Mercy Ships

I went to pay Mercy Ships a visit today. Mercy Ships is an NGO which provides maternal care to women in Sierra Leone. They have a small obstetric fistula hospital close by. They are a partner of Health Unlimited, and carries out fistula repair surgery.

For those who do not know what obstetric fistula are, I'll explain. A fistula is defined as an abnormal channel connecting two organs in the body. Obstetric fistula are a result of damage to tissues in the pelvis due to childbirth, most often obstructed labour, where a woman can be labouring for days. Fistulae can occur between the vagina and bladder or rectum, and leads to severe social, psychological and physical health problems. Incontinence is a constant problem, interfering with all aspects of life. Women are often stigmatised, ostracised, isolated from their communities, sometimes because of the smell. The causes of fistulae go beyond the mere physical. Distances from skilled birth attendants, the cost of transport and healthcare, women's lack of decision making authority, the financial dependency on their husbands, malnourishment that lead to pelvis deformities, the young age of the women/girls, and the belief that prolonged labour is a sign of infidelity, are all possible factors in play.

Terri, the manager of the facility and former midwife talked about the future programmes that they have, and are applying for grant money for. They plan to train Sierra Leonean midwives, with midwife trainers coming to volunteer from Australia and South Africa soon. This is vital if the vision of an independent, self-sustainable healthcare system is to be established in Sierra Leone. NGOs cannot, and should not, be planning to stay forever.

She showed me the wards where the women stay, and showed me the sorts of things that women learn, to reskill them if necessary to improve their opportunities. The facility also acts as a maternity unit where women can come and give birth. The operating room had 2 tables, and there was an adjoining recovery room. There was a small pathology lab, and 3 wards. It seemed very well organised, with many friendly staff. I met a few midwives, some teachers, admin staff, a surgeon, an anaesthetist. They also operate a paediatric outpatient clinic, which can currently see a daily case load of 35, sometimes up to 80+ depending on voluntary ex-pat staff who sometimes volunteer.

I'm not sure what the effect of the hospital has on the retention of health workers in the public government hospitals. Wages and working conditions may be higher than in the government health sector. Many patients will wait from the early morning, or even in overnight, in the torrential rain, to be seen at the outpatient clinic. Terri said it's because of the high quality and cheap cost of care.

Tomorrow, I will attend the 'Gladdy Gladdy', a celebration of women who have undergone successful fistula repair surgery. They will be presented with jewellery and a new outfit to return home in. I will hopefully have chance in the near future to observe some fistula repair surgery, something which is very rare in the UK due to the fantastic maternity care provided by the NHS!

For more information, please look up Mercy Ships, and the Campaign to End Fistula.