Obstetric
Fistula: Women in some African countries may endure
days of obstructed labor, due to an immature pelvis secondary to early
marriage, or a contracted vaginal opening due to female genital
mutilation. (See my latest column
on genital mutilation at sadjascolumns.blogspot.com.) The baby is often stillborn, or the woman dies in labor
because of a lack of hospitals performing Cesarean sections. If she survives, the prolonged pressure
on the vaginal walls often causes openings to appear between the vagina and the
rectum or bladder. She will leak
urine and feces, becoming an outcast, often living alone and prone to
suicide. The story of one such
woman is remarkable. After three
days of obstructed labor in Ethiopia, and a dead baby, she was taken to a
hospital in Addis Ababa that specializes in fistula surgery. The hospital is
run by two Australian doctors, who spend their lives in fistula reconstruction.
The patient, Ms. Mamitu, was cured and decided to stay on at the hospital. She was given a job making beds for
other patients. Then she began
helping out during surgeries. After a couple of years of watching, the doctor
asked her to cut some stitches. Eventually, she was performing the entire fistula
repair herself. . She gradually became an experienced
fistula surgeon, teaching gynecologic surgeons from many countries. Still illiterate, she decided to go to night
school to learn to read and write.
When last heard of, she was in third grade. This is a wonderful story of
enormous perseverance and a drive to help regardless of qualifications.
•
Women
on Waves (WoW)
has sent a ship to international waters outside of Guatemala. Women on Waves is
a Dutch prochoice, non-profit
organization
created in 1999 by Dutch physician Rebecca Gomperts, in order to
bring reproductive health
services, particularly non-surgical abortion services, to women in countries
with restrictive abortion laws. Other services offered by WoW include contraception and reproductive counseling.
Services are provided on a commissioned ship that contains a specially
constructed mobile clinic. When WoW visits a country, women make appointments,
and are taken on board the ship. The ship then sails out to international waters
(where Dutch laws are in effect on board the ship) to perform the medical
abortions
(abortion performed in the first 10 weeks of pregnancy with pills). Abortion is legal in Guatemala
only if the woman’ life is in danger from the pregnancy, and if the procedure is
endorsed by two doctors. As a result an estimated 65.000 illegal and unsafe
abortions take place in Guatemala each year. Yearly, approximately 21.600
women are hospitalized with complications, and unsafe abortions are the third
cause of maternal death in the country. Especially at the dawn of the Zika
crisis, access to safe abortion is fundamentally an issue of social
justice. WoW is asking the Guatemalan government to remove abortion from
the penal code, to provide evidence based sexual education in schools and to
ensure access to contraceptives;
•
On
22 February 2017, the WoW ship docked in Puerto
Quetzal on
the Pacific coast for a planned five-day visit. On 23 February, a scheduled
press conference was shut down shortly after it started and a blockade
was imposed by Army troops, preventing the activists from disembarking and visitors from boarding.
was imposed by Army troops, preventing the activists from disembarking and visitors from boarding.
WoW
is active in many countries throughout the world where abortion is
illegal. When contacted by phone
or Internet, they will send abortion pills by mail, with careful instructions
for use. They have sent pills into
Poland by drone! You can donate to
Women on Waves by check or credit card - by going to their
website.
Sadja
Greenwood, MD, MPH
No comments:
Post a Comment