Obstetric Fistula needs more specialists

It is now more than one hundred years since the condition of vesico-vaginal fistula (VVF) was first described, when a poor immigrant woman from the west of Ireland was treated in America by the world-famous gynaecologist, Dr. Marion Sims. It took thirty-two surgical procedures before that woman's fistula was finally closed.

According to Sister-doctor Ann Ward, until recently VVF has been the 'Cinderella' of the profession of gynaecology. Back in 2003, there were only about 20 men and women specialists at a London Conference on the subject.

With the complex surgeries required to repair the condition, training doctors takes a long time and a huge commitment. Sister-doctor Magdalene Umoren (right) is one of two younger MMM sisters who did post graduate training in these skills.

Until now relatively few of those affected by this condition have been able to access the help required but the new attention to the topic gives hope for those who suffer with this terrible condition.

FIGO, the International Federation of Gynaecologists and Obstetricians, now gives the problem the priority it deserves. Major health organizations are aware that thousands of women are still awaiting treatment, forced to live in isolation with a terrible sense of shame. It is acknowledged that even to successfully treat one woman suffering from VVF is worthwhile. FIGO has expressed great interest in promoting the cause, and is very interested to start immediately a programme to heal as many women as possible.  They are asking all of us who have these skills to train others. They can see that the setup in general hospitals is not as suitable as specialist units like those at Itam, Nigeria and Kitovu, Uganda.

Dr. John Kelly (right), retired now from his obstetric work in Birmingham, UK is one of several specialists who are devoted to passing on these skills. He regularly goes to Sudan, Pakistan, Tanzania, and Zambia, and is a regular visitor to the Fistula Unit at Kitovu Hospital in Uganda.

The largest and very famous unit, the Addis Ababa Fistula Hospital, is located in Ethiopia. It was founded by two gynaecologists, Australian-born Dr. Catherine Hamlin, and her late husband, Dr. Reg Hamlin, originally from New Zealand. Sister Ann and Dr. Catherine Hamlin first met in 1972 when Sister Ann visited the Addis Ababa facility.