Every year, thousands of women in the East African country of Uganda experience medical complications of very long — or obstructed — labor during childbirth. Pressure from the baby’s head pushing against pelvic bone can destroy tissue and form a fistula, or opening between the vagina and bladder or rectum. Urine and feces can pass through the fistula and leak from the vagina, causing women to be shunned by their husbands and society. While obstetric fistulas are rare in developed nations, the World Health Organization estimates that nearly 2,000 Ugandan women develop fistulas each year, and 200,000 area women are living with the condition.

Since 2009, teams of UCLA Health specialists have been traveling to Uganda to perform fistula repair and other gynecologic procedures. The bi-annual medical missions are sponsored by Medicine for Humanity, a nonprofit organization founded in 1995 by Leo Lagasse, MD, professor emeritus, obstetrics and gynecology, David Geffen School of Medicine at UCLA.

The team’s most recent trip to Uganda last September was especially memorable because it marked the opening of the new Centre for Gynecologic and Fistula Care at Mbarara Hospital. “When I started going to Uganda almost 10 years ago, women were sleeping on the ground in makeshift tents after undergoing surgery,” says Christopher Tarnay, MD, division chief, UCLA Female Pelvic Medicine and Reconstructive Surgery, and president and medical director, Medicine for Humanity. “Eventually, the hospital built a shed that housed about 30 beds, but many women still slept on floors. It wasn’t an environment that promoted recovery.”

Fundraising efforts to build the new 50-bed hospital ward began in late December 2016. By mid-2017, Medicine for Humanity, with the help of UCLA Health, had raised more than $100,000. In addition to providing women with a hygienic, comfortable place to recover, the Centre is also equipped for training local providers.

With each medical trip, UCLA Health doctors, residents and nurses train Ugandan medical staff in fistula repair and other surgical techniques. “These doctors, in turn, train other doctors, so we’re increasing the number of doctors in Uganda who can help these women long-term,” says Dr. Tarnay.

The September trip marked the third visit for Tamara Grisales, MD, an OB/GYN and female pelvic medicine and reproductive surgery specialist at Ronald Reagan UCLA Medical Center. “During my last trip in 2012, women were recovering in the shed,” she says. “It was remarkable to see this beautiful new facility with accessible bathrooms for the women. The Centre restores a sense of dignity to women who have suffered through so much.”

Having a safe place for women to recover for two weeks after surgery is critical to preventing re-injury. “Many of the women are transported from remote villages on bicycles or mopeds,” says Dr. Grisales.
“Traveling long distances home after this type of surgery isn’t feasible. Plus, if women leave too soon, they often go right back to caring for children and working in fields.” Medicine for Humanity covers the women’s expenses, including transportation to and from the hospital, food and medical care. To learn more about Medicine for Humanity, visit medicineforhumanity.org.