Doing Global Women’s Health as a Staff-less Non-Profit

I am the executive director of a miniscule, yet global effort to improve the health of all women.

Writing that felt empowering! The reality is that the organization I founded,  the International Partnership for Reproductive Health (IPRH), is a staff-less not for profit. I did not have delusions of grandeur when I selected the name of the organization, I was searching for descriptions and dreams. I did not pursue study in the field of global health but I had the opportunity to see what women’s health looked like in Ethiopia eighteen years ago. The journey of “ a thousand miles” began in 2000. I left Ethiopia with the overwhelming recognition of how my small world had been transformed. I did not have words for the experience, however, I now know that what I felt was the expansion of self that occurs when one becomes a global citizen.

In 2007, following my first invitation to work as an obstetrician-gynecologist in Adama, Ethiopia, I was inspired to return. I knew nothing about forming a non-profit. I researched the language and legalities of becoming a 501 c-3 which led to mission statements, objectives, by-laws, and boards of directors.

Originally, the mission statement of IPRH focused on working to improve the reproductive health and wellness of women and girls in Ethiopia, including those with disabilities, by enhancing the knowledge and skills of medical professionals, supporting community healthcare services, and providing material and human resources.” I envisioned partnerships with other non-profit organizations and provate businesses designed to adress identified needs in the area of women’s reproductive health.  I knew that many big international non-governmental organizations (BINGOS) were funded to decrease the HIV/AIDS impact. I also knew that cervical cancer was an AIDS identifying diagnosis. As a gynecologist, I knew the importance of screening for pre-cancer changes of the cervix. My model for thinking was clearly based on my training, which assumed the availability of Pap smear screening, the availability of colposcopy ( low-power, steroscopic, binocular, field microscope with a powerful variable-intensity light source that illuminates the area being examined), pathologists, labs technically designed for screeing populations, and healthcare insurance.

All of the a priori assumptions I made were dispelled as I read about the World Health Organization’s “see and treat” approach to cervical cancer screening in low income countries. The ‘see’ was perfomred by applying a dilute solution (3-5%) of acetic acid to the cervix following placement of a vaginal speculum and the eyes of the examiner. According to the International Agency for Research on Cancer (IARC), the acetic acid causes a reverible coagulation or precipitation of the nuclear proteins cellular components.

The ‘treat’ involves use of cryotherapy in conjunction with nitrous oxide or carbon dioxide as a refrigerant gas.

The Ethiopia Project

The goal of IPRH was to assist the community in decreasing the burden of HIV/AIDS and cervical cancer utilizing appropriate techniques and evidence-based medicine for screening and treatment. The work of IPRH was inded ‘standing on the shoulders of giants’-WHO, PATH, Pathfinder International, IARC.