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Introduction: Obstetric fistula is the presence of an opening between a woman’s genital tract and urinary tract or between the genital tract and the rectum due to untreated obstructed labor or iatrogenic causes. This disease is characterized by the leakage of the urine and/or stools through the vagina. Objective: The general objective of this need assessment is to contribute in decreasing the obstetric fistula related morbidity Nepal by providing strong information that could help in struggle against Obstetric Fistula related morbidity. Methods: This is a cross-sectional study of 4 health sites in the Republic of Nepal between, November 1rst 2011 and December 16th 2011. Data were collected on the prevention, the management, the social reintegration, the training and the research related obstetric fistula. Standard assessment tool, structured questionnaire for health workers and patient’s interview were used. We have also performed a literature review on obstetric fistula in Nepal. Results: With the MMR of 281/100,000 live birth, it is estimated that there is 200 to 400 new cases of OF in Nepal each year leading to the overall 4300 prevalent cases. Our assessment shows that, obstetric fistula surgery is practiced in three sites with information verifiable on the registers and files. One fourth site is willing to be really involved in struggle against OF. None of the site is dealing with the five pillar of obstetric fistula. Two of three sites have OF surgery in permanent base while one site actually proceeds by camps. Even where surgery is practiced, there is still a need for training, nursing and surgical technical protocol related to obstetric fistula. Struggle against obstetric fistula is not really coordinated at the country and regional level. Conclusion and recommendations: We recommend elaborating a national strategy of struggle against the obstetric fistulas, to elaborate protocols for care, training tools; organize the struggle against obstetric fistula while founding on the five pillars that are the prevention, management, reintegration, training and operational research. While dealing with the national strategy, it is urgent to empower the facilities really involved in OF surgery and the one committed to start the program.
When gynecologists Catherine and Reg Hamlin left their home in Australia for Ethiopia, they never dreamed that they would establish what has been heralded as one of the most incredible medical programs in the modern world. But more than forty years later, the couple has operated on more than 20,000 women, most of whom suffered from obstetric fistula, a debilitating childbirth injury. In this awe-inspiring book, Dr. Catherine Hamlin recalls her life and career in Ethiopia. Her unyielding courage and solid faith will astound Christians worldwide as she talks about the people she has grown to love and the hospital that so many Ethiopian women have come to depend on. She truly is the Mother Teresa of our age. The second edition includes an afterword that brings Catherine's story up to date and new color photographs.
This practical manual has three main objectives: to draw attention to the urgent issue of obstetric fistula; provide background information along with principles for developing fistula prevention and treatment strategies and programmes; and contribute to the development of more effective services for women under treatment for fistula repair.
From the Publisher: Essentials of Global Health is just one offering in Jones and Bartlett's new Essential Public Health series. The book is a clear, concise, and user-friendly introduction to the most critical issues in global health. It illustrates key themes with an extensive set of case studies, examples, and the latest evidence. While the book offers a global perspective, particular attention is given to the health-development link, to developing countries, and to the health needs of poor and disadvantaged people. This introductory level textbook is perfect for undergraduate students and others new to the field of public health or global health. It is based on and designed for a one-semester global health course.
"The 2012 report recognized that expanding women's agency - their ability to make decisions and take advantage of opportunities is key to improving their lives as well as the world. This report represents a major advance in global knowledge on this critical front. The vast data and thousands of surveys distilled in this report cast important light on the nature of constraints women and girls continue to face globally. This report identifies promising opportunities and entry points for lasting transformation, such as interventions that reach across sectors and include life-skills training, sexual and reproductive health education, conditional cash transfers, and mentoring. It finds that addressing what the World Health Organization has identified as an epidemic of violence against women means sharply scaling up engagement with men and boys. The report also underlines the vital role information and communication technologies can play in amplifying women's voices, expanding their economic and learning opportunities, and broadening their views and aspirations. The World Bank Group's twin goals of ending extreme poverty and boosting shared prosperity demand no less than the full and equal participation of women and men, girls and boys, around the world." -- Publisher's description.
The global burden of disease: 2004 update is a comprehensive assessment of the health of the world's population. It provides detailed global and regional estimates of premature mortality, disability and loss of health for 135 causes by age and sex, drawing on extensive WHO databases and on information provided by Member States.--Publisher description.
Including a preface by HRH The Princess Royal, Princess Anne. The Australian doctor saving the lives and dignity of thousands of women in Africa, one surgery at a time. From Ethiopia to Sierra Leone, Tanzania to Togo, Dr Andrew Browning has been helping women affected by obstetric fistulas - a debilitating condition resulting from obstructed childbirth - for nearly two decades. Andrew began his African career in the 1990s working with the late Dr Catherine Hamlin and since then has started the Barbara May Foundation, which has built hospitals, trained staff and established programs to heal fistulas and also prevent them from occurring around Africa in the world's most disadvantaged women. Two million African women are estimated to be suffering with obstetric fistulas. They are often made outcasts in their own community, unable to leave their homes and left with little prospect of a happy, fulfilling life. Andrew's operations, and the spread of fistula-skilled surgeons he is training across the continent, don't just relieve the emotional and physical pain of the women affected, but give them hope and a future. A Doctor in Africa is the uplifting story of Andrew's life, from the challenges faced along the way to the stories of the women whose lives he has forever changed. All royalties from the sale of this book will be donated to the Barbara May Foundation. Praise for A Doctor in Africa 'Andrew's compassion for the women of Africa will inspire and uplift you. Written with warmth and enormous empathy, this book will make you cry - often with tears of joy - and on turning the page have you laughing out loud. A Doctor in Africa is a masterpiece in compassion, sensitivity and caring.' Dame Ann Gloag DBE. Founder, Freedom From Fistula 'Andrew Browning's deep compassion and wonderful surgical skills have given new life to thousands of mothers suffering severe, often horrific childbirth injuries. This Australian doctor has dedicated his life to helping women in Ethiopia, Tanzania and right throughout Africa and beyond regain their dignity and place in society.' Dr Robert Tong AM, Chair, Hamlin Fistula Australia 'Through Dr Browning's astonishing work, countless women shunned even by their own communities are healed, and rivers of tears are turned to laughter and joy. You will cry, you will weep, you will be aghast, but ultimately you will thank God for people like Andrew Browning. Read this if you want your heart broken, then sewn back together richer and pumping with gratitude.' Canon Tim Swan, CEO Anglican Aid 'Dr Andrew Browning is known to us as "the surgeon of difficult cases". In his book, he brings us real stories of the victims of fistula, but with restored good health. Andrew is a compassionate, skilled, devoted, young surgeon who has brought hope and dignity to many vulnerable African women. He awakens our inner being, moving us to become more compassionate.' Sister Dr Imelda Nabukalu, Deputy Medical Director Kitovu Mission Hospital, Masaka, Uganda 'Following in the footsteps of his legendary mentor, Dr Catherine Hamlin, Dr Andrew Browning's extraordinary life is as fascinating as it is inspiring. Dr Browning is living out his faith by giving the priceless gift of health to multitudes of African women suffering horrendous injuries simply for trying to bring a child into the world.' Kate Grant, CEO of the Fistula Foundation USA 'I urge you to take up this wonderful read and find your heart deeply thankful and your mind wonderfully informed. The work that Andrew has been doing is a bright signpost to the God he serves. If there is a more thrilling description of what one Aussie doctor has seen and done in African villages to get women restored and rejoicing I'd like to know about it. This book is one of the best antidotes to despondency and doubt I have ever read.' Simon Manchester, Former Rector, St Thomas Anglican Church North Sydney 'Andrew's deep connection with Africa, the land and her people is both confronting and inspiring. Restoring dignity to a marginalised woman is powerful for that individual and her society. His message is one of joy, and hope for a better world.' Dr Vijay Roach, President, Royal Australian and New Zealand College of Obstetricians and Gynaecologists 'Like an Odysseus of modern Africa, Andrew Browning's extensive, interesting and compassion-rich travels with his family to care for local women are also amazing for their rugged versatility and adventurous brio. An exciting story off the beaten track, both literally and medically.' Richard Hamlin 'It has been a privilege to know and work with Dr Andrew Browning. He has been a mentor, role model and great fistula surgeon. He has surrendered his life to help fistula patients. His dedication in fistula work has brought smiles to thousands of women. His life story is inspirational and I would wish to walk in his footsteps.' Dr James J. Chapa, MD, MMed (Obs/Gyn), MPH, Fistula Surgeon and FIGO Accredited Trainer, CCBRT Hospital, Dar es Salaam, Tanzania
The 2006 edition of UNICEF's annual report focuses on the millions of children who are most in need of access to essential education, health and protection services, but who are also the hardest to reach and often overlooked by current development programmes. These include children living in the poorest countries and most deprived communities within countries, children who face discrimination on the basis of gender, ethnicity or disability, children caught up in armed conflicts or affected by HIV/AIDS, children who lack a formal identity and who suffer from abuse and exploitation. The report examines the factors which result in their exclusion from current child development programmes and services, and highlights the policy options and actions required to address these challenges, in order to ensure all children benefit from the progress being made to achieve the Millennium Development Goals. Topics discussed include: income disparities and child survival, the marginalisation of Roma communities and their children, disability issues, children and HIV/AIDS, children living on the streets, early marriages, child labour, child protection and child rights.
Having a child remains one of the biggest health risks for women worldwide. Fifteen hundred women die every day while giving birth. That's a half a million mothers every year. UNICEF's flagship publication, The State of the World's Children 2009, addresses maternal mortality, one of the most intractable problems for development work.The difference in pregnancy risk between women in developing countries and their peers in the industrialised world is often termed the greatest health divide in the world. A woman in Niger has a one in seven chance of dying during the course of her lifetime from complications during pregnancy or delivery. That's in stark contrast to the risk for mothers in America, where it's one in 4,800 or in Ireland, where it's just one in 48,000. Addressing that gap is a multidisciplinary challenge, requiring an emphasis on education, human resources, community involvement and social equality. At a minimum, women must be guaranteed antenatal care, skilled birth attendants and emergency obstetrics, and postpartum care. These essential interventions will only be guaranteed within the context of improved education and the abolition of discrimination.