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Dr. Mohammed Alhaji Gana Headshot

Freeing Women From Isolation Through One Simple Procedure

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May 23rd is the United Nation's International Day to End Obstetric Fistula which promotes action towards treating and preventing obstetric fistula, a condition that affects many girls and women in developing countries.

The day a baby is born should be joyful. Mothers should be filled with anticipation, envisioning an exciting future with their child. However, too many women on my ward see their baby's day of birth as the beginning of a life filled with pain, shame and isolation.

The women I see live miles away from the nearest health facility. Often times, they gave birth alone or only with the support of someone with little training and were in labor for more than 3 days. Sadly, many of their babies could not survive the birthing process, and these women have been left childless, with obstetric fistulas resulting in incontinence.

Not knowing what to do or where to go, they live in insolation, sometimes for months or years.

But there is hope: Thanks to community information and outreach, many of these women found their way to my hospital.

I work in Niger State -- a country with a population of over 4 million but only a handful of trained fistula surgeons. Before I was a fistula surgeon in my facility, the nearest hospital was between 400 and 600km by road. This is a gruelling journey, particularly for someone who probably has not left the confines of her home in many years.

Fistula surgery was not part of my general medical training, a shocking fact when you consider the millions of women who need this care. However, with the generous support of International Federation of Gynecology and Obstetrics (FIGO), I was fortunate to receive my first comprehensive fistula care training at the Babbar Ruga National Fistula Hospital in Katsina.

FIGO sees a world in which all women achieve the highest possible standards of physical, mental, reproductive and sexual health and wellbeing throughout their lives.

Following the FIGO training manual with the guidance of expert trainers, I understood how a simple surgery and compassionate aftercare could completely transform the life of a woman suffering from fistula. Mrs. Yusuf was one of them.

Mrs. Yusuf is 27 years old. She married when she was 17 and became pregnant soon after. Only family members were around to help her during labor, an arduous event that lasted almost 5 days. She lost her baby and developed a fistula. Although Mrs. Yusuf survived, her foul smell due to her inability to control her bodily wastes left her divorced and her parents' deaths from cholera left her destitute. A health worker found her and brought her to our hospital, where her fistula was successfully repaired. The smile on her face when I said she was healing is one I will never forget.

Mrs. Yusuf is now a community health worker herself, helping women who suffer from the same pain she once endured.

FIGO is proud to be implementing a competency-based training program for fistula surgery.

The program, supported by Johnson and Johnson and the Fistula Foundation, seeks to train dedicated physicians at accredited training centers using a standardized curriculum that will allow the doctors to acquire the knowledge, skills and professionalism needed to prevent obstetric fistula and provide proper surgical, medical and psychosocial care to women who have incurred fistula in countries where the condition is prevalent.

If you work with women needing fistula surgeries and would like to improve your skills in caring for them, please write to figo@figo.org.

For more information on the maternal health programmes undertaken by FIGO, such as the promotion of misoprostol for the management of postpartum hemorrhage; the prevention of unsafe abortion; the provision of immediate postpartum IUD services and the implementation of the Essential Interventions for maternal and newborn health please see www.figo.org