Each year in sub-Saharan Africa, it is estimated that more than 33,000 women develop obstetric fistulae and subsequent urinary and/or fecal incontinence. Unfortunately, these women are currently not able to be adequately repaired by local physicians due to lack of training and resources.
Last month, B. Star Hampton, MD, of the Division of Urogynecology and Reconstructive Pelvic Surgery at Women & Infants Hospital of Rhode Island, traveled to Rwanda with the International Organization for Women and Development (IOWD), as part of a fistula repair team. She was accompanied by her urogynecology senior fellow, Nicole Korbly, MD. Jessica Salak, MD, a private practice obstetrician/gynecologist with the Center for OB/GYN, returned for the second year, along with Edie McConaughey, CNM, a certified nurse midwife at Women & Infants Hospital, who are working with IOWD to expand their services to include general obstetric and gynecologic teaching.
“This mission is an annual reminder about how truly lucky we are to have access to some of the finest, most sophisticated health care in the world,” commented Dr. Hampton, who has been traveling to Africa each year since 2005, when she was a urogynecology fellow at New York University. “Our team was able to provide basic and advanced care to the women in Africa, women whose lives were definitely improved. We worked hard to tackle difficult surgical cases and to create meaningful results for the women of Rwanda.”
During this trip, Dr. Hampton’s team evaluated more than 200 women with fistula who were waiting for them and their skilled surgical hands. The team was able to successfully operate on nearly 50 of these women and has set up 50 more women to be cared for during the next IOWD mission in April.
Obstetric fistulae are usually the result of a tear in the soft tissue in the birth canal during an obstructed labor. This medical complication is particularly prevalent in parts of the world where emergency obstetric care is non-existent or difficult to access, nutrition is poor, and there is an early age of marriage.
Dr. Hampton commented, “The physical trauma of fistula is often accompanied with social trauma. Many women are divorced or abandoned because of their subsequent incontinence. Obstetric fistulae are demonstrative of gender inequalities, lack of education and resources, and deficient medical care. Our fistula repair teams are often the only hope for these women.”
While obstetric fistulae are rarely seen in the U.S., where there is generally adequate access to health care, some physicians do encounter fistula resulting from radiation or an adverse complication from surgery. “Our experiences with the repair of fistula in Rwanda make us especially adept at tackling these problems at home,” said Dr. Hampton.
The team from Women & Infants Hospital, worked in Kigali, Rwanda, where they served for two weeks at Kibagabaga Hospital with a team of American surgeons, anesthesiologists, and nurses. They collaborated with and trained Rwandan physicians, medical students, and nursing staff, teaching them post-surgical care for the women, as well as basic anatomy, surgical preparation, sterility concepts, evaluation, and surgical approaches.
About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns. The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women’s medicine, Women & Infants is the ninth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. In 2009, Women & Infants opened what was at the time the country’s largest, single-family room neonatal intensive care unit.
New England’s premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, breast disease, and reproductive endocrinology and infertility. It is home to the nation’s only mother-baby perinatal psychiatric partial hospital, as well as the nation’s only fellowship program in obstetric medicine.
Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; a National Accreditation Program for Breast Centers through the American College of Surgeons; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute’s Gynecologic Oncology Group and the National Institutes of Health’s Pelvic Floor Disorders Network.