In The Global Effort To Prevent Maternal Deaths, Doctors Without Borders Is Leading The Way

By Anni Irish
At a hospital in Côte d'Ivoire, Dr. Rasha Khoury and the Doctors Without Borders surgical team perform a Caesarean section to deliver a baby. © Jean-Christophe Nougaret/Doctors Without Borders.

In early 2016, a woman arrived at a maternity hospital in Khost, Afghanistan at 5 a.m. She had come from three hours away. Weak and barely able to walk, the woman had given birth at home before arriving at the medical facility. Addressing her most immediate needs, doctors and hospital staff worked tirelessly through the early morning hours to repair a tear in the woman's cervix.

After five hours in surgery, and with the help of multiple units of blood and fluids, the injury was treated and the woman survived. Although her uterus had to be removed due to complications during surgery, she was among the lucky ones — if she had not made it to the hospital in time, she would have died. Two years later, in 2018, Dr. Rasha Khoury, one of the doctors who had helped operate on the woman, saw her again. By this time, she had fully recovered and her baby was thriving. She had returned to the same hospital to assist another woman in her village who chose to give birth there rather than at home.

Dr. Khoury, along with doctors, midwives, and other medical staff at the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in Khost see thousands of patients like this woman on a daily basis. Women often come to the hospital after giving birth at home, and while some are able to make full recoveries, others suffer from life-altering complications.

According to the United Nations, approximately one woman dies every two minutes from causes related to pregnancy or childbirth across the globe, which is estimated to be 830 women per day. Fifty percent of these deaths occur within 24 hours of labor. The reality is that many of these deaths are preventable when women have access to the proper medical care. But getting access to good maternal health care can be difficult or nearly impossible in some parts of the world – especially considering various factors such as distance, time, safety, and social norms.

In Afghanistan, deliveries often take place at home, with two out of every three births taking place without the help of a midwife or doctor, according to Doctors Without Borders. This can lead to many complications such as hemorrhaging or tearing of the vaginal wall and cervix. And yet, due to traditions in parts of the country, women are often not able to get medical attention without the permission of a male guardian – which means they often do not get care fast enough. In many cases, a male caretaker must accompany women and girls to medical appointments, and a male must consent to medical procedures and family planning options. On top of all of this, violent conflict still flares across Afghanistan, making the journey to seek health care even more difficult and dangerous.

As an ob-gyn, reproductive health specialist, and activist, Dr. Khoury has made a career of helping women get the medical attention they need while navigating these complex social spaces. Dr. Khoury’s worldview was shaped by her upbringing, born in the Palestinian Territories and raised in the Middle East by parents who were human rights journalists. Her early experiences instilled in her a need to help others.

Over the past five years, Dr. Khoury’s work with Doctors Without Borders has helped women gain access to the kinds of essential medical care they need regardless of circumstances. To date, she has completed six assignments across the globe, including Sierra Leone, Afghanistan, Lebanon, and Iraq. She is also a member of the US board of directors for Doctors Without Borders, contributing to critical decisions about how the international organization carries out its lifesaving work.

In her various roles, Dr. Khoury always returns to the fundamental importance of patient-centered care. “When we are in the context of delivery care, the entire project is set up with the most vulnerable people in mind,” Dr. Khoury told Elite Daily.

Dr Rasha Khoury visits a patient the day after her operation in a maternity ward in the Ivory Coast. © Jean-Christophe Nougaret/Doctors Without Borders.

Afghanistan still struggles with high infant and maternal mortality rates, however progress is being made thanks to a variety of programs and initiatives. In 2002, the infant mortality rate in Afghanistan was one of the highest in the world, with nearly 8,540 deaths per 100,000 live births. In 2018, the rate had fallen to 4,790 deaths per every 100,000 live births, according to data provided by The World Bank. In 2006, the maternal death rate was 1,120 women per 100,000 live births. As recently as 2017, this number has gone down to 638 women per 100,000 live births.

Dr. Khoury has seen firsthand what women face in Afghanistan. To date, she has completed two medical assignments with Doctors Without Borders there, the most recent of which was a trip to Khost in 2019. Her time spent at the Khost maternity hospital highlighted the critical need of having midwives and female staff in a hospital that only treats women and newborns. "Our teams' respect of cultural norms is heavily valued and publicized and that helps us gain more access to women who need our services," Dr. Khoury said.

In the last three years, Doctors Without Borders staff have supported five other health centers in Afghanistan to respond to the huge need for better obstetric care.

Today, Doctors Without Borders has maternal health programs in over 25 countries that offer several services ranging from pregnancy and prenatal consultations, postnatal follow-ups, emergency obstetric care, check-ups, family planning options, as well as access to safe and free abortion care.

Doctors Without Borders and their teams have worked tirelessly for more than 40 years to provide medical aid to the people who need help the most.

In many parts of the world, access to healthcare continues to be one of the largest barriers’ women face in living full and healthy lives. Through the work of individuals like Dr. Khoury and organizations like Doctors Without Border, there is real change happening. As the struggle to prevent maternal and infant deaths continues, Doctors Without Borders and their staff will continue to address the health needs of individuals who need it most around the world. Donate to Doctors Without Borders today.

This post is sponsored by Doctors Without Borders.