Guest blog by Dr. Jennifer Hirshfeld-Cytron, Reproductive Endocrinology and Infertility Fellow, Department of Obstetrics and Gynecology, Northwestern Memorial Hospital

The Obstetrics and Gynecology Grand Rounds this morning was given by past FIGO (International Federation of Gynecology and Obstetrics) and previous chairman of the department, Dr. John Sciarra.  He provided an incredibly informative and moving description of the global issues affecting women, particularly in the developing world.  He highlighted the issues of maternal mortality, maternal morbidity, STDs, cervical cancer, and education inequality.

For instance, in Afghanistan, 1 in 6 women will DIE from pregnancy related complications compared to 1 in 4100 in the developed world.  Pregnancy related complications include: abortion related deaths, hemorrhage, thrombotic events and eclampsia (see below). 20.5 million unsafe abortions occur each year worldwide and account for 60,-80,000 deaths.

Furthermore, HIV/AIDS accounts for 11% of worldwide deaths with approximately 47 percent of the 34.3 million adults living with HIV/AIDS being women. Cervical cancer, a preventable cancer with appropriate screening, sex education and potentially the vaccine, affects 200,000 women worldwide and is second only to breast cancer in incidence.  Cervical cancer screening in the developed world centers on cytology, which is not available in the developing world. He further highlighted the inequities of women.   Worldwide women work 66% more than men but receive only 15% of the income.  Illiteracy in parts of the developing worth is greater than 65% for women. This just begins to highlight the complicated issue of providing appropriate family planning education to the developing world.

These staggering and incredibly disturbing statistics leave us with only one question; how can we raise the status of women worldwide? Efforts are being done to partner developed with developing world medical schools to increase technical skills for the care of women, such as safe abortions.  A website (www.glowm.com) has been started by Dr. Sciarra and others providing education in the form of book chapters and how-to videos to begin to enhance knowledge to the developing world.  Access is huge problem for women and foundations such as the Bill and Melinda Gates Foundation are working towards these and other efforts.  In short, get involved.

As Mahmoud Fathalla, past president of the International Federation of Gynecology and Obstetrics, said: "Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving."

Comments

"Afghanistan, 1 in 6 women will DIE from pregnancy related complications", OMG what the hell are official doing there in that country. I hope the US government can do something about this.

How will this foundation get the message delivered? and does educating them actually raise their morbidity rate? I get that unsafe medical practices are involved - but does educating the women keep the male doctors from treating them the same? What will we do to address this?

From the BBC

"For instance, of the estimated 136 million women who will give birth this year, around 58 million will receive no medical assistance during and after childbirth - potentially putting their lives at risk"

Another cause of inequality.

S

It is absolutely chilling to see a statistic of 1 in 6 deaths (in Afghanistan) due to pregnancy related issues. I've not been to Afghanistan, but I do travel to the Caribbean where sometimes the living conditions don't always appear to be terrific for the locals (at least from my outside perspective). This article makes me wonder about women's health issues in places like that, and since I have not had children myself, your comments were quite an eye opener for me. Thank you.

“Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.”

It is sad that this is the way it is now. Hopefully one day women will be treated equally. And valued.

You wrote, that in Afghanistan, 1 in 6 women die from pregnancy, but why you do not take into account that women in such countries die from war, men atrocity and many other factors. I think that your statistic do not display the real processes

This post was correct, the stats are staggering for women. I hope that the word spreads about this so we become "worth saving".

I think the key to overcoming the disparity in Health issues between men and women is to entice more women to train in the medical field.With an understanding that their talents can help the health of more than just individuals but an entire gender is powerful.

Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.”

“Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.”

It is the greatest challenge to change the thinking of societies that human life is indeed valuable.

Is is so sad to see the globally wide disparity of health and education, especially for women. Women have historically been treated as property given the history of marriage. Disturbingly, this has not changed in many other countries. As we see people from these countries and belief systems immigrating to North America, we also now see the related crimes against women being carried out by fathers and brothers who feel that their daughter/sister is property and justify "honor killings" against them. Not only do we have to contribute to womens health, but fundamental beliefs within certain religions and groups need to be changed, as well.

"HIV/AIDS accounts for 11% of worldwide death"

this only means one thing: people need to challenge the myths and misconceptions about human sexuality that translate into dangerous sexual practices.

That is such a sad but amazing statistic that 1 in 6 women die in labor in Afghanistan, something needs to be fixed with hat. This article is a huge eyeopener, apart form the media we cant deny numbers. With 11% of deaths worldwide being AIDS more awareness needs to be brought up with this. Great article very scary.

The horrendously high rate of pregnancy related complications in Afghanistan is shocking, but not solely a women issue surely? The average man's life expectancy would be low and his life hard, as well. However, I do take the point and the women are certainly taking more than their fair share of the burden. I do so hope as others have said, that the military campaign can really make a difference in the country.

I believe many girls and women still do not have equal opportunities to realize rights recognized by law. In many countries, women are not entitled to own property or inherit land. Social exclusion, “honor” killings, female genital mutilation, trafficking, restricted mobility and early marriage among others, deny the right to health to women and girls and increase illness and death throughout the life-course.

We will not see sustainable progress unless we fix failures in health systems and society so that girls and women enjoy equal access to health information and services, education, employment and political positions.

This article presents some big questions that have no simple answers or solutions. Certainly, education and societal support is key to furthering the quality of life and health for women worldwide, but how to convince peoples in other countries of this is not so easily accomplished. A lot of the male centered societies of south Asia, for example, may at times, appear to agree with the need for such education and support, but when it comes down to it, they simply do not have the desire or drive to do anything significant with the information they are given for helping their women. I speak from first hand experience, having spent some months in the northwest Frontier Province of Pakistan a number of years ago. I was able to closely observe how people from that culture conduct their day to day lives, as well as learn how the structure of their society works, and it was nightmarish, to say the least. The pervading attitude I saw in the men there was an extreme selfishness for what best served themselves and their goals, and somehow, they did not see better treatment and care of their women as being included in that equation. What is to be done in such situations? You cannot force people to do things they do not want to do, and yet, it is heartbreaking to stand by, knowing that so many women are not only lacking good education and health care, but that they are also experiencing disparaging abuse and emotional neglect.

What a good revelation this is. In Africa, women health education is a great cause of health problems and death. This is more so in the rural areas. Rural health education( at a high level)will reduce death greatly.

This is so sensitive and its one thing my country has been trying to fight.Women are experiencing so many problems and among these include pregnancies and other issues.The developing countries don't have enough facilities to provide to them thus suffering from all these diseases.This information is so educative and we must work together to get a solution to all these problems that are affecting our countries.Sex education must be the key to all schools.Great site

This article makes me wonder about women’s health issues in places like that, I hope some people will finally wake up after reading this.

I agree that women are certainly taking more than their fair share of the burden. Equality between women and men is a fundamental right, a common value of the EU. The best way to overcome the difference in health issues between women and men is to educate and encourage more women to remain in the health industry.

Really useful article, but I guess it will take long time before see any improvement in women rights in developping countries! which kinda makes me sad :(

I cannot agree more with this quote:
“Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.”

This is a very informative and well written article. I could not believe some of the statistics, unbelievable.

Not to make this a political issue but politics do play into things. The U.S. has the best healthcare in the world. Flawed, yes, but as it is it is the best. Education is also so important, especially in the role of preventing dangerous abortions and preventing the spread of STD's. Private donations and mission work go a long way.

How will this foundation get the message delivered? and does educating them actually raise their morbidity rate? I get that unsafe medical practices are involved – but does educating the women keep the male doctors from treating them the same? What will we do to address this?

Equality between women and men is a fundamental right, a common value of the EU, and a necessary condition for the achievement of the EU objectives of growth, employment and social cohesion. Although inequalities still exist, the EU has made significant progress over the last decades in achieving equality between women and men. This is mainly thanks to equal treatment legislation, gender mainstreaming and specific measures for the advancement of women.

Hey I dont understand why my comments aren't getting published on here. As a woman who used to do volunteer work in South Africa, i can definately relate to this issue. We may be living in the 21st Century but 90% of people's mindset is still living in the stone age and thats the truth. Since we are talking about equalities here, please give me the same opportunity to get my opinion across and let me comment on your blog ma'am.

More women's health information. You will greatly help a lot of women by posting articles like this. More power!

This is very important especially here in Kenya where women were not even considered to be citizens in the past constitution. So yes you could bear children but you were not a citizen by right but through your husband...

This is a very informative and well written article. I could not believe some of the statistics, unbelievable.

It's sad in today's society that there are still these kinds of issues taking place. It's about time in the 21st century that women rise to the equality of men. Women deserve the same rights to education, support and care that men afford themselves. After all without women there would be no men.

This is shocking but important information about the plight of women in developing countries. . We must all do what we can in this situation but raising awareness such as this article is the first step.

This is important information about the plight of women in developing countries. Women’s health should be made to be more of an issue in countries like those. I hope my country will do the best they can.

Women's health should be made to be more of an issue in countries like those, there is no reason that such an obvious case of what would seem to be little more than gross negligence should continue to be tolerated with such little consequence, if any.

The best way to overcome the difference in health issues between women and men is to educate and encourage more women to remain in the health industry. As their understanding of women is of course a lot better than the male counterparts.

Thank you for sharing this post, its interesting. I think that education also play an important part to maintain a healthy life... If the people/women in the under developed countries are being educated about their health, mortality rate might decrease and lives could be saved. Barbara.

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