Wednesday, October 31, 2007
Lasting Care for Women in Kosovo
Doctors of the World-USA (DOW) began working with the women of Kosovo in 1997 to reduce high rates of maternal and infant deaths. Confronting a situation made worse by entrenched discrimination and regional conflict, DOW remained committed to the communities in Kosovo before, during, and after the crises that devastated the region.
DOW’s first initiative in Kosovo was directed at ethnic Albanian women
who had been excluded from the public health system. Reaching out to these ma
rginalized women, DOW’s project ensured they had access to prenatal care, would have assistance when they delivered their babies, and had follow up care to ensure both mother and child survived.
who had been excluded from the public health system. Reaching out to these ma
rginalized women, DOW’s project ensured they had access to prenatal care, would have assistance when they delivered their babies, and had follow up care to ensure both mother and child survived.The armed conflict in 1999 devastated the region. Public health facilities were overcrowded, often had no electricity, lacked essential equipment, and in some cases were looted and destroyed. DOW volunteer Dr. Adrienne Moore recalls that while in Kosovo, “On a bad day, a young mother died. She might not have died in the United States, because we would have had a defibrillator right there, not in the surgery building across the street.”
DOW responded by working with public health facilities to replace equipment, as well as train nurses and doctors on safe birthing, nutrition for infants, and emergency obstetrics. DOW put in place a comprehensive Labor and Delivery Outcomes Database, created Health Information Centers in 14 existing health facilities, trained midwives, and established antenatal clinics.
After the initial rebuilding, many international organizations left Kosovo. DOW remained in the region to ensure emergency recovery efforts were followed by infrastructure improvements, a corps of trained local providers, and commitments from government agencies to maintain standards. In 2003, DOW established two Women’s Wellness Centers (WWC) in Kosovo to provide women with comprehensive health care. These WWCs are now operating independently and are entirely supported by the Ministry of Health. Last year, DOW replicated this successful model at the largest public primary care facility in Pristina, the capital of Kosovo.
The improvements go beyond better facilities and include significant changes in practice that go a long way to ensure women have access to quality care. Dr. Mary Packer, DOW’s Project Director in Kosovo, notes that one major improvement is that midwives are now in direct contact with women, whereas before they served as secretaries. “The midwives take full history details, examine appropriately, give advice and counseling, arrange health education groups related to pregnancy and childbirth, and identify risks that women might face.”As we conclude our work with the people in Kosovo, we leave behind a corps of trained health care professionals, a network of community educators and advocates, and three comprehensive Women’s Wellness Centers serving over 30,000 women each year.
Other DOW initiatives in Kosovo established community homes for children with special needs, created a comprehensive TB control program, and formed a community health organization for Roma. Today, each of these initiatives functions under local ownership.
Long-term commitment to communities whose basic human rights have been denied is at the core of DOW’s mission, and is key to achieving sustainable results. Around the globe, DOW is building the capacity of local partners to enable them to provide life-saving services long after our projects are completed.