 300+ deliveries are performed monthly. The ward consists of six large open rooms with up to ten beds in each. Every single bed is occupied, not only by the patient but the family caring for her and her newborn; there is zero privacy. Those in labour can be seen walking the open halls, sitting on the front steps or crouching in the hallways. From time to time, one hears a labouring woman cry out.  Nurses in starched white uniforms, tights and shoes navigate the crowds to deliver medication, checks IV’s or get a blood pressure.

Our afternoons are spent scanning. Most of the patients have been obstetrical though we have had at least two that insisted they were pregnant but alas, no IUP was discovered.  It is very hard to convince these ladies that they are not pregnant. I am told this happens quite often here in Haiti.  The rooms for scanning are small but the enthusiasm high. The trainees critique each other:

“Slide, don’t rotate.” says one.

“Where is the stomach on the abdominal circumference?” says another.

The patients wait patiently for their scans. Most are more than 24 weeks GA and having their first scan. We practice our 6-Step-Approach and the four transducer moves. By the second day, the trainees are getting really getting good.

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Patients waiting patiently (Image by L. Hanson)

Around 5:30 PM, the ISUOG Team heads back to the hotel for a shower and dinner.  We talk about the day, call home to check on family, review the next day’s lectures and fall into bed.

After all, the rooster will wake us up in just a few hours….. “

Keep following our blog throughout the week for more live updates from Haiti. For more information around our work in Haiti, be sure to visit our website.

 

ISUOG Outreach returns to Haiti!

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Day 1 ISUOG Outreach in Cap-Haitien (Photo by V. Lemaire)

ISUOG Outreach returns to Haiti this week – this time, the Northern city of Cap-Haitien. Partnering with Hopital Universitaire Justinien (HUJ) and local NGO Zanmi Lasante, the lead – led by Dr. Lisbet Hanson, will be training a group of 18 doctors on basic ultrasound in Obstetrics and gynecology. For this endeavour, Philips has donated a machine for the project to the University Hospital. What makes this program so dynamic is that ISUOG Outreach is proud to site that one of its previous trainees from the ISUOG Haiti (St. Damien) program, Dr. Vladimir Lemaire, has now joined the team as an ISUOG Outreach Trainer! Catch his blog below as he explains how the day unfolded and the emotion it brought:

“After a very early morning breakfast, my heart was completely full as I walked back to the Hopital Universitaire Justinien (HUJ) here in Cap-Haitien where almost 13 years ago, I undertook my own residence. Inspired by the familiarity and with both great pride and humility, I returned but this time as a trainer.

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Dr. Vladimir Lemaire teaching with the donated Philips machine (Photo by L.Hanson)

During the time I was there for my residence, ultrasound training seemed to me at the time completely out of reach, But after ceremonial formalities and a brief introduction from Dr. Lisbet Hanson (USA – Haiti Team Leader), time was of the essence and we went rapidly into the subject. Dr. Stéphane Michel (Haiti), Ms. Gail Ghiretti (USA) and myself gave our presentations one by one, with the pre-test interwoven between the first and second talks.

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Trainees listening attentively to lecture (photo by V. Lemaire)

We were pleasantly surprised by the quality of the questions and case studies of the participants during the lectures and this feeling was reinforced during the practical lesson where they really showed a good level of skill.

The day ended with a debriefing with Dr. Hanson, during which she reemphasised the “points to improve on”, responding the last questions from the participants – it was an incredible day!”

Check out more about our previous work in Haiti by visiting out website and stay tuned for more blogs straight from the field during the week!

 

Visions of Burma – supporting training in Yangon

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Outreach team (from left to right: Franti Grochal from Slovakia, Dr. Philippe Jeanty from USA, Ya Chiao Hu from Taiwan and Federico Badano from Argentina).
Image courtesy of Dr. Philippe Jeanty of TheFetus.Net

On 7 March 2017, Outreach Committee Member and Founder of TheFetus.net Dr. Philippe Jeanty (USA), led a group of trainers in Yangon, Myanmar to train 30 trainees from across the country in basic OB/GYN ultrasound. ISUOG Outreach supported this mission and below, Dr. Jeanty provides his first impressions of Yangon from early this week.

“First day:

This is the first Outreach course we’de done in Yangon, Myanmar. The first day was rest and recovery from very long trips! Federico Badano was the longest distance flyer (29 hours from Argentina), followed by Franti Grochal (26 hours from Slovakia). Ya Chiao Hu from Taiwan and Gwang Jun Kim from South Korea had an easier time but still pretty long trips!
We did some light visiting, taking a local train to site see. Interestingly, we crossed the tracks a few time to get from platform to platform. Very surprising to me!  The train was full of colorful people. They use some ground up stone for makeup and sunscreen. In the train there was a panel with 3 warnings: you can’t smoke or litter, but more surprisingly, you cannot kiss on the train!

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Yangon train
Image courtesy of Dr. Philippe Jeanty of TheFetus.Net

The train was really packed and vendors circulating with all types of food, drinks and trinkets. They even sell betel leaves that people keep in their checks, a little like the coca leaves in the Andes with similar bad effects on teeth! We chatted with some people who were very friendly and quite interested in us. Actually mostly interested in Ya Chiao and we learned later that Korean movies are very popular here and they thought she was a Korean actress!!
We visited a pagoda with an immense Buddha statue made of a single block of marble imported (if I am correct)  from Nepal.
The food is very varied and influenced by Chinese and Indian cuisine.
Today was the first day of the course and we met with our local contact, Dr Yin Yin Soe, who organized the course.
We had 30 students and they come from all over Myanmar! It was incredible that many had come from hospitals with only one obstetrician so it was apparently difficult to get government permission for them to attend the course and have surgeon cover their absence. Many travelled by train the night before. Compared to previous Outreach courses, they are much less intimidated which makes the contact easier.
We had class room in the morning and workshop the afternoon.
It is very very hot! 37 C/99 F, but the students were really eager to learn!

Second day:

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Yao Chiao scanning with a trainee
Image courtesy of Dr. Philippe Jeanty of TheFetus.net

Since I am so hard at hearing, I got in the habit of asking people to write their questions on paper and drop them on the desk. This is also a great technique for shy students and women who otherwise would not ask questions. Well, we were inundated and the questions reflected a very good level of knowledge. This is an interesting situation with knowledgeable students who just have very little hand-on practice. So I worry that our lectures were too basic.
For Ya Chiao, this was her very first ever presentation in front of a class and even behind her impassible stoic face, she was clearly nervous! Sonographers don’t often teach physicians in Asia but she did a very good job!
Gwang Jun had the second presentation and talked about CNS anatomy and the views. As expected, he had a great presentation and has a unique style of teaching, for instance a way to remember the ventricular system by folding the fingers was a refreshing approach to the usual topic!
Federico and Franti then did their presentation with the ease of someone who has spent years doing them.

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Trainers with trainees
Image courtesy of Dr. Philippe Jeanty of TheFetus.net

The afternoon we had tons of patients with anomalies, including large cephalocele, missed AB, triplets and so on. Some patients needed TV examination which we rarely do in courses like this and Concordia rapidly got us a TV probe and we did several scans. It helps that women here are accepting and that almost all the students are women.
They know what they need to look for but needed help in coordinating what they see on screen with the movement of the transducer. So I hold their hand and show the movement. And invariably they look at my hand moving theirs instead of looking at the screen! So finally I took a patient chart as a “blind” to force them to just look at the screen!
The machines we have are uneven resolution. The three top end machines are fantastic but the low end one makes you realize what it is to scan in a country that has a hard time affording to machines: we are very spoiled!”

Stay tuned for more stories from Myanmar and next week, as we report from Ghana!

 

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Outreach team (from left to right: Franti Grochal from Slovakia, Dr. Philippe Jeanty from USA, Federico Badano from Argentina, Ya Chiao Hu from Taiwan and Dr. Gwang Jun Kim from South Korea)
Image courtesy of Dr. Philippe Jeanty of TheFetus.net

Day 1 in Sudan and ready to learn

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(ISUOG Ambassador and Trainer Hisham Mirghani speaking to trainees; image courtesy of G.A Báez for ISUOG Outreach)

Sunday the 13th of November kicked off the ISUOG Outreach program in El Obeid, Sudan with 30 trainees eager to get started at the Planned Parenthood Headquarters in El Obeid. The morning began with an opening ceremony, presented by the Minister of Health, Dean of the University of Kordofan, along with ISUOG Ambassador Hisham Mirghani and ISUOG International Development Coordinator Gesu Antonio Báez. This was followed by a practical scanning session. And the sessions were big – up to 70 patients were in the waiting room ready to be scanned by the trainees who were also eager to learn.

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(Hands on training with ISUOG Trainer Yasmin Casmod; image courtesy of G.A Báez for ISUOG Outreach)

MindRay generously loaned two machines to the program to enhance the training experience. The rest were provided from local hospitals and were functioning in full form!

Each trainee was divided into groups based on their years of experience with ultrasound in order to provide a tailored approach to their learning. This also allowed them to get to know other trainees who came from afar – some travelled up to five hours from other parts of Sudan!

Dr Reem Abu-Rustum ended the day with theoretical training by going over the “Six Step Method”.  Prof Mirgani demonstrated how to properly handle the probe, Yasmin Casmod covered knoblology and Dr Angela Ranzini spoke about Fetal Biometry.

With day one already a success, the group looks forward to taking the scanning skills of the groups to next level. With hope, it will be a successful week to follow, or as they say in this part of the world “inshallah”.

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(ISUOG Trainer and Ambassador Reem Abu-Rustum with trainees; image courtesy of G.A Báez for ISUOG Outreach)

The purpose of the ISUOG Outreach project to Sudan is to provide ultrasound training to local OB/GYN practitioners with the intention that these trainees eventually become local trainers.

Phase I comprises of three week-long training programs, which will take place in a 12-18 month time frame with a space of 6 months between training. Between training, trainees will be mentored by designated trainers from the project team to provide guidance on scanning. By the end of Phase I, trainees will be competent in ultrasound scanning techniques and conduct quality scans in line with basic training outreach templates (SO2).

For more information on the goals and outputs on the program see http://www.isuog.org/Outreach/Projects/Sudan/Sudan+1.htm

ISUOG Outreach off to Papua New Guinea!

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Training in Papua New Guinea
Image courtesy of Dr. Nayana Parange

Some exciting news – in partnership with the Australasian Society of Ultrasound in Medicine (ASUM ) on their first Outreach endeavor – ISUOG Outreach will be supporting a program in Port Moresby, Papua New Guinea from 23 October to 27 October. Led by ISUOG Outreach volunteer Dr. Nayana Parange, a team of three from Australia (Dr. Alice Robinson, Dr. Kris Barnden and Dr. Sujatha Thomas) will be training nine trainees from around the area in basic OB/GYN ultrasound at the Port Moresby General Hospital. While they will be working on the current two machines in place, GE Healthcare has partnered with the program to lend portable machines for this endeavor.

Of all the countries in the Asia/Pacific region, Papua New Guinea (PNG) has the highest levels of maternal mortality and has actually shown little (if any) progress on achieving the previous Millennium Development Goals (MDG’s) on reducing maternal mortality at a staggering 230 women dying for every 100,000 (according to HDR 2014 Report).  More statistics on PNG can be found here via the World Health Organization.

With the levels of women dying in the country due to preventable causes, providing basic training in OB/GYN ultrasound is vital to help identify issues in advance. Be sure to watch this space as we hear more from the field and provide more updates from the team!

 

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Village near Port Moresby
Image courtesy of Nayana Parange

Why women’s health is a vital part of global human rights

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Mothers in Ghana
(Image courtesy of Gesu Antonio Baez for ISUOG Outreach – Ghana)


10 December was Human Rights Day. When Hillary Clinton made the statement, “Women’s rights are Human Rights” during the 1995 UN Conference on Women in Beijing, it rocked global consciousness in recognising women’s rights as an integral part of human rights. But what about women’s health?  Is it a part of human rights and how does ISUOG defend this? ISUOG’s International Development Officer, Gesù Antonio Báez, explores this topic further.

 

It would be foolish to believe that women’s health didn’t play a crucial role in global women’s rights or human rights in general. Yet somehow, despite the numerous international conventions and covenants that have been championed by the UN and its global partners, women’s health has been pushed as merely a topic for development and humanitarian endeavours, as clearly demonstrated with the now defunct Millennium Development Goals (MDGs) and newly initiated Sustainable Development Goals (SDGs) this past September.

Of course, this is not to belittle its category as an important item on the developmental agenda; in fact, it’s paramount to it! But women’s health amounts to so much more than as a single task to accomplish in a nation’s pursuit towards overall development. Because truth be told, women’s health – particularly their right to quality healthcare – is vital not just for global development, but crucial in the fight to defend women’s rights. For if women are the backbone to society and essential for a country’s empowerment, then denying them adequate healthcare is both a violation of their human rights and a denial for a country in achieving its true potential in global development.  Human rights are, first and foremost, a matter of preserving dignity and guaranteeing women access to competent doctors and health services is a task in which all nations and key human rights agents must be willing to invest upon in order to properly demonstrate their commitment to the Universal Declaration of Human Rights (UDHR), adopted by the international community exactly 68 years ago on 10 December 1947.

As an agent for women’s health, ISUOG’s mission is to ensure that every woman has access to competent ultrasound scanning and that OB/GYN conditions are effectively diagnosed because it is a women’s right – her human right – to receive proper treatment and care.

Either via an ISUOG Approved Course in Nigeria, a World Congress in Rome, an International Symposium in India, or an Outreach program in Papua New Guinea,  ISUOG strives to ensure this sacred right is respected and honoured by empowering OB/GYN professionals with the necessary skills needed to conduct a proper scan with quality educational resources, no matter where in the world they are located because the key to ISUOG’s mission is every woman.

Women’s rights are human rights as Hillary Clinton said nearly twenty years ago in Beijing, but women’s health is a fundamental part of this because it honours the women’s right to live. Through ISUOG’s mission and role in the important task of upholding this right, I believe we are on the way towards making an overall respect for this right completely universal.

SANA’s Spring Reflections from the Lebanese Outreach

Reem Abu-Rustum, MD FACOG is the founder and President of SANA Medical NGO (an ISUOG partner), dedicated to outreach obstetrical care in Lebanon. She is also ISUOG’s Ambassador to Lebanon and the Middle East, being actively involved in the integration of ultrasound in medical education. SANA celebrated 4 years of success this past May and in this post, Reem graciously shares her insight on not just outreach in the under deserved communities in Lebanon, but also accommodating new disadvantaged communities coming in from neighboring Syria as well.


Spring, earth’s time of rebirth and regeneration.

It brings with it endless hope and promise. This spring, it marked a most special time for SANA Medical NGO during which it celebrated its 4th birthday on 19 May 2015 and renewed its commitment to its mission.

It has been an amazing four years during which SANA had to evolve and adapt to the changing needs within the Lebanese Outreach. So many missions, lessons and stories have had a lifelong impact and have been forever etched within SANA’s memory; the endless images of stoic expectant mothers wearing appreciative smiles of reassurance and the bright faces of SANA’s trainees empowered by their new skill and knowledge. There lies the driving force behind SANA, infusing it with such a sense of purpose.

On its 4th birthday, SANA reflects back on its teachers, trainees, patients and supporters who have all been an endless well of inspiration.

Without its teachers, who served as the ultimate role model, SANA would not have come into existence. The incredible work that was being accomplished all over the globe by Alfred and Sharon Abuhamad, Titia Cohen-Overbeek, Jean-Claude Fauron, Lisbet Hansen, Philippe Jeanty, Anthony Johnson, Dario Paladini, Ann Tabor and the ISUOG Outreach volunteers is what led to the birth of SANA. It was founded in loving memory of Dr. Sana Elias with the goal of carrying out ISUOG Outreach’s work in ‘our own Lebanese backyard’. To its teachers, SANA is forever grateful.

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Over the past 4 years, SANA has been blessed in being able to partake in the sonographic education of over 30 deeply committed and motivated trainees of various ages and qualifications. The training is ongoing at different phases to the diverse groups. Regardless of their background, whether or not they could read or write, they held the probe with contagious excitement and dedication soon after putting their newly acquired sonogaphic skills to tremendous use. Nothing is as gratifying as watching SANA’s trainees positively impact the medical care being provided to the underserved expectant mothers in the Lebanese Outreach, which now comprises of both native Lebanese mothers and Syrian refugees. SANA is proud of its first group of nine midwives and nurses who have completed the basic training and received ISUOG certificates. They are now undergoing continuous advanced training. In addition, one of SANA’s star trainees, Midwife Loulou, has lectured to the newest group of 16 midwifery students igniting their interest and capturing their attention. Today, SANA is as committed as ever to making available proper sonographic training to all interested probe-handlers.
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As SANA reflects back, it becomes quite apparent that perhaps the most powerful images are those of its patients. SANA was established with a primary goal of providing high standard quality care to underserved Lebanese mothers. Little was it known back in 2011 that over one third of SANA’s patients would be Syrian refugees. SANA had to adapt to mounting needs where, in addition to the pre-existing suboptimal conditions in the Lebanese Outreach, it was faced with the additional challenges of a growing number of patients who had witnessed the atrocities of war in all its forms, due largely to the current conflict in Syria. But these patients were combatting death by bringing in life and as such, SANA has managed to take care of several patients now in their second and third pregnancies during their displacement in Lebanon. These patients tended to be either much younger or grand multiparas with higher rates of prior home births and prior cesarean births when compared to their Lebanese counterparts. SANA is indebted to its able partners who have facilitated its mission in delivering quality prenatal care to over 1000 patients. Most importantly now, it is through the actions of SANA’s trainees, who have been most gracious in providing quality prenatal care to underserved Lebanese and Syrian refugees, that SANA’s existence is validated.

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And how could SANA have ever succeeded in any of its activities had it not been for its volunteers? They have been giving consistently and selflessly, serving as a key to SANA’s sustenance.

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As SANA’s reflections come to a close, it looks forward to a most promising future fueled by unwavering passion and acquired wisdom, aided by its donors and supporters. Today, SANA renews its vows to carrying on with its mission thanking each and every one who has accompanied it on this most unforgettable journey in the glorious Lebanese Outreach.

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WHO Meeting in London: maternal health in the post-2015 agenda

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ISUOG participated as an active observer during the WHO-PMNCH Board meeting in London, chaired by Graça Machel, former First Lady of South Africa and Mozambique.

As a member of WHO’s Partnership for Maternal and Newborn Child Health, ISUOG participated in their Annual Board Meeting on Monday 20 April 2015, at the RCOG headquarters in London.

Chaired by former South Africa/Mozambique First Lady, Graça Machel (who is also the widow of Nelson Mandela) the energy in the room was electric with discussions on strategies to improve women’s health and focused on identifying priorities for maternal and child health for the post-2015 Sustainable Development Goals (SDG) agenda. However, identifying these priorities became a real challenge for the board which tried to agree on what these should be and at the same time recognise the needs of all nations. This stems from the common issue of data and feedback monitoring which proved to be inconsistent over the years and there is now a lack of concrete and inconsistent reporting on what the main issues are in various countries.

ISUOG is a proud to partner with PMNCH and our presence at this meeting helped address the importance of providing doctors with quality education and training so that they can deliver effective obstetric and gynecological care to women all over the world.

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Amina Mahamad of Nigeria, UN’s Advisor to Maternal and Child Health for the Post-2015 agenda, responds to why educating doctors is crucial in saving the lives of countless women.

Highlighting the importance of ensuring all OB/GYN’s are empowered with quality education in training, Amina Mahamad of Nigeria, who serves as the UN’s Advisor to Maternal and Child Health for the Post-2015 agenda, shared her own experience as a mother. When giving birth to her four children in Nigeria, she was found subject to squalid conditions and dealt with doctors who were not sure exactly how to manage the childbirth. She highlighted that it is indeed time for countries to invest in education and resources for their health practitioners to help prevent maternal mortality. She mentioned as well her own cousin, who died of pre-eclampsia, which was not diagnosed until it was too late, despite having been to all her routine check-ups. Her message was clear; all mothers should be given the assurance and ease of mind that their doctor is fully capable of delivering their baby safely and this only comes through quality education for our doctors.

The agenda for the Sustainable Development goals aim to incorporate the needs of both the developing and developed world; and, it is clear that many more conversations will be needed to ensure that the goals fulfil the health requirements of women and children globally. ISUOG is very proud to be part of this process and looks forward to progress in the years to come.