A mother and her child in Chautara, Nepal, by the metal shelters they had moved into after their homes were destroyed by an earthquake.
An important part of empowering girls and women is bringing to life the real stories of what access – or lack of access – to sexual and reproductive health and rights means to women around the world. Today, on World Press Freedom Day, we’re sharing one journalist’s journey to document these rights. Here’s a firsthand account from Patrick Adams, an independent multimedia journalist whose work has appeared in The New York Times, NPR, Foreign Policy, and more:
Universal Access Project: How did you begin reporting on sexual and reproductive health and rights?
Patrick Adams: I got a master’s degree in public health in 2008, and while I was interested in all kinds of issues – infectious diseases, non-communicable diseases, environmental health, food safety, nutrition -- one common thread, I realized, was women’s sexual and reproductive health. So I wanted to learn more about it, and I realized that few numbers so starkly illustrate the global disparities in health outcomes – due to differential access to skilled care, life-saving technology, and health information – as the maternal mortality ratio (MMR). As a journalist, I wanted to expose wrongdoing, and the persistence of high MMRs in the 21st century is, in part, really a legacy of wrongdoing that puts the most vulnerable people in society at greatest risk of death and disability.
My first real experience reporting on reproductive health was a piece for the New York Times on folic acid fortification for the prevention of neural tube defects. I was struck by the general silence around, and seeming indifference to, a problem that continues in the face of overwhelming evidence for a safe, highly cost-effective, easily implemented solution. Especially compelling was the irony that while many developing countries had heeded this evidence and taken action, not a single EU country (including those that fund the intervention overseas) could muster the political will to push it through at home.
Then I learned about misoprostol, and that really stopped me in my tracks. The story of misoprostol is amazing and a lot of it is about wrongdoing. What is the leading cause of maternal mortality globally? Postpartum hemorrhage. It’s too bad we don’t have a cheap, heat-stable pill that could prevent postpartum hemorrhage in the vast majority of cases and that you could give to women in poor countries (or any country) to keep on hand in case they can’t get to a health facility to deliver the baby or there isn’t anyone around that day. Oh wait - there is, and we’ve had it for decades, but governments restrict women’s access to it for fear they might “misuse” it. (Misoprostol can be used to safely induce an abortion). That seemed like some wrongdoing, so I went to one of the few countries where the government was at least willing to try to make misoprostol available to women cut off from the formal health care system (Nepal), and I wrote about it for Foreign Policy.
UAP: What is the best part of covering these issues? What is the most challenging?
PA: Like anyone, I want my work to be relevant, and I enjoy bringing to light issues that for one reason or another often don’t get the attention they deserve. But the best part would have to be the interaction with people on the ground who have devoted their lives to these issues – the volunteer health workers, the traditional birth attendants, the lone nurse or doctor in a remote outpost.
One of the most challenging things about reporting on reproductive health and rights (and other public health issues) is doing so in a way that accounts for the nuances of these issues in a small amount of space. That can be tricky. Another is convincing editors that they merit the real estate; when you’re talking about an issue that almost exclusively affects women in, say, sub-Saharan Africa or South America, that’s not always an easy sell. And a third is the dearth of reliable data in developing countries – on everything from disease surveillance to time spent on unpaid work to sexual violence and more. Which is why the Gates Foundation’s commitment to closing these gender data gaps is so important.
UAP: From your perspective, why is media coverage of sexual and reproductive health and rights so important?
PA: Well, we know that around the world, since forever, the deck has been stacked against women and girls. We also know there’s a long lag time between the development of tools in donor countries (often with knowledge and resources derived from poor countries) and their availability in poor countries. A current example of that in the realm of women’s sexual and reproductive health is HPV vaccination: of the estimated 118 million women targeted through HPV immunization programs between 2006 and 2014, just 1% were from low-income or lower-middle-income countries, where the vast majority of cervical cancer cases occur.
These challenges are now compounded by policy goals of the Trump Administration. In addition to reinstating the Global Gag Rule and ending U.S. contributions to the United Nations Population Fund, Trump has proposed eliminating the U.S. Agency for International Development’s Global Health Security programs, which support ministries of health in poor countries to detect outbreaks of pathogens like the Zika virus. Media coverage that carefully documents the impact of these policies can raise the awareness needed to end them.
UAP: What advice do you have for journalists just beginning to cover these topics?
PA: I am no veteran and have far less experience than many folks out there, but it was important and encouraging to me to know that there is a great unmet need for reporting on these topics – that there is a lot of work for journalists to do on women’s sexual and reproductive health.
I think it’s also important to keep in mind that successfully pitching editors often comes down to how you frame it, how you connect it to larger or more current issues (because few of these things are new), and to the personal narrative; and that experts in this field are generally excellent advocates happy to educate journalists on what can be very complex issues. Read the literature, and reach out to them.
UAP: Share your most memorable story you’ve covered on sexual and reproductive health and rights.
PA: I had the opportunity to visit Za’atari Refugee Camp in Jordan last year with the United Nations Foundation and UNFPA, and that was an eye-opening experience. Having fled their homes in Syria, women in the camp were safe from the violence of war. But many continued to face gender-based violence in the camp, including intense pressure to get married at an early age and to have children as soon as possible.
Learn more about the Universal Access Project and get involved at www.universalaccessproject.org.