Catholic Medical Quarterly Volume 63(4) November 2013
Faith in Medicine:
Rebuilding lives by fistula repair
By Dr John Kelly
Editorial note:
We agreed to publish this article, which John submitted before his death earlier this year.
Eleven years ago Helma presented at El Fasher Hospital, Darfur, for treatment following her third vaginal delivery; that baby was stillborn. Her two earlier deliveries (vaginal) resulted in live babies who sadly died at the age of 4 and 3 years of age. These babies would appear to be two of the ten million babies (almost all in the Developing World) who each year die before attaining the age of five.
Helma had her fistulae (vaginal and rectal) repaired and, fortunately, she did well. She displayed her great ability and willingness to assist in the pre and post-operative care of other women with fistula. She showed true compassion for them all.
Later, Helma and 15 other treated fistula patients were selected to do an 18 months training course (theoretical and practical) enabling them to be Certificated Village Midwives. She became one of the leading midwives in the area.
Each year, when I would be in El Fasher repairing fistulae, she made a point of coming to see me, and informed me of all that was going on. Five years ago she told me, with joy, that she was now married.
Three years ago her concern was that she had not conceived again. I provided her with the information about the fertile time in the cycle using the Mucous Method. In my last visit, in March 2012, she told me that she was 3 months pregnant; she also explained that all she wanted from God was a baby who would continue to survive (she used the term ‘God’ when speaking to me, while I use the term ‘Allah’ when speaking to her). Dr Adam Salih, obstetrician and gynaecologist, El Fasher, has recently sent us the good news of Helma having a safe vaginal delivery of a healthy baby.
Our aim is that, with the correct information and approach, we will eliminate the tragedy of obstetric fistulae and help our poor women and their children achieve a life of dignity.
This story of Helma shows what we are all trying to achieve for these poor women – access to appropriate emergency obstetric care when required, provision of safe drinking water and sanitation for them and their children (including suitable children’s immunisation programmes)… She, who has suffered so much, and has given us all so much, demonstrates how some of our efforts are being directed at the causes and management of fistulae. The Team involves our patients, local staff (hospital and community) and donors.
Update from November 2012
El Fasher hospital has now become a University Teaching Hospital; thanks are due to entirely local staff.
J.K. has been going to Darfur for 13 years. Michael Breen, from Zambia, has given his services on several occasions - we hope he will continue! The late Fiona Burslem also gave dedicated service.