UCSD doctor helps women suffering from obstetric fistula
With developed maternal health care, c-sections and timely interventions, obstetric fistula is almost unheard of in the US. In the developing world, however, this debilitating condition affects as many as three and a half million women every year.
“Fistula is a complication of several days of prolonged labour,” said Anna Kirby, MD, OB/GYN and fellow in The Female Pelvic Medicine and Reconstructive Surgery Program at UC San Diego Health System. “Without medical intervention, the pressure from the fetal head trapped in the birth canal destroys tissues separating a woman’s vagina from her bladder or rectum.”
The consequences are devastating. Not only do women usually lose their babies, they also sustain injuries which cause them to steadily leak urine and sometimes feces. Traumatized, often abandoned by husbands and isolated from communities, they are forced to live on the edges of villages in horrific conditions. Some decide to end their despair by suicide.
This year Kirby joined Andy Norman, MD, gynecologist at Vanderbilt University Medical Center, who previously spent 13 years working and teaching family medical practice to residents in Nigeria. Norman and Kirby traveled to Somaliand in Africa to train physicians and perform surgeries on women who suffered from obstetric fistulas.
The health of the people of Somaliland is among the worst in Africa, with one of the highest maternal and infant mortality rates in the world. According to the available statistics, one in every eight babies dies in infancy and nearly 4000 Somali women die in childbirth every year. These numbers can be attributed in large part to the long civil war which brought about the death or departure of nearly all of the region’s trained healthcare professionals.
However, with proper medical attention, the lives of many Somaliland woman can be saved. “In the case of fistulas, reconstructive surgery can return not only women’s health, but also their dignity and their place in society. Success rates are as high as 90 percent for uncomplicated cases,” said Kirby.
In Somaliland, Kirby and Norman worked at the Edna Adan Maternity Hospital in Hargesia. Edna Adan, the hospital founder, is a remarkable woman who is bringing desperately needed health care to local women. She was featured in the widely acclaimed book by the Pulitzer Prize winning authors Nicholas Kristof and Sheryl WuDunn Half the Sky: Turning Oppression into Opportunity for Women Worldwide - also the basis for an upcoming PBS documentary. Adan is the first qualified nurse-midwife in Somalia, the first Somali girl to study in the UK, and the first Somali woman to drive. After working with the World Health Organization in the region, she dedicated her pension and life savings to build the first teaching hospital in Hargesia, in a plot donated to her by the regional government - a site formerly used as a garbage dump. The hospital started with 25 maternity beds. Now it can serve 69 patients, including newborn babies.