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PostPosted: Mon Sep 24, 2018 11:55 am  |  Posted from: Australia
  

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Obstetric Fistula.

A sensitive medical problem for women, in fact for families. In countries like Egypt sensitive issues don’t get talked about and therefore never fixed. I post it to show that some poor backward places face up to serious female medical problems – and succeed. In some ways it’s a very positive story about an awful medical problem.

Basically long, young or mishandled child births leads to ripped skin which causes permanent double incontinence and infections if not fixed by skillful surgery – which does not exist in Egypt, maybe not even for the rich. In some cases it can lead to paralysis in the lower leg.

If leads to disgust by community members and often destroys marriages and makes conventional jobs impossible. There is major emotional trauma on the women associated with shame and smell.

Of relevance to Egypt FMG increases the chances of this as do young mothers and we all know that 3 decades of UN FMG programs in Egypt have utterly failed to stem this practice which might be as high as 80-90%. Millions don’t work if managed by morons. http://www.policyproject.com/pubs/MNPI/ ... I_2002.pdf

On a positive note a very poor and backward country Ethiopia has been almost leading the world for 60 years in treatment and prevention led by a remarkable surgeon Catherine Hamlin and her time and the money she scrounged. In the area of NGO’s she is an undoubted hero who never attended a Geneva cocktail party. She is Australian female doctor of a generation that had to be bright, tough, practical, enterprising and unremitting. From an upper middle class background and a superb medical education she moved to Ethiopia with her doctor husband in 1959 and brought up her family there and did the work for local women https://hamlin.org.au/catherine-hamlin/

Decades ago, at least in this country, fistula and FMG were openly discussed without embarrassment because of her media coverage. The NYT has described her as a modern day Mother Teresa. At 94 she still lives in Addis and occasionally helps. A documentary on her won an Emmy. https://www.youtube.com/watch?v=ZUe5QChQyvg

The Pope, Royal College of Surgeons, a Nobel nominee (twice), the American and Scottish Colleges of Surgeons, 4 or 5 world class universities, the UN and the American Medical Association have awarded her. I can find no record that al Azhar, the Red Crescent or the Copts have recognized or helped her.

Here she is with her trainee midwives part of her prevention program.

Image

Note the cleanliness and order – not found in all places in the region.

Here she is in Addis with our then Prime Minister and her helper Professor Gordon Williams from Harvard. WHO/FAO and related projects generally just get assistance from those with nothing better to do.

Image

She breaks all the U/WHO rules and trains former patients to be nurses and midwives, to use their experience as victims to help others including those with fistula and to preach prevention programs. Her hospital is a post graduate teaching hospital for both Ethiopians and westerners. How many NGO/UN programs would be worth learning from. Her people have travelled abroad to teach doctors in many countries – including India, but not countries in the Middle East. Unlike others she is cheap and treats about 1200 women a year for a budget north, but not by much, of $US500,000 pa. That wouldn’t pay the Cairo office rental of the WHO. She gets no money from the UN and probably doesn’t want any.

More that 2 million world wide, some say 3, have fistula and somewhere up to 150,000 deaths a year.

The Egypt Independent says its rare in Egypt. They give no evidence for this or any other of their views. Rot, FMG increases the risk, poorly trained nurses/midwives adds to the problem as do early marriages and young mothers. Their version (without evidence) is that incompetent surgeons cause it in Egypt – which is pure Monty Python. https://www.egyptindependent.com/poor-h ... nce-women/. The truth is there is no data because no one is interested.

The world famous Johns Hopkins tries to get a picture based on facts. For example in Egypt for every maternal death during child birth there are 297 complications from each birth – twice as many as India and Bangladesh which are much poorer countries. That gives you a picture of Egyptian medical negligence, incompetence or laziness part of which will cause fistula. Egypt can rest easy because these stats are Jew stats produced by that dirty filthy Jew philanthropist Bloomberg and much better research is available in Egypt from philanthropic foundations the names of which are state secrets and the studies can’t be located at this particular time.

Used to be a problem in the 19th century west up to 120 years ago but fixed with modern midwifery and doctor training – something Egypt has yet to find. Prevention isn’t complicated nor expensive.

Modern surgical techniques using electricity, gloves, a disinfectant and a mask work well in 80-90% of cases.

Tentative studies in Egypt indicate that better educated women know and avoid the risk of fistula. This implies that risks are highest amongst the poor – who also marry and have children younger and less access to quality medical care. If correct this explains why there are no stats or help on the basis that it’s a poor person’s problem and not worth it. https://journals.plos.org/plosone/artic ... ne.0085921

In typical fashion Egypt grabbed increasing interest in fistula and established the Africa headquarters in Cairo of the African Fistula and Continence Society (AFCS) in Egypt with itself as head. 8 years later it doesn’t exist but there were nice press conferences at the time. https://www.rcog.org.uk/en/global-netwo ... la-manual/

Some primitive places are franker than Egypt and the International Continuance Society is holding its 7th Workshop for Surgical Repair of Vaginal Fistula & Urinary Incontinence. The workshop will take place on 12-14th December 2018 at the Ministry of Health, Khartoum State, Sudan. Would never happen in Egypt. (Brief checking indicates that all Gyno and Obstetrics professors in Egypt are male and whilst not 150 years of age definitely over 70 and usually with dreadful - only Egyptian - qualifications).

My general point is that fistula is like a lot of health problems in Egypt – ignored – unless it affects the middle class or the west offers a truck load of cash.


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PostPosted: Mon Sep 24, 2018 12:41 pm  |  Posted from: Egypt
  

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Perhaps that's why the majority of births in Egypt are by caesarean.


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PostPosted: Mon Sep 24, 2018 2:04 pm  |  Posted from: United Kingdom
  

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carrie wrote:
Perhaps that's why the majority of births in Egypt are by caesarean.


More than likely. C-section is surely a safer option in Egypt.

Moreover it's popular with hubby......minimising the amount of time their spouse is ' hors de combat'.


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PostPosted: Tue Sep 25, 2018 8:38 am  |  Posted from: United Kingdom
  

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Not so Newcastle - traditionally over 40 days "rest" are given to the new mother.

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PostPosted: Tue Sep 25, 2018 8:47 am  |  Posted from: Australia
  

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The Hamlins have been my heros for years. Sadly he passed away.

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PostPosted: Tue Sep 25, 2018 12:08 pm  |  Posted from: United Kingdom
  

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Mad Dilys wrote:
Not so Newcastle - traditionally over 40 days "rest" are given to the new mother.


As with mothers worldwide, I expect Egyptians adhere to the usual 6 weeks post-partum avoidance of sexual relations whether the birth is natural or by caesarean

Thereafter....well , my information was given by my Egyptian family, who are expecting their third child. Whether their view (in this case the husband's) accords with general Egyptian custom, or has any scientific basis, I wouldn't know.


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PostPosted: Wed Sep 26, 2018 5:02 am  |  Posted from: Egypt
  

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I watched a documentary on this terrible medical condition last year, within Africa, but can not now remember which country. As stated, it destroys the young women's lives suffering from this. But the operation to correct it seemed to be quite simple and cost effective, but even such low costs were not within reach of many, so a charitable organization stepped in and provides the operation and aftercare for free. All they have to do is get themselves to the clinic. Sometimes its hard to except that its 2018 and not 1820.

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PostPosted: Wed Sep 26, 2018 6:39 am  |  Posted from: United Kingdom
  

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These third world countries need a visit from the Roman's..... :cg

What Have the Romans ever done for us ? apart from the sanitation, the medicine, education, wine, public order, irrigation, roads, a fresh water system, and public health...

There is of course a bigger picture to that statement, for those with the eyes to see... My Right.. ? 8)

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PostPosted: Wed Sep 26, 2018 6:47 am  |  Posted from: United Kingdom
  

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Thanks for this post Hafiz. I was able to share it with a friend with a personal interest because her mother had worked with Hamlins.

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PostPosted: Thu Sep 27, 2018 5:35 am  |  Posted from: United Kingdom
  

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I remember seeing a documentary many years ago on this but I vaguely remember it being a Scandinavian Doctor.


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PostPosted: Thu Sep 27, 2018 7:10 am  |  Posted from: United Kingdom
  

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I've scoured the internet but cannot find any mention of a Swedish Doctor practicing fistula surgery in Africa, so it seems I must have been mistaken. The documentary must have been about the Hamlins. I remember it made a memorable impact on me mentally when I watched it. Some of the sufferers were children as young as 11 or 12 years old, who had been abandoned by their husbands and thrown out of their homes. Some walked for days on end to reach the fistula clinic, and in most cases they were the lucky ones who had heard of it. Some, unfortunately, in the early days of the clinic, died because it was too far away or unknown to them. I think one of the worst things I saw was the alacrity the husbands showed when reclaiming their wives after successful surgery! :urm:


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PostPosted: Thu Sep 27, 2018 2:49 pm  |  Posted from: Egypt
  

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A like for the post Ruby Slippers but the thought of those men welcoming back their young wives makes me feel qui8te sick.


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PostPosted: Thu Sep 27, 2018 3:42 pm  |  Posted from: United Kingdom
  

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Mmm! Me too, Carrie! Me too!


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