Introduction

The World Report on Women's Health was first published on the occasion of FIGO's 40th anniversary. Now, as we approach our 50th anniversary, it is my great pleasure to write an introduction to this, the fourth report. As was the case with the previous issues, this one offers commentary on a vast array of topics impacting the quality of care—or all too often the lack of it—around the world. I have to thank Dr Louis Keith and his colleagues at the IJGO Editorial office in Chicago for the invaluable help they provided throughout the preparation of this issue. It could truly not have been done without them. As my predecessor Markku Seppälä noted in the second edition, factors affecting women's health go well beyond the classical biomedical definitions describing conditions causing infirmity or disease. The papers contained in the following pages certainly validate this concept, ranging as they do from female genital mutilation and the ongoing debate in Nahid Toubia's paper about whether progress has really been made, through issues of safe motherhood and the success of the FIGO Save the Mothers Initiative, and the persistently worrying matter of violence against women, often inflicted by their life partners in a domestic environment. This edition of the World Report has been structured to group together issues relating to Childhood and Adolescence, Reproductive Health, Technology and Women's Health, Medical and Ethical Issues, and Sexual and Reproductive Rights—a field where, with support from the David & Lucile Packard Foundation, FIGO has done some remarkable work in recent years through its dedicated Committee chaired by Dr Dorothy Shaw from Vancouver, Canada. The past few years have seen FIGO evolve from an organization involved purely in advocacy to one that has ‘rolled up its sleeves’ and actively intervened in areas where it could be of great help. The World Report—although not specifically about FIGO—reflects this new determination to ‘do something’ about the problems that our profession faces on an almost daily basis. The articles detailing the activities of the Save the Mothers Initiative by G. Benagiano and B. Thomas give a fascinating insight into the manner in which FIGO has harnessed its unique ability to bring together those from the so-called ‘developed’ world—who have most to offer—with those from the so-called ‘developing’ world—who have most to gain. This has been a long-term project that has been fraught with difficulty but which, with perseverance, has been an undoubted, albeit qualified, success. The treatment of vesico-vaginal fistulae is also an area in which—along with the Averting Maternal Death and Disability Section at Columbia University—FIGO has begun to take action. The paper written by P. Hilton provides an insight as to why this is a long overdue area for action by the obstetric/gynecologic community worldwide. It is tempting, when writing an introduction to a report that is published only once every three years, to reflect on the past and what has happened since the last volume. Certainly, many of the papers presented here do just that. But I would like to think that, in looking at the past we are in fact looking to the future by building on the experience gained and the lessons learned. Dr Shirish Sheth, in his introductory remarks to the World Report on Women's Health 2000, made the point that the then new millennium offered both endless possibilities and exciting challenges. The papers presented in this World Report on Women's Health 2003 clearly show that our profession, whilst facing up to these new challenges and addressing them head on, still has much to do to achieve our aim of providing quality care to women and their children worldwide regardless of their geographic location. By working together, however, I believe that we can make major improvements and I pray that, in three years time, my successor, in writing his or her introductory remarks is able to reflect again on the progress made and enhancements to well being that have been achieved in that relatively short period of time. Sometimes, by taking a lot of small steps, we can cover great distances.

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