Georgia's Mobile Teams Improve Reproductive Health and Save Lives
TSKALTUBO, Georgia — The former resort community of Tskaltubo is nestled in the rugged snow-clad foothills of the Caucasus Mountains in Western Georgia. After the collapse of the former Soviet Union, this town’s economy unraveled overnight. The health spas and hotels that once catered to the Soviet elite stand abandoned and dilapidated. Most people now live from hand to mouth on less than $60 per month.
One of the few buildings with lights is the local maternity hospital, which has its own generator. But with fuel in short supply, it provides electricity to only the operating and recovery rooms. The overwhelming majority of patients in the freezing waiting room are women, who are here to take advantage of a mobile team of reproductive health specialists. Most have come for gynecological or neonatal checkups, breast and cervical cancer screening, and family planning information and supplies.
The leader of the four-person mobile team, which operates out of the hospital in Kutaisi about 30 kilometers way, is Dr. Leri Khonelidze, a gynecologist who is a household name in Kutaisi, referred to simply as Dr. Leri. The team, which spends roughly 80 days on the road each year visiting small towns and remote communities that have limited or no reproductive health care services, will spend the entire weekend in Tskaltubo.
“This is our fourth visit to this town in 2006,” explains Dr. Leri. “We cover 22 districts in the western part of Georgia and manage to visit most of them three to four times per year. The mobile teams are the brainchild of Tamar Khomasuridze, the Assistant Representative for UNFPA, the United Nations Population Fund, in Georgia. The country office initiated the program in 2001, with the enthusiastic cooperation of the Zhordania Institute of Human Reproduction, part of the Ministry of Labour, Health and Social Affairs. In all, four mobile teams cover all of the country’s 67 districts.
“With the virtual collapse of our health care system in the early 1990s, it was imperative to improve reproductive health care and offer family planning services, especially in remote, hard-to-reach communities,” she explains. “So the UNFPA/ Georgia office came up with the idea of mobile teams of reproductive health specialists strategically-based to cover the entire country, providing high-quality reproductive health services free of charge to local communities, and on-job training for doctors in the field.
UNFPA provides them with medical equipment and vehicles, as well as contraceptives, pregnancy and STI tests, and informational materials. The mobile teams also train local doctors in contraceptive technology, counseling skills, and diagnosis and treatment of sexually transmitted infections.
“We provide a complete array or reproductive health services to these communities,” says Dr. Leri. Over the course of 2006, Dr. Leri’s mobile team consulted with and treated over 2,700 women throughout the region.
Since 2001, the four mobile teams have provided free reproductive health care services to over 60,000 women, including emergency obstetric care to more than 100 women who likely would have died without it.
“We have high rates of disease among pregnant women,” says Dr. Leri, “including hormonal disorders, and iron and iodine deficiencies. Anemia among pregnant women is epidemic and 25 percent of all pregnancies develop complications.”
At the regional hospital in Kutaisi, Dr. Leri’s home base, up to 115 women give birth every month. Nearly 30 percent of them require Caesarean sections. Thanks to UNFPA, the maternity ward has the most modern equipment available, including baby heaters, fetal heart rate monitors, and a variety of reproductive health supplies and drugs.
On a warm second floor recovery room, Natia, 25, has just given birth to her second child. “I am very happy to be able to have my baby here in this hospital because it has a reputation for providing excellent care,” she says, cuddling her newborn. “We won’t have another child, two is enough,” she adds. “But if I did get pregnant again, I would not give birth anywhere else.”
Demand for family planning services has increased significantly in the western part of Georgia and throughout the country. “This has resulted in a 70 percent decline in the number of abortions since 1995,” points out Dr. Leri.
According to Mr. Kote Gvetadze, head of the Regional Public Health Department of the Imreti Region, based in Kutaisi, there has been a surge of interest in family planning, especially over the past decade. “We have given out free of charge over 300,000 cycles of contraceptive pills,” he says, “and more women are requesting information on family planning methods every month.
Plans are already in the works for expanding the scope of services provided by the mobile teams. “This program has really made a difference to the health of women throughout the country,” observes Mr. Gvetadze. “But we need to be able to expand our coverage, for instance to diagnose and treat iodine deficiencies, among other things.”
Dr. Leri, who has performed over 15,000 surgical operations and delivered 5,000 babies over the course of his 42-year career, is grateful for the support provided by UNFPA. “We could not provide this level of reproductive health care without the assistance and expertise provided by UNFPA.”