Stories of Hope
December 2012

Confronting Age-Old Problems
Spring 2012

Making a Difference
February 15, 2011

A Tale of Two Women
May 17, 2010

Investing in Our Common Future: Healthy Women, Healthy Children
September 29, 2009

Think globally, act locally
July 30, 2009

Funding the health MDGs
May 11, 2009

International Women's Day and maternal health
March 9, 2009

Inaugurating a new direction part II
January 27, 2009

Inaugurating a new direction
January 20, 2009

Then and now
December 16, 2008

A note on the US election
November 10, 2008

Stories of Hope

December 2012

Dear Friend,

In the ten minutes you spend reading and thinking about this letter, five women will lose their lives to complications of pregnancy and childbirth. Almost all of them — and almost all of the nearly 300,000 women who will succumb to preventable maternal death this year — will have lived, and died, in the villages and slums of Africa, Asia, and Latin America. Each, dead from causes that are routinely prevented or treated in the world’s wealthy countries, will leave behind her a trail of grief — devastated parents, a bereft husband, motherless children, a community in mourning — and a deepening cycle of family poverty.

These stories are heartbreaking, but I am writing to tell you other stories with a quite different ending. During these same ten minutes, countless lives are being saved:

  • A teenager, not yet fully grown, is learning how to avoid a pregnancy for which she isn’t ready, physically or emotionally.
  • An expectant mother, at a routine prenatal visit, is being screened for pregnancy-induced high blood pressure which, undetected and untreated, could result in her death.
  • A woman in labor is being rushed from her remote village, on a donkey cart kept ready for just such a crisis, to a clinic where a specially-trained midwife will perform a C-section and save two lives, mother and baby.
  • Just after giving birth, a woman takes a small pill, given to her by a community health worker, that will stop her bleeding before it can develop into a life-threatening hemorrhage.
  • A new mother is learning the importance of feeding her baby only breast milk during the first months of life, avoiding the dangers of malnutrition and diarrhea that kill millions of infants each year.

Each of these stories ends not with grief but with hope. A thousand women will survive today who, on this same date a quarter-century ago, when FCI began our work, would have died needless and tragic deaths. Each of these survivors will live to explore a world of opportunity, of expanding possibilities, of choices she will make for herself. They are the face of a revolution that is taking place right in front of our eyes.

Today, as always, Family Care International stands at the very center of these momentous changes. FCI’s highly-qualified local staff is on the ground in five countries in Africa and Latin America, we work in over a dozen more, and our impact extends across the developing world. Our goal is to make sure that every woman, everywhere, receives the essential, lifesaving care that she needs. We need your support for this urgently important work.

In the coming year, with your help, FCI will work to ensure that even women in the most remote communities have access to skilled maternity care. With your support, we will teach women’s groups that have little experience in defending their rights how to advocate effectively for themselves. In urban slums and rural villages, we will give young people the information they need to avoid unintended pregnancy and HIV. We will provide expert assistance to Ministries of Health, helping them develop policies and programs that expand the reach of essential health-care services.

And in capitals from Washington to Ouagadougou to Quito, FCI will make sure, thanks to your generosity, that women’s lives, women’s health, and women’s rights are given the priority they deserve and so desperately need. FCI is on the front lines, fighting to save lives, to educate and empower women, and to hold governments accountable for keeping their promises. We, and all of the women and families who feel FCI’s impact, depend on your support.

This is FCI’s 25th anniversary year. As we look back at the last quarter century, we are inspired by the great progress we have seen — and helped make happen — and motivated by the tremendous need and challenges we still face. At this critical time, your contribution will build on what we have achieved together. It will help us to build sensible, sustainable strategies to address age-old problems, whose solutions are now in our sight. It will ensure that FCI — at a time when organizations like ours face unprecedented financial pressures — will have the resources we need to continue and expand our unique and important work.

Most of all, your gift will empower teenagers who want only to make their own choices in life. It will bring more accessible, affordable obstetric care to women in deserts, mountains, jungles, and teeming cities. It will help drive national policies that are sensitive to women’s needs and rights, and evidence-based programs that save lives. Your contribution is an investment in the dreams and opportunities of women in a thousand villages; an investment in their future, and in all of ours.

When you make a donation to Family Care International, every dollar broadens and deepens our impact. We need your support; we cannot do our work without you. Please give as generously as you can.

Warm wishes,

Ann M. Starrs
President

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Confronting Age-Old Problems

Spring 2012

Dear Friend,

For pregnant women in poor countries, joy and expectation are always mixed with fear. They know that giving birth is one of the most dangerous things they will ever do. Today, a thousand women in the villages and cities of the developing world will die needlessly from complications — preventable and treatable complications — of pregnancy and childbirth, and a thousand more tomorrow.

Over the last century we learned, for the first time in human history, how to make pregnancy and childbirth safe. And yet, all over Africa, Asia, and Latin America, women continue to die as if these transformative advances in knowledge and technology had never happened.

Imagine a classroom somewhere in Africa, filled with eager, chattering teenage girls. The statistics tell us that one of them will fall victim to this epidemic of maternal death. For too many of those schoolgirls, their reproductive years will be a minefield of unintended pregnancies and unattended deliveries; those who are lucky will make it out alive.

For the unlucky one, death may come in a tiny hut in a remote village, where there’s nothing to do when a new mother starts bleeding but watch her die. It may find her at a clinic, where no one has the skills to perform an emergency C-section. Or she may die in a city hospital, after arriving too late when unwanted pregnancy and unsafe abortion led to a life-threatening infection.

Each maternal death becomes the center of a wider circle of devastation and pain: a newborn who won’t survive without his mother, a daughter who must leave school to go to work or take care of younger siblings, a grieving husband getting by on half the family income, parents suffering an unspeakable loss, a community deprived of a young woman’s energy, creativity, and productivity.

Family Care International has been working for a quarter-century to build long-term, sustainable solutions to these age-old problems. We are in the slums of Mali, helping young people protect themselves from unintended pregnancy, HIV, and sexual violence. We are in mountain villages in Ecuador, making sure that indigenous women choose to give birth in modern clinics because they know they’ll receive respectful, high-quality care. We are on the edge of the Sahara in Burkina Faso, and in the Amazonian swamplands of Bolivia, to ensure that women can reach the emergency obstetric care that will save their lives. And on the global stage, FCI is one of the world’s leading voices for maternal and reproductive health, fighting to put women’s lives at the top of the policy agenda, and to make sure that governments follow through on their promises.

This work is urgently important, and we will keep at it until every woman can decide for herself whether and when to have children, until every woman who chooses to get pregnant has access to skilled care throughout her pregnancy and childbirth, until surviving pregnancy is not just a matter of good luck.

But we cannot do it alone: we need your support.

Even in the midst of the current global financial crisis, major foundations, governments, and other donors continue to support FCI’s programs. But cutbacks in their budgets mean that we need your help to fill critical funding gaps. Your contribution is essential to all of FCI’s vitally important work, now more than ever. Please give as generously as you possibly can.

Thank you, as always.

Warm wishes,

Ann M. Starrs
President

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Making a difference

February 15, 2011

Dear Friend,

A few minutes ago, a young woman in Kenya developed a sudden hemorrhage just after giving birth; she received emergency treatment, and survived. Right now, an expectant mother in India is getting medicine to control the high blood pressure that threatens her life and that of her baby, due to be born within weeks. Later today, a teenage girl in a Bolivian mountain village will learn how to use contraceptives; she won’t get pregnant until she decides she’s ready, will finish school, and will have a chance to lift herself out of poverty.

These are the powerful, if unremarkable, stories of women whose lives are being saved every day in our battle against maternal death. When Family Care International began in 1987, more than half a million women were dying every year from complications of pregnancy and childbirth. New research shows that the policies and programs FCI has fought to put in place are working — maternal deaths have been reduced by nearly 200,000 a year. Every three minutes, a woman who would have been carried to the graveyard now goes home to her family, child in her arms.

FCI’s work over the past two decades has helped make this happen. Here is some of what we’ve done this year, thanks to the support of FCI’s donors:

  • In Burkina Faso, a landlocked, desperately poor country in West Africa, we helped residents of nearly 700 rural villages — most of which lack even basic health clinics — arrange transportation so that women with obstetric complications can get the lifesaving care they need; and we continued our program that has provided more than 300 women with surgical treatment for obstetric fistula, a childbirth injury that often leads to a lifetime of illness and social ostracism.
  • In South America, FCI provided women in indigenous communities with information and skills to fight for the maternal health services that are their legal right; and we partnered with six national governments to identify and promote the most effective ways to help teenagers — whose risk of maternal death is four times higher than for adult women — avoid getting pregnant.
  • In New York, we teamed up with the UN Secretary-General to launch a Global Strategy for Women’s and Children’s Health, an unprecedented, progressive plan to save the lives of 16 million women, newborns, and children in the world’s poorest countries. Almost 50 countries committed to new financial investments, policy changes, and health services, giving our work more visibility and greater momentum than ever before.

These successes, and the many women’s lives that have been saved, do not mark the end of our work —only the end of the beginning. A pregnant woman or new mother still dies every ninety seconds, 350,000 each year. Almost all of these deaths are preventable, and at least one in five results from an unplanned pregnancy.

That is why FCI is here, and why we urgently need your generous contribution. FCI holds governments accountable for meeting their commitments to invest in maternal health and family planning, build clinics, train health workers, and distribute essential medicines. We educate doctors, nurses, midwives, and clinic managers to offer appropriate, effective care. And our programs and publications empower women and communities to demand the information, education, and health services they need to make healthy decisions, avoid unwanted pregnancy, and live healthy, productive lives.

Your help is essential to all of FCI’s critically important work, now more than ever. This year, the global financial crisis has severely limited the grants available from governments and foundations: we need you to help fill the gap. Please give as generously as you possibly can. Thank you, as always.

Warm wishes,

Ann M. Starrs
President

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A tale of two women

 

May 17, 2010

Dear Friends,

I’d like to tell you about two women. Both are young, barely out of their teens, and both are pregnant. The two have much in common, but their very different stories illustrate the range of heartbreak and joy that pregnancy can bring in the developing world.

The first woman lives in a rural village in a very poor country. She gives birth, like most women in her village, at home, with the help of a local "auntie." After delivering a healthy baby, she begins to hemorrhage. Neither her traditional birth attendant nor the understaffed and ill-equipped local clinic, where her family eventually takes her, has the skills or the supplies to help her. She bleeds to death. Her newborn child, left without a mother, will succumb a few days later.

The second woman lives in a similar village. She, too, experiences a life-threatening hemorrhage. But Family Care International has been at work - fighting for more maternal health funding, stronger policies, and better programs; working to improve maternity services in her district; and helping persuade village women to give birth at the local health center. She chooses to give birth at the clinic, whose skilled staff knows how to stop her bleeding. Before long, she will be back at work in the family’s fields, baby happily strapped to her back.To the naked eye, these two villages look the same: remote, traditional,terribly poor. But for two young women, the differences are as stark as life or death. In so much of the developing world, the second woman’s story is still far too rare. The first story, the one that ends so cruelly, is repeated every minute of every day.

For more than two decades, it has been FCI’s mission to change that ending, for millions of women. We put women’s health and survival at the center of global policy discussions. We pioneer new approaches in the field, from improving dysfunctional clinics to promoting new treatments for common complications of childbirth. We teach women and young people in villages and cities from the Sahara to the Andes about their bodies, their reproductive health, and their rights, and empower them to make a difference in their own lives and communities.

The world has yet to deliver on the promise that it owes to women everywhere to value their lives and enable them to deliver on their potential, for the sake of their children, for their communities, and most of all for themselves. Our work will continue until it does.

Warm regards,

Ann Starrs, President

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Investing in Our Common Future: Healthy Women, Healthy Children

September 29, 2009

 

Dear friends,

The last week of September is an exciting time here in New York City, as the world comes together at the UN to confront its most pressing challenges and paralyze our streets. This year’s events showed us both the tantalizing nearness of our goal and the obstacles we must overcome to reach it.

President Obama brought not just a new tone to America’s voice but also a public commitment of $63 billion for global health, some of which will go to strengthen public health systems, whose inadequacy is the key reason that Millennium Development Goal 5 (Improve maternal health) is so far off track. Women dying in childbirth, he said on September 23rd, are a daily challenge to our common humanity.

That same day, FCI — as lead advocacy partner in the Partnership for Maternal, Newborn & Child Health — helped to organize an event, hosted by the UK prime minister and the president of The World Bank, called Investing in Our Common Future: Healthy Women, Healthy Children. The focus was on funding for health systems: the presidents of several developing nations promised to provide free health care for women and children, and donor countries committed their support with over $5 billion in new health aid over six years, much of it through new and innovative mechanisms. The event also launched a new global Consensus for Maternal, Newborn and Child Health, setting out five key action steps to save the lives of more than 10 million women and children by 2015.

This represents real progress, but it mainly highlights the work still to be done. It is so profoundly not enough.

The Consensus calls for $30 billion of additional funding specifically for reproductive, maternal, newborn, and child health services over the next six years. However, this figure does not include basic investments in strengthening health infrastructure and personnel, and it assumes that donor governments will meet their existing commitments, which few are doing. Barack Obama told the world this week that “the future will be forged by deeds and not simply words.” It is up to all of us to make sure that our leaders follow the hopeful words we heard in New York with actions that actually save lives.

All our best,
Ann Starrs, President

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Think globally, act locally
July 30, 2009

Dear friends,


“Think globally, act locally”: this has become a cliché, because it reflects an essential truth about how social change happens. Policy matters — and a broad view of problems and solutions is necessary to getting policy right. But people’s lives are lived locally, and change, when it comes, occurs in individual lives, families, and villages. American schools were integrated by a Supreme Court decision, but real change had to happen in classrooms, on schoolhouse steps, and in people’s hearts. Reversing climate change will require smarter energy policies everywhere, but all if us will have to alter our lives to consume less.

To defeat the age-old scourge of maternal death, we must seek solutions at both levels. Thinking globally, we and our many colleagues argue, cajole, and demand that national and international leaders use their power to save women’s lives. This is among FCI’s most important and effective work, and it will continue until women are no longer needlessly dying in pregnancy and childbirth.

But our years of work in the villages of Africa and Latin America have taught us that, while crucial, policy alone will not solve the problem. Yes, it is urgently important to build health systems that can provide skilled care, emergency treatment, post-partum care, and family planning for every woman. But clean, accessible, professionally-staffed health centers can only save the lives of women who use them. And in many villages, in many countries, social and cultural barriers — traditional health practices, gender inequities, taboos and other beliefs, insensitive medical practices — keep women away from clinics. After all, in the places where women are dying, women have always died from complications of pregnancy, unsafe abortion, and childbirth: women and their communities need to see that these deaths are preventable. Change needs to happen locally, because all health care is local.

We believe that communities are the “missing partner” in efforts to end maternal mortality. FCI’s field work often focuses on building communities’ capacity to overcome these barriers — to persuade women to use, and empower them to demand, the care that can save their lives — particularly by working with respected, influential local leaders who can be powerful agents of change at the grassroots level. In the coming months, I’ll write more about FCI’s work to make communities a full partner in improving maternal survival. Stay tuned!

All our best,
Ann Starrs, President

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Funding the Health MDGs

 

May 11, 2009.


Dear friends,

The fight against AIDS has led to an urgent set of policy responses — including innovative funding mechanisms and new structures for distribution of lifesaving medications. Now is certainly no time to declare victory — HIV is still infecting people faster than antiretroviral treatments are being rolled out — but this extraordinary mobilization of resources does offer some useful lessons.

Recently I joined colleagues from the child health and HIV/AIDS communities to articulate one important lesson. The result appears in the May 5 issue of The Lancet: a Comment calling for “bold action to streamline the global aid architecture for health” through the creation of “a global fund for the health MDGs.”

The current Global Fund to Fight AIDS, Tuberculosis and Malaria has, since 2002, directed over $15 billion into 140 countries. This represents a monumental increase in money available to fight these diseases, during a time when resources for other health needs has stagnated and when little progress has been made in reducing the number of women who die in pregnancy and childbirth.

This exceptional approach to fighting AIDS must now be broadened, fully resourced with increased funding and appropriate staffing, and applied to strengthening the under-resourced, understaffed, and often dysfunctional health systems in developing countries, enabling them to fulfill every person’s right to a full range of health services — including reproductive, maternal, newborn, and child health. This radical, yet rational approach would continue to support prevention and treatment of AIDS and other diseases while also, finally, driving progress on critical health challenges that require systemic responses.

In this context, it is notable that the Obama Administration’s recently-announced global health budget, which includes a strong statement of support for maternal and child health, makes more of a moral than a financial commitment. But moral support is not enough: training health workers, making skilled care facilities accessible, buying essential supplies — all require money, and the need is urgent. The Global Fund has been effective at mobilizing funds for AIDS, and AIDS remains a crisis that demands even greater, not fewer, resources. But AIDS is not the only health crisis in developing countries, where women, newborns, and children are dying every day because health systems are not in place to keep them alive. It is time for the U.S. and other governments, the global community, and the Global Fund to recognize this reality, and to take action.

All our best,
Ann Starrs, President

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International Women's Day and Maternal Health

March 9, 2009.


Dear friends,

Yesterday’s observance of International Women’s Day had me thinking about how we talk about maternal health.

With 1,500 women dying in childbirth every day, the insufficient financial resources being invested in ending maternal death can be frustrating. We know that so much of the solution comes down to money — because that’s what it takes to build health systems to provide essential maternal health services.

But we need to talk not only about money to be raised, but also about work to be done. In recent years, technical experts have come together around four core health strategies that, when provided to every woman everywhere, will release women in poor countries from the grave risks they now face in every pregnancy. These lifesaving strategies are:

• family planning and other reproductive health services,
• skilled care during pregnancy and childbirth,
• emergency care when life-threatening complications develop, and
• immediate post-natal care for mothers and their newborn babies.

To provide them, nations must build public health systems with reach and quality that go far beyond what is in place today. They need to train doctors, nurses, and midwives in essential skills; build and equip clean, functional health centers; and establish efficient communication and transportation networks. They must teach health care workers to treat even the poorest women with respect and sensitivity; enlist community leaders in encouraging greater use of maternal health services; and educate women, men, and young people about family planning.

All of these cost money, yes, but they also require hard, smart work — by health ministry officials, by local health workers and educators, and by NGO professionals like the dedicated, highly-skilled members of FCI’s local teams in Africa and Latin America. Our staff is at work every day, often in the poorest and most remote parts of their countries, helping to build and strengthen the services that save women’s lives.

On International Women’s Day, we re-committed ourselves — as we do each year — to our fight against maternal death. Please join us.

All our best,
Ann Starrs, President

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