Patients at the health center
The women at the Koulikoro referral health center in Mali each have their own personal obstetric health histories which have affected their lives. Each comes to the facility hoping to undergo a successful repair surgery to heal her fistula. Their accounts reveal some unmistakable parallels:
Sali is 27 years old and developed obstetric fistula during her second pregnancy. After laboring for three days, she received an emergency cesarean to remove her stillborn child. She’s lived with a fistula for nine years and has lingering incontinence after receiving two previous fistula repair operations. Of two total pregnancies, she has only one living child.
Korotimi is 43 years old and developed obstetric fistula after 24 hours of labor during her third pregnancy. She’s lived with a fistula for 10 years and has lingering incontinence after two previous repair operations. Of seven total pregnancies, she has two living children.
Doussouba is 61 years old and developed obstetric fistula during her eighth pregnancy after laboring at home for three days. She’s lived with incontinence for more than 20 years. Of eight total pregnancies, she has three living children.
Their stories reflect a health system that offers inadequate access to high-quality perinatal care. But their narratives also uncovered a much larger systemic problem: how to provide the multifaceted support necessary for these women who have fallen through the cracks of a struggling health system and been left to endure the debilitating consequences.
Their most obvious and immediate need is for physical healing. But many different levels of health providers are needed to addresses the physical and psychosocial needs of these women. And, although each cadre provides a different specialization, collaboration is the key underlying factor for successful healing. Each member of the fistula repair team—nurses, surgical aids, anesthetists, surgeons—has an official role, but also understands the imperative need for cooperation and collaboration. Surgical aids calm anxious clients. Anesthetists help clean patients. Nurses chase mosquitoes out of bed nets.
These health workers are united in their goal of serving women and playing their part in the holistic model that has made this project successful. This multidisciplinary and multilayered approach of the health care team offers a glimpse of the solidarity and dedication required not just to perform successful repair surgeries, but to fully and wholly cure a women suffering from obstetric fistula.
* A version of this report written by Ingrid Marzoula was orginally published on Vital, IntraHealth's blog