When yet another team sets off from the Department of Obstetrics, Gynecology and Reproductive Science for some remote location in Africa or Central America, its thoughts are on how to provide the superior standard of care, considered to be the routine at home, to women in drastically resource poor settings. Upon returning, what our teams often realize is that the tremendous expertise they develop in these countries is the very thing that makes them the experts in their own fields at home. Fistula repair is the perfect example of this.
“Obstetric fistula is a tremendous problem in sub-Saharan Africa,” says Charles Ascher-Walsh MD, Assistant Professor, Director of Gynecology and Urogynecology, Department of Obstetrics, Gynecology and Reproductive Science. “In many countries there is very little maternal health care and, as a result, maternal mortality rates top 1% in some of these countries. These rates are unfathomable in the United States.” If a woman is lucky enough to survive childbirth, the rates of developing some type of post-partum fistula vary between 2 to 5 per thousand births. This equates to between 50,000 and 100,000 new cases of vesico-vaginal fistula in West Africa alone every year. These women, constantly drenched in their own urine, become social outcasts and live a life of physical and social misery. This problem, however, often has a surgical cure that can reinstitute these women into society.