We are specialists in the repair of childbirth injuries, obstetric fistula surgery or vesico-vaginal fistula (VVF) repair. The cause of these terrible injuries is simply lack of access to basic medical care during complicated labour, to restore a woman’s dignity and give her a life again is the most rewarding surgery imaginable.
In Uganda, as in other poor countries, many women deliver at home or far from any medical help. If a woman develops obstruction in labour she needs an emergency caesarean section. If this can’t be done she may die of a ruptured uterus or deliver a stillborn baby after days of agony in labour. If this were not enough she may find that she has permanently lost control of her bladder or even her bowel. The prolonged pressure of the baby’s head against the bony pelvis wears a hole between the bladder and vagina and sometimes the rectum. This is called a vesico-vaginal fistula. This will never heal, so she will be incontinent for life unless she can find someone to perform a surgical repair. Women with this condition will visit any hospital they can but rarely find anyone who can help so they return home to a life of misery and rejection. They also fear the fees that have to be charged by the voluntary hospitals or private surgeons. They are usually abandoned by their husbands and give up all hope of being cured.
The surgery requires a high degree of training that can only be learnt by hands on operating in countries where the condition is prevalent under guidance of a more experienced surgeon.
National surgeons have little chance to learn and rarely have the resources to practice safely.
Their priority is to work towards prevention by means of better access to functioning hospitals with skilled obstetric staff.
We have worked in a number of hospitals in Uganda, but our main focus is on Kamuli Hospital which we visit three times a year. When we are there, we can spend up to 9 hours a day carrying out operations, and usually complete about 25 major operations in a week. Sadly we see no reduction in numbers, although now that we provide a sustainable service patients are coming forward earlier, but we still regularly come across patients who have been totally incontinent for over 20 years.
A few can be cured quite easily, others are more challenging and in a few cases the damage is so bad they are beyond cure. We keep a careful audit of our work and find that 80% are completely cured after the first operation. About half of the remainder can be improved by a further operation.
We provide free treatment for all our patients and provide them with money to cover all their transport costs.
We are funded entirely by donations and have no administrative costs. All our work is carried out by volunteers, so every penny donated to the Fund is used to help these unfortunate women in rural Africa. 60% of our income is spent on providing free treatment, 30% on our travel costs and 10% on medical equipment such as good quality instruments, lighting, sutures and spinal anaesthetics.
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