Treating fistulas in Liberia

This past April, I returned to Liberia for the third obstetric fistula campaign in 9 months. Each visit builds on the previous trip, on the surgical skills taught to the Ob/Gyn residents in Phebe and the care given to our fistula patients, many whom need multiple surgeries to repair pelvic damage due to obstructed labor and fistula formation.

This last trip was funded in part by WAHA International and I am very grateful for their support. WAHA is an amazing organization that is committed to helping women and children worldwide. Our work was also supported by the hospital staff and the Liberian College of Physicians and Surgeons as well as the Ministry of Health. On the ground, in addition to wonderful staff, nothing could have been done with out the help and coordination of Dr. Lise Rehwaldt, an Ob/Gyn and attending in Phebe and the senior Liberian Ob/Gyn residents, Drs. Wheesah, Massaquoi, Geha and Karbah.

The Phebe Hospital and School of Nursing is in Bong County, Liberia, over 100 miles from the capital, Monrovia. It was opened in 1965 with the support of various churches and the Liberian Government . It currently relies heavily on donor assistance. Major departments include medicine, Pediatrics, Surgery nad Ob/Gyn. It was established as a 62 bed hospital with rudimentary Intensive and Critical Care units. It is also a school of nursing in collaboration with nearby Cuttington University.

Phebe has 2 operating rooms and has a dedicated generator. Running water is occasionally present, however, my experience was more with stored water in large plastic containers. There are full-time Nurse Anesthetists and NA students who are highly capable, helpful and always available. The senior Ob/Gyn residents spend the year in at Phebe and and a local Maternity Hospital.

A structured and MOH-approved VVF curriculum allows for a resident to scrub on every fistula case and also for a structured series of lectures based on FIGO’s VVF Training Manual.

After arriving late in the evening into Monrovia, I was met by a driver from the Liberian College of Physicians and Surgeons. I spent the night in Monrovia and left for Phebe, a 3 hour drive, early in the AM. Upon arrival, I settled into a room on the Phebe Hospital grounds spent the day pre-operatively evaluating the women who may need surgery. With Dr. Rehwaldt, and Ob/Gyn based in Phebe and senior Ob/Gyn residents, women were interviewed, examined and scheduled for surgery if deemed candidates for an operation. Lectures that are part of the residents’ fistula training curriculum were given during 2 afternoon sessions.

We are grateful to these Liberian women for trusting us with their care and thankful that IMR can continue to work with Phebe Hospital to train the next generation of Ob/Gyns in Liberia in vaginal surgery and obstetric fistula repairs.

Together with our partners who support us and those on the ground, we can make strides to end fistula in Liberia! Our next trip is planned for fall of 2016. We would love your support to continue our work!

Ambereen Sleemi