Paving the Road to Postpartum Recovery

Days after delivering a stillborn child, Umuhoza had grown terribly ill, She was running a fever, barely able to walk and incontinent. Her mother grew increasingly concerned and knew she had to get Umuhoza to a hospital, even though it was hours from their rural village in northwest Rwanda.

By the time they arrived at the University Central Hospital of Kigali (CHUK) last June, Umuhoza was in bad shape. Her delivery had been so traumatizing that she could not remember any details. Based on the extent of her injuries, her doctor, Lauri Romanzi, estimated that she had been in labor for at least five days. The extended delivery had given Umuhoza two large fistulas -- holes in her vagina and rectum -- that produced her incontinence.

After treating her infection and fever, Dr. Romanzi operated and successfully closed both of Umuhoza's fistulas effectively stopping the leaking of urine and feces. Umuhoza is undergoing physical therapy and can now walk again, though slowly. She and her mother have now been at CHUK for over six months.

Dr. Lauri Romanzi is the current head of the fistula care team at CHUK. She is an expert pelvic floor surgeon whom Fistula Foundation has funded to provide surgeries in several countries in the past few years. Dr. Romanzi told us recently that Fistula Foundation's support "literally saved Umuhoza's life from disaster." Romanzi is being modest. While funds from Fistula Foundation were important, it's Romanzi's surgical skills that transformed Umuhoza's life.

To successfully treat a patient like Umuhoza, it takes more than the cost of the surgery; it also requires a well-equipped operating facility and a surgeon trained specifically to treat fistulas.

Fistula Foundation works to treat women suffering from obstetric fistulas, a debilitating childbirth injury that can occur when a woman endures a prolonged, obstructed labor, and does not have access to emergency obstetric care, like a C-section. Since 2009, the group has funded more than 14,000 surgeries across 29 countries, but it isn't easy to make those surgeries happen.

Thanks in part to support from Johnson & Johnson, Fistula Foundation has been able to expand its pool of trained surgeons in Rwanda, and beyond. Dr. Romanzi has been working with her team at CHUK to prepare them to treat more complex fistula cases. Also thanks to Johnson & Johnson support, two of CHUK's female trainees were able to accompany Romanzi, their trainer and mentor, to Somaliland, becoming the first staff surgeons at Edna Adan University Hospital who are women. As a team, they worked together to advance their skills and now they are each able to treat fistula cases on their own.

Prior to Romanzi and team's program, women with fistula in Rwanda were too often dependent on temporary fistula clinics which offered treatment by visiting surgeons, but not longer-term clinical care. At the height of Umuhoza's condition, there weren't any of these temporary clinics. Waiting until one had opened would have dangerously advanced her condition.

Thankfully, Umuhoza is on her way to recovery. And it's a road that gets shorter every day.

Kate Grant is CEO of Fistula Foundation, which works in 29 countries to treat women who suffer from the childbirth injury obstetric fistula. Follow the organization at @Fistula_Fdtn.