Category Archives: Africa

Testimonial: Midwife Sarah Ibrahim in Ethiopia

For two years, Sarah Ibrahim has been working for Doctors of the World Germany in the Malayko Health Center (Somali Region, Ethiopia). Below she shares her experience working in the field.
 
What can happen to a woman if there is no midwife?
 
If there is no midwife, the situation can get dangerous. If there are complications, the mother can die while giving birth. There are sometimes dangerous signs like preeclampsia. Even if there is a TBA (Traditional Birth Attendant) and another skilled person, there could be a lot of different problems. 
 
To avoid these problems, you have provided training sessions. What do you teach other midwives?
 
We talk to pregnant mothers about how important it is that they come to the health facility when they feel that birth is about to begin. After birth, I consult and train the mother on how to take care of her baby and about hygiene for the baby and herself. I show this also to my colleagues and teach them for example how to detect preeclampsia and what to do in these cases. 
 
Do you have some words for our readers abroad?
 
I am greeting all the other women in the world. We are all family and we have to care about women and children regardless of the color of the skin or where they come from. It is a question of humanity and we have to take care of all of us.

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Universal Day of the Elimination of Violence Against Women

More and more minors are becoming victims of violence
 

“Early and forced marriages, unwanted pregnancies linked to sexual abuse, unsafe abortion practices of pregnancy (IVG): in the DRC, and particularly in South Kivu, gender-based violence is everywhere. And it is not decreasing, or not very noticeably. We know that from an OCHA report in 2020, GBV increased by 86% that year compared to 2019, this violence concerns more and more minors and young girls under 18 years of age are becoming pregnant. In the face of this violence, stigmatization and lack of care are still common for many victims,” explains Eric Wynants, deputy coordinator of DotW in DRC, who has coordinated the project to combat violence in Panzi.

In South Kivu, a region marked by ongoing conflict and an alarming humanitarian situation, rape has long been used as a weapon of war by the warring parties. Today, rape has spread in Congolese society, particularly through demobilized former child soldiers, militiamen, ex-rebels and various armed groups. The victims seem to be increasingly young, sometimes under the age of ten. This violence is in addition to other violence committed in a domestic or criminal context. In order to help the victims of this violence, DotW intervenes in the territory of Uvira and in the city of Bukavu. Our organization carries out community prevention activities, offers health care and provides psychosocial support, promotes the reintegration of victims into the workforce and refers them for legal advice. Given the tense security situation and the lack of humanitarian organizations present in certain areas, the intervention of DotW is essential.
 

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Universal Day of the Elimination of Violence Against Women

More and more minors are becoming victims of violence
 

“Early and forced marriages, unwanted pregnancies linked to sexual abuse, unsafe abortion practices of pregnancy (IVG): in the DRC, and particularly in South Kivu, gender-based violence is everywhere. And it is not decreasing, or not very noticeably. We know that from an OCHA report in 2020, GBV increased by 86% that year compared to 2019, this violence concerns more and more minors and young girls under 18 years of age are becoming pregnant. In the face of this violence, stigmatization and lack of care are still common for many victims,” explains Eric Wynants, deputy coordinator of DotW in DRC, who has coordinated the project to combat violence in Panzi.

In South Kivu, a region marked by ongoing conflict and an alarming humanitarian situation, rape has long been used as a weapon of war by the warring parties. Today, rape has spread in Congolese society, particularly through demobilized former child soldiers, militiamen, ex-rebels and various armed groups. The victims seem to be increasingly young, sometimes under the age of ten. This violence is in addition to other violence committed in a domestic or criminal context. In order to help the victims of this violence, DotW intervenes in the territory of Uvira and in the city of Bukavu. Our organization carries out community prevention activities, offers health care and provides psychosocial support, promotes the reintegration of victims into the workforce and refers them for legal advice. Given the tense security situation and the lack of humanitarian organizations present in certain areas, the intervention of DotW is essential.
 

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Testimonial of two survivors of sexual violence in the Democratic Republic of Congo

“I tell my daughters: refuse the gift of an unknown man, who will inevitably expect something in return.”

Myriam (not her real name), widow, mother of three children, from Makobola, says: “It was July 2021. I was working in the fields. I was sexually assaulted by three men when I was alone. I went home drained, down and distressed. I didn’t speak anymore, neither to my children, nor to the village chief. I didn’t leave the house for days which alerted Bobylia, the focal point of the protective community. I confided in him.

Myriam then went to the Makobola health center, supported by DotW.
“When I arrived, I couldn’t sleep, I felt guilty, I was discouraged. Thanks to the psychological support I received from DotW psychosocial assistant, I was finally able to talk to my children.”

Today, having become a member of the ‘protective community’, a DotW project, Myriam is raising awareness about sexual violence among other Makobola residents.
“I advise victims of violence to go to medical facilities. I also teach my daughters to be careful, to avoid insecure places, and that they should not accept gifts from foreign men, who will inevitably expect something in return.”
 
Photography

© Caroline Thirion
 
 

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Testimonial of two survivors of sexual violence in the Democratic Republic of Congo

“I tell my daughters: refuse the gift of an unknown man, who will inevitably expect something in return.”

Myriam (not her real name), widow, mother of three children, from Makobola, says: “It was July 2021. I was working in the fields. I was sexually assaulted by three men when I was alone. I went home drained, down and distressed. I didn’t speak anymore, neither to my children, nor to the village chief. I didn’t leave the house for days which alerted Bobylia, the focal point of the protective community. I confided in him.

Myriam then went to the Makobola health center, supported by DotW.
“When I arrived, I couldn’t sleep, I felt guilty, I was discouraged. Thanks to the psychological support I received from DotW psychosocial assistant, I was finally able to talk to my children.”

Today, having become a member of the ‘protective community’, a DotW project, Myriam is raising awareness about sexual violence among other Makobola residents.
“I advise victims of violence to go to medical facilities. I also teach my daughters to be careful, to avoid insecure places, and that they should not accept gifts from foreign men, who will inevitably expect something in return.”
 
Photography

© Caroline Thirion
 
 

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Our COVID-19 Response in Haiti, South Sudan and Ukraine

Infection, Prevention and Control   
 

The first objective in our COVID-19 programs was to ensure that the healthcare facilities were prepared for a COVID-19 outbreak in their region. The DotW team carried out training sessions to prepare healthcare staff and community health workers on COVID-19. These sessions focused on IPC strategies (quarantine, isolation, etc) as well as providing information on the COVID-19 virus including its etiology, transmission, symptoms, risk, diagnosis and treatment. Staff were also trained on Mental Health and Psychosocial Support (MHPSS), particularly within the context of COVID-19. 

Besides training healthcare staff on COVID-19, Doctors of the World donated Infection, Prevention and Control (IPC) supplies like PPE as well as medicine and medical equipment to the various healthcare facilities it supported in Haiti, Ukraine and South Sudan.  

Another key aspect of our COVID-19 response was raising community awareness by disseminating information about the virus to the public so that individuals were better equipped to recognize symptoms, prevent infection and seek out treatment. DotW prepared messages and presentations that were shared on the TV, radio, and across various social media platforms like Facebook. DotW had additionally partnered with local community leaders and organizations that could further amplify the message. 

In Ukraine, Doctors of the World organized phone consultations where individuals could call and receive the necessary information about COVID-19, as well as launched a video competition among children on how to prevent the spread of COVID-19. 

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Our COVID-19 Response in Haiti, South Sudan and Ukraine

Infection, Prevention and Control   
 

The first objective in our COVID-19 programs was to ensure that the healthcare facilities were prepared for a COVID-19 outbreak in their region. The DotW team carried out training sessions to prepare healthcare staff and community health workers on COVID-19. These sessions focused on IPC strategies (quarantine, isolation, etc) as well as providing information on the COVID-19 virus including its etiology, transmission, symptoms, risk, diagnosis and treatment. Staff were also trained on Mental Health and Psychosocial Support (MHPSS), particularly within the context of COVID-19. 

Besides training healthcare staff on COVID-19, Doctors of the World donated Infection, Prevention and Control (IPC) supplies like PPE as well as medicine and medical equipment to the various healthcare facilities it supported in Haiti, Ukraine and South Sudan.  

Another key aspect of our COVID-19 response was raising community awareness by disseminating information about the virus to the public so that individuals were better equipped to recognize symptoms, prevent infection and seek out treatment. DotW prepared messages and presentations that were shared on the TV, radio, and across various social media platforms like Facebook. DotW had additionally partnered with local community leaders and organizations that could further amplify the message. 

In Ukraine, Doctors of the World organized phone consultations where individuals could call and receive the necessary information about COVID-19, as well as launched a video competition among children on how to prevent the spread of COVID-19. 

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Doctors of the World response to humanitarian crisis in Eastern DRC

The Democratic Republic of Congo is facing a multitude of compounding crises with serious consequences for the civilian population.
 
Political instability, chronic conflict, and natural hazards, like volcanic activity and flooding, have left a large part of the population in need of humanitarian assistance. 

Doctors of the World (DotW) has drawn its attention to one region where populations are left vulnerable to a variation of health and security disasters. In the Fizi Highlands, civilians have found themselves trapped between two conflicting territories: the Minembwe and Itombwe. The region has endured violence and armed conflict for over a decade, however in the spring of 2020, there was an escalation in violence between the Mai-Mai and the Banyamulenge communities. Civilians have been further targeted as human rights organizations report cases of murder, rape, burning of villages, and looting of livestock. In response, the Armed Forces of the DRC have mobilized in the areas of violence, in order to put an end to the fights between armed groups.

The consequences of the conflict have also resulted in forced displacement, lack of access to essential services like healthcare and sanitation, as well as impacted the population’s food security. The situation remains tense as this conflict has caused division of the population by ethnicity, and individuals are forced to continuously move between territories to avoid further violence. According to OCHA, about 39,700 persons (approx. 7,940 households) were displaced during the violence in this region. Many internally displaced persons (IDPs) have been separated from their homes since 2019 and returns remain very low. 

In response to these conflicts, Doctor of the World ran a project, funded by USAID, that used multi-sectoral lifesaving interventions targeting the most vulnerable conflict-affected individuals in Itombwe and Minembwe territories in. The sectors of focus for this project included health, nutrition, water, hygiene and sanitation (WASH), and protection.

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Cervical cancer: the cancer of inequalities

Cervical cancer is an unfortunate indicator of global health inequities. Worldwide, cervical cancer is the 4th most common cancer in women, with an estimated 604,000 new cases appearing in 2020. According to the WHO, of the 342,000 global deaths in 2020, about 90% occur in Low and Middle Income countries (LMIC). 

The tragic aspect of cervical cancer is that it is largely preventable. We estimate that more than 95% of cervical cancer cases are a result of a Human Papillomavirus (HPV) infection, which is typically transmitted through sex. HPV is a group of more than 150 related viruses, although HPV 16 and HPV-18 are largely associated with increased risk of cervical cancer.  A HPV vaccine exists to protect against most types of HPV that are linked with cancer. However, the vaccine should be administered at a young age (between 9 to 12 years old)and up to 26 years old at the latest. 

Unfortunately, less than 30% of LMIC have introduced HPV vaccination and less than 3% of adolescents are vaccinated against HPV. The combination with low cervical cancer screenings means that many women do not find out about their HPV-related cervical cancer until it is too late, leading to hundreds of thousands of preventable deaths. According to the WHO, by 2030 it will kill more than 443,000 women per year in the world if no concrete action is taken urgently. 98% of these deaths will occur in developing countries, with 90% of them in sub-Saharan Africa.

Cervical cancer is indicative of health inequalities and gender inequalities. Its burden rests solely on women and girls. Globally it is the 4th most common cancer in women, despite being largely preventable in the first place. With vaccinations and screenings, more than 340,000 deaths could be prevented every year. 

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LGBTQ+ Health Needs Require Targeted Interventions to Address Health Disparities

For this month, Doctors of the World has taken a closer look, both at the international community as well as within its own chapters, to see how LGBTQ+ needs are identified, and more importantly addressed. Looking into the representation of LGBTQ+ needs in the global health landscape, it is clear that significant gaps exist, given the health disparities recorded. Doctors of the World has always been vocal on human rights, we firmly believe in confronting discrimination and violence taken against marginalized groups. To not speak up is to condone. 
The United Nations 2030 Agenda on Sustainable Development Goals (SDG) was established as a guide to improve our world, with its overarching mission to “leave no one behind”. SDG 3 in particular was created “to ensure healthy lives and promote well-being for all at all ages.” Overall, the SDGs offer intersectional approaches that seek to improve the quality of life for all. However, due to the consensus nature of negotiations for this agenda, the document was unable to include LGBTQ+ as a specific group facing barriers to the right to development. Advocates were able to ensure that people that were marginalized because of their sexual orientation, gender identity and expression, and sex characteristics (SOGIESC) were inserted in commitments to “leave no one behind”. Nonetheless, by failing to specify LGBTQ+ in its agenda, it perpetuates the huge disparities that exist when it comes to LGBTQ health data, treatment, and inclusion. 

A 2017 briefing published by the Global Forum on MSM and HIV and OutRight Action International, looks to amend the UNSDGs Agenda by providing recommendations on how to better improve LGBTQ+ health. The authors identified seven SDG 3 targets that Member States and civil society should work to address. The Agenda 2030 for LGBTQ+ Health and Wellbeing further stresses the importance of collecting and disseminating data and knowledge, so that evidence-based policy can be established that successfully addresses health disparities. 
As part of the global humanitarian community, it is vital that Doctors of the World exchange research and knowledge on the topic. Today, we will discuss one of the projects we are incredibly honored to be a part of, the LGBTQ+ health in Uganda. However, if you are curious to learn about our other LGBTQ+ programs, be sure to keep an eye out on our social media platforms to get insights on other programs occurring around the world.  It is vital, for the sake of this community, that knowledge is shared, that all voices are heard, and most importantly, action is taken. 

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