Obstetric fistula is a neglected public health and human rights issue and a devastating birth violation. Women remain permanently incontinent and it is currently estimated that only 1 in 50 women have access to corrective treatment.
The FIGO training initiative for fistula surgeryis a globally recognized, pioneering program that offers training and education in fistula surgery. Our 67 aspiring surgeons – ‘FIGO Fellows’ – provide life-changing care in some of the world’s most underserved regions, helping to bridge the fistula management void.
This month we met with FIGO trainer Dr. Hillary Mabeya spoken of by Gynocare Women’s and Fistula Hospital in Eldoret, Kenya (a FIGO fistula training center) on his experiences as a fistula surgeon and FIGO trainer and what it takes to eradicate the fistula by 2030.
“As a young doctor who wanted to become a pediatrician, I was transferred to West Pokot, a remote part of northern Kenya, in 1997. The suffering of the women I saw there – from handicapped labor and fistulas, high stillbirth rates, maternal deaths and female genital mutilation – encouraged me to train as an obstetrician / gynecologist. After having been trained as a reproductive health specialist through many voluntary AMREF outreaches, I decided to train as a fistula surgeon. “
After a short stay at the WHO in Geneva for postgraduate training, I went to the Hamlin Fistula Hospital in Addis Ababa, Ethiopia in 2002 to complete a training in fistula surgery. From then on, I have performed thousands of fistula surgeries for patients free of charge and trained many doctors and nurses in fistula care. “
“These experiences inspired me to start Gynocare Women’s and Fistula Hospital in Eldoret, Kenya, in 2011. Our focus is on surgical repair of obstetric fistulas and rehabilitation and reintegration of patients after surgery. We have had more since opening than 5,000 women treated with fistula. Gynocare offers free treatment because women with obstetric fistula are usually very poor and cannot afford medical care. We offer this marginalized patient group comprehensive and holistic care despite considerable financial constraints. ”
The devastating effects of the COVID-19 pandemic
“The COVID-19 pandemic has posed extreme challenges to our fistula treatment work. As the pandemic began, there were curfews and lockdowns and mothers couldn’t make it to the hospital. As a maternity home, we saw mothers coming late with stillbirths, handicapped labor and dire conditions Perineal tears for trying to deliver at home. “
“Some mothers were afraid to go to the hospital because they feared they would get COVID. When they finally came, many had very bad damage and were very sick.”
“At a time when lockdown restrictions have been relaxed, many patients have come to the hospital with complex fistulas. The number of fistulas has really increased, and this is due to the increase in home deliveries. In particular, economic difficulties due to the loss of jobs that meant that many families are unable to raise the money to travel and give births to women in hospitals. Hospital visits have also been restricted, which has definitely helped increase home deliveries. “
Be a FIGO trainer
“I am honored to have been working as a FIGO trainer since 2014. I have trained many surgeons from different countries including areas where there was no fistula surgeon. These surgeons in turn managed to perform many fistula operations in their respective home countries . “
“The FIGO training initiative has shortened the waiting time for patients for life-changing fistula surgery. As a FIGO trainer, I have created an immense capacity to reach many deserving populations.”
Obstetric fistula eradication in 10 years by 2030
“In order for us to achieve obstetric fistula eradication, more efforts must be made to prevent fistulae through robust, safe maternity care, including increased maternity hospitals, access to a functioning maternity hospital, and safe caesarean sections. This means advocacy and awareness-raising around the To encourage governments to allocate resources to motherhood and safe motherhood, which requires a concerted effort from the international community and governments themselves. “
“At the same time, much more work needs to be done to reach women with fistulas who need surgery and to ensure the proper rehabilitation and reintegration of patients who have had fistula repair.”
May 23rd marks the yearbook International Day for the Ending of Obstetric Fistula.
Help FIGO end the obstetric fistula Donation to the FIGO Fistula Surgery Initiative, as well as spreading the message on social media using our toolkit.