International Women’s Day 2015: Why adolescent health?
As a medical humanitarian organization, Médecins Sans Frontières sees International Women’s Day (IWD) as an opportunity to reflect on the medical needs faced by women in the countries where we work.
For IWD 2015, we are focusing on the medical needs of our teenage patients. Adolescent girls, who fall in the age bracket of 10 to 19 years, are often overlooked in the maternal and child health sector. Yet, as they become sexually active, they are at higher risk than adults for complications from pregnancy and childbirth, and sexually transmitted infections, including HIV.
Adolescence can be a difficult time as young people negotiate their identity, their place in society and their physical development. But in many countries, adolescents face another level of difficulty. Girls and young women in particular are often deprived of basic sexual and reproductive health education and face significant barriers to accessing health care. Gender roles can mean that women lack the power to make their own health care decisions, but this is exacerbated for adolescents who may also lack the financial power to access the health care they need.
When it comes to family planning, young women may not have the partner, parental and social support to participate, or it may not be offered at all. Not surprisingly, in countries where family planning coverage remains low, teen pregnancy is extremely common and dangerous. Worldwide, 95% of births to adolescents take place in developing countries.
In projects around the world, Médecins Sans Frontières provides essential medical care to adolescent girls. In addition, all Médecins Sans Frontières medical services are free and confidential, overcoming some of the barriers that prevent young women from seeking treatment.
In Kibera, Kenya, for example, Médecins Sans Frontières provides family planning information and advice to young women and couples struggling with early parenthood and a lack of appropriate support. I In Dhaka, Bangladesh, Médecins Sans Frontières recently reoriented its project to meet the educational and nutritional needs of pregnant and breastfeeding girls up to the age of 19. Many girls did not know how to prevent pregnancy and were also unaware of care and its complications.
Teen pregnancies can be particularly dangerous. In fact, maternal causes are the second leading cause of death among 15-19 year olds, according to the World Health Organization. For many years, Médecins Sans Frontières has prioritized emergency obstetric care to treat life-threatening complications that occur during pregnancy, childbirth or the postpartum period. In comprehensive emergency obstetric and neonatal care centers in Afghanistan, Nigeria and Haiti, Médecins Sans Frontières treats complications including eclampsia (hypertensive disorder), obstructed labor and postpartum haemorrhage.
Obstructed labor in young women is usually associated with their lack of physical development and can have devastating and disabling consequences such as obstetric fistula. Jahun in northern Nigeria is a project where we focus on fistula repair – specialized surgery accompanied by months of treatment and rehabilitation without which a young woman can be ostracized for life.
In general, young women are more at risk of rape than older women. Without proper care, as with any woman exposed to sexual violence, this can lead to sexually transmitted infections, HIV, unwanted pregnancies and psychological trauma. The consequences are often much worse for young women because they may lack the confidence or even the language to explain what happened.
In the Mathare slum of Nairobi, Kenya’s capital, more than 50% of patients at our sexual violence clinic are under 18 years old. Round-the-clock service means psychological and medical care is available. In Tegucigalpa, Honduras, the number of rapes is high among girls aged 10 to 14, who are generally deprived of the limited emergency services available. Médecins Sans Frontières continues to press for better access to care for this vulnerable group.
Adolescence is a time when girls make choices that will affect the kind of women they will become. How their health needs are met is crucial to their future well-being and survival.