How the first million will be spent

$1,000,000 from Americans in Support of UNFPA

Over 100,000 Americans have voiced their support for international family planning through the “34 Million Friends of UNFPA” campaign. The first million dollars raised from the campaign will help make pregnancy and childbirth safer for women; reduce the spread of HIV/AIDS; equip hospitals with essential family planning supplies; support adolescents and youth; and prevent and treat obstetric fistula. Country specific programmes include:

• In Timor-Leste, UNFPA will equip the only two hospitals in the country that provide emergency obstetric care with two-way radios to reach on-call doctors in time to save women’s lives. In addition, three Timorese doctors will receive obstetrical training to ensure that women in need of Caesarean sections can get help outside the two main hospitals. Currently, the country relies heavily on expatriate doctors and there is an urgent need for local expertise. UNFPA will also provide 80 motorcycles to midwives to reach women living in districts with poor roads and no public transportation.

• In Ghana, UNFPA will purchase essential reproductive health equipment for clinics that provide safe motherhood services to young women and adolescent girls. This includes supplies to treat women who have suffered from female genital cutting.

• In Rwanda, UNFPA will provide ambulances to transfer patients in need of emergency obstetric care. Voluntary counselling and testing kits for HIV/AIDS will also be provided to health clinics. There is a high demand for testing thanks to community outreach campaigns. Therapy kits will also be provided to treat women who are victims of sexual abuse.

• In Eritrea, UNFPA will train 1,000 health assistants in basic emergency obstetric care in an effort to reduce the high incidence of maternal mortality. This training will teach providers how to perform life-saving interventions for complicated deliveries, thus "buying time" before a woman can reach a hospital. There are only a limited number of facilities that provide emergency obstetric care in the country.

• In Mongolia, UNFPA will provide information on modern contraceptive methods to adolescents, men and women nationwide. Most people rely on traditional methods and are unaware that modern contraceptive methods are available, affordable and reliable. Clinical guidelines on treatment of disease and illness during pregnancy will also be distributed to all reproductive health service providers. In addition, 63 health care providers from the country’s 21 provinces will be taught how to provide quality reproductive health care and counselling. Skilled providers are particularly needed in remote rural areas.

• In Bhutan, UNFPA will focus its work in Zhemgang, one of the country’s poorest districts, which has high rates of teenage pregnancies, infant and maternal deaths. Funds will be used to: train health personnel to provide emergency obstetric care; develop a system to report maternal deaths; revise maternal death audit forms to ensure they include the cause of death, which will help prevent future deaths; provide clinics with reproductive health equipment; and, provide young women and adolescents with reproductive health services to promote safe motherhood and help them avoid unwanted pregnancies and unsafe sex.

Addressing Obstetric Fistula

Half of the first million raised by the “34 Million Friends” campaign will be used to address obstetric fistula, the most devastating of all pregnancy-related disabilities. Eliminated in wealthy countries, including the United States, over a century ago, fistula affects an estimated 50,000-100,000 women each year. It usually occurs when a young, poor woman has an obstructed labour and cannot get a Caesarean section when needed. The baby usually dies. If the mother survives, she is left with extensive tissue damage to her birth canal that renders her incontinent.

Fortunately, fistula is both preventable and treatable. Delaying early pregnancy, educating young women about their bodies and providing skilled medical care at childbirth can help prevent fistula. Reconstructive surgery costs about $350 and is over 90 per cent effective if done properly.

UNFPA grants will be provided to six countries - Mali, Senegal, Nigeria, Benin, Malawi and Bangladesh - to prevent and treat fistula. These funds will be used to renovate facilities, train doctors and nurses and purchase much needed surgical equipment and supplies such as suture material, operating theatres, beds and antibiotics. Community outreach will also be undertaken to raise awareness about fistula.

Mapping the Problem

Data on obstetric fistula are scarce. In fact, the full extent of the problem has never been mapped. The World Health Organization estimates that over two million women are living with obstetric fistulas today, but these figures are likely to be grossly underestimated. To address this need for information, UNFPA will conduct rapid needs assessments in seven countries to gauge the extent of the problem in each country and the ability of hospitals to perform surgery and provide post-operative care. Countries include Senegal, Togo, Eritrea, Somalia, Djibouti, Yemen and Sudan. Findings will lay the groundwork for programmes to prevent further cases and treat women living with fistula.

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