Agnes Varraine-Leca
Incontinence, Pain, Isolation: could physiotherapy change the lives of mothers? Insights from Yemen
After nearly a decade of conflict, Yemen’s health system has been severely weakened, with particularly serious consequences for women. In the field, MSF teams observe that difficulties in accessing maternal healthcare expose patients to complicated pregnancies and high-risk deliveries. Long distances to travel, a lack of appropriate facilities, and shortages of qualified medical staff lead to complications which, in the absence of postnatal follow-up, can have lasting effects on women’s health and quality of life.
At Haydan hospital, where MSF operates, rehabilitation services already exist to address a range of conditions—orthopedic trauma, burns, and pediatric care—but there is no physiotherapy expertise to address women’s specific health conditions occurring during pregnancy and postpartum. Elizabeth’s mission aimed to assess the specific needs of women patients and identify ways to train and support local physiotherapy teams in developing this expertise.
Pelvic floor disorders are common after pregnancy or following prolonged or traumatic deliveries. They can lead to incontinence, pain, nerve damage, and the risk increases with the number of pregnancies. These often-disabling complications can be prevented and treated through rehabilitation, using targeted exercises and appropriate follow-up."
For the needs assessment, Elizabeth could count on the midwives, who play a key role in maternity care. Their close contact with women during the perinatal period makes them essential partners for identifying pelvic floor dysfunctions and referring patients to future rehabilitation care for women's health conditions.
Thanks to this collaboration, a survey was conducted in Haydan with 109 women. It revealed frequent cases of urinary or bowel incontinence, as well as moderate to severe pelvic pain, often with radiation to the lower limbs, limiting daily life activities. On average, nine women per day could benefit from specialized follow-up to regain continence, mobility, autonomy, and dignity.
These initial findings, still under analysis, indicate that expanding rehabilitation services could significantly improve the health and well-being of women in the region.
MSF Foundation plans to return to Yemen to support physiotherapy teams in developing their skills in women's health and to integrate this specialization into the care pathway. This collective effort, carried out in coordination with other healthcare providers, will help sustainably improve the quality of care for women in MSF programs in Yemen.
The launch of this initiative is scheduled for the second semester of 2026.