The Silent Tragedy in Africa

Source: Mercy Ship Australia
Posted: Tuesday, 9 June 2009, 8:03 (EST)

“Even in countries where obstetric fistula is common, many in the general public remain unaware of its cause and therefore its prevention. It really is a silent tragedy.”

Those are the words of Brisbane urogynaecologist, Dr Hannah Krause, who has returned from West Africa again as a volunteer with Mercy Ships performing corrective surgery on a small number of the millions of women still suffering silently.


“Over the past 14 years I have made several trips to Africa, and first became aware of obstetric fistula while working as a resident doctor in a rural hospital. Women came to the hospital as a result of obstructed labour during childbirth. Babies were stillborn, and the mother sustained a fistula. The big problem is that many such women are shunned by family and their community and are forced to become outcasts, hidden away with their shame.”

After seeing the problems faced by African women, Dr Krause received training at the now famous Addis Ababa fistula hospital. Since then she has returned to West Africa to perform fistula surgery and to train local surgeons in the procedure. Her most recent time was spent in Benin onboard the hospital ship Africa Mercy, operated by Mercy Ships.

“As with most of my visits to West Africa, I go for a short time – usually a few weeks – arrive, work hard, then leave. So I don’t often get to see much of the country apart from during my days off. What I do see, however, is always very confronting. The level of poverty and suffering is heart-breaking.”

“I have a lot of compassion for these women. I try to help by visiting various fistula centres, usually in Africa, to perform surgery. I usually go about twice a year for a few weeks each time during my holidays. It is hard work, but the results are so worthwhile when you see women’s lives restored. My patients are so amazing and resilient. I learn so much from them. God has given me my skills and training, enabling me to do this work. When I operate I pray that these women will be healed physically, spiritually and emotionally."

"The fistula women have very tragic life stories. Most have lost a child in labour and the fistula caused by the long labour causes them to leak urine and/or faeces continuously. Some of the women we see have developed this injury only recently and are still grieving over the loss of the baby. But most of those we see have had their fistula for years … some for more than 30 or 40 years. It’s remarkable how such women have survived life despite the extreme adversity,” she concludes.

Mercy Ships provides free corrective surgery for obstetric fistula patients onboard the Africa Mercy, currently on assignment to Benin, as well as at a dedicated fistula centre in Sierra Leone where Mercy Ships works in partnership with another organisation. Patients also have opportunities to learn about community and maternal health, while other programs seek to increase awareness of the plight of women with fistulas. When a patient is discharged there is a time of great rejoicing. Each woman receives a new dress in the fabric of her choice, signifying a new beginning, while dancing and singing reflect the change.

Discharge teaching includes instructions about sexual intercourse, family planning and the need to have caesarean delivery for subsequent pregnancies to reduce the risk of recurrence. Provision for C-section surgeries is arranged with local providers who bill Mercy Ships for former patients. In an effort to build fistula surgeon capacity in West Africa, Mercy Ships also provides training for local surgeons interested in contributing to the treatment of obstetric fistula in Africa.

Mercy Ships is an international Christian charity that has operated hospital ships in developing nations since 1978. Following the example of Jesus, Mercy Ships brings hope and healing to the poor, mobilizing people and resources worldwide. Mercy Ships offers a range of health and community development services free of charge. Working in partnership with local people, Mercy Ships empowers communities to help themselves. The result is a way out of poverty.

The emphasis is on the needs of the world’s poorest nations in West Africa, where the hospital ship Africa Mercy provides the platform for services extending up to ten months at a time. Mercy Ships works on land-based projects in Sierra Leone in partnership with other organisations, while teams also work in several nations of Central America and the Caribbean. There are 14 support offices around the world, including the Australian office on the Queensland Sunshine Coast.

Article provided by www.mercyships.org.au