Reconstructive Surgery for Women
Starting in 2016 with the Hamlin Fistula Hospital in Addis Ababa and CCBRT in Dar es Salaam, 2nd CHANCE ran a dedicated training programme in posterior perineal reconstructive surgery for women living with the consequences of traumatic childbirth.
The condition
For the poorest women in remote areas, where skilled birth assistance and caesarean section are not always available, an obstructed delivery can have dramatic consequences for both mother and child. The mother may lose her baby, and suffer severe injuries to the perineum: obstetric fistulas, which are abnormal openings between the vagina and the bladder or rectum, sometimes combined with a tear of the anal sphincter.
These injuries are preventable, yet more than a million women live with an untreated obstetric fistula in Africa, most of them young. The resulting incontinence affects their dignity, their working and intimate lives. Isolated from their families and communities, many face separation and depression.
The surgery literally gives them a second chance.
What we did
The programme was designed for gynaecologist-obstetricians already trained in gynaecological and urological surgery, who lacked specific skills for injuries involving the rectum and the anal sphincter. Our training added a dedicated colo-proctology module to their practice.
Surgeons were selected on their clinical experience and their exposure to fistula patients, then followed a certifying cycle of at least three workshops:
Sexual medicine adapted to post-partum perineal injuries was also introduced, to address patients’ quality of life beyond the anatomical result. The programme was led with colorectal surgeons from Geneva University Hospitals (HUG).
Here are our latest actions in the field: through specialized interventions, patients suffering from burns, congenital malformations, obstetric fistulas, or goiters have regained their health, dignity, and independence. These essential treatments transform not only the lives of the patients but also those of their families and communities.
For detailed results and figures, see our annual reports.
