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There is now a worldwide awareness of the vast number of women with untreated childbirth injury in Africa and other poor countries. These shameful injuries are preventable but this will not occur until there is improved access to quality obstetric care. While improvements in these services are the top priority, there is a great need to train more surgeons, especially nationals, to have the skill and resources to help these long-suffering incontinent women.
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.
Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
Over the past few decades, maternal childbirth injuries have become a potent symbol of Western biomedical intervention in Africa, affecting over one million women across the global south. Western-funded hospitals have sprung up, offering surgical sutures that ostensibly allow women who suffer from obstetric fistula to return to their communities in full health. Journalists, NGO staff, celebrities, and some physicians have crafted a stock narrative around this injury, depicting afflicted women as victims of a backward culture who have their fortunes dramatically reversed by Western aid. With Beyond Surgery, medical anthropologist Anita Hannig unsettles this picture for the first time and reveals the complicated truth behind the idea of biomedical intervention as quick-fix salvation. Through her in-depth ethnography of two repair and rehabilitation centers operating in Ethiopia, Hannig takes the reader deep into a world inside hospital walls, where women recount stories of loss and belonging, shame and delight. As she chronicles the lived experiences of fistula patients in clinical treatment, Hannig explores the danger of labeling “culture” the culprit, showing how this common argument ignores the larger problem of insufficient medical access in rural Africa. Beyond Surgery portrays the complex social outcomes of surgery in an effort to deepen our understanding of medical missions in Africa, expose cultural biases, and clear the path toward more effective ways of delivering care to those who need it most.
The fifth volume in Dr. Jonathan Berek’s bestselling series, Operative Techniques in Obstetric Surgery provides superbly illustrated, authoritative guidance on operative techniques along with a thorough understanding of how to select the best procedure, how to avoid complications, and what outcomes to expect. Easy to follow, up to date, and highly visual, this step-by-step reference edited by Drs. Michael A. Belfort, Alireza A. Shamshirsaz, Steven L. Clark, and Karin A. Fox covers the most common operations in obstetrics and is ideal for residents and physicians in daily practice. Succinct text, bulleted points, and quick-reference tables allow you to review information quickly and understand best practices and potential problems for each procedure. Hundreds of full-color intraoperative photographs and drawings, as well as more than 20 high-quality videos, capture procedures step by step and help you immediately apply your knowledge. Each clinical problem is discussed in the same templated format: general principles, anatomy and differential diagnosis, imaging and other diagnostics, preoperative planning, surgical management, procedures and techniques, pearls and pitfalls, postoperative care, outcomes, and complications. Coverage includes Cesarean delivery, management of postpartum hemorrhage including hysterectomy for placenta accreta spectrum, operative vaginal delivery and repair of lacerations, obstetric fistula repair, and more. Perfect for a quick preoperative review of the steps of a procedure. Volume editors and contributors are thought leaders in their respective subspecialties and are known for their surgical expertise. Enrich Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.
Written by an expert in the obstetric damage repair field, this book shows that fears and concerns surrounding vesico vaginal repair are often unfounded, as many fistulae can be cured locally, without sophisticated equipment or specialist surgeons. It is for those dealing with obstetric fistulae in both developing or developed countries.
Obstetric fistula is as old as mankind. While the incidence has diminished progressively with better health care in Western societies, the situation has changed little in many developing countries. Fistulae of pelvic organs, often monstrous defects, still are a major complication of child-birth causing misery to uncounted young women, and if they cannot find help in one of the very few hospitals with trained specialists, they became urological cripples losing everything: family, home and job. The magnitude of the problem is illustrated by some figures given by Reginald and Catherine Hamlin-about 700 fistula patients treated each year-a total of over 10,000 cases operated upon in their fistula hospital in Addis Ababa, Ethio pia. Most of these injuries could be prevented by better health care at the village level as some studies have shown conclusively. The incidence of fistula is an indicator of the standard of health and obstetrical care. The author of this book-Obstetric Fistula-is an internationally known Australian gynaecologist who for many years has been interested in all aspects of gynaecological urology, especially urinary stress inconti nence, other forms of involuntary loss of urine, and associated gynaeco logical conditions. He has devised a number of new operations to treat pelvic defects. Robert Zacharin's interest in obstetric fistula was a con sequence of his surgical activity in developing countries.
This open access edited book brings together new research on the mechanisms by which maternal and reproductive health policies are formed and implemented in diverse locales around the world, from global policy spaces to sites of practice. The authors – both internationally respected anthropologists and new voices – demonstrate the value of ethnography and the utility of reproduction as a lens through which to generate rich insights into professionals’ and lay people’s intimate encounters with policy. Authors look closely at core policy debates in the history of global maternal health across six different continents, including: Women’s use of misoprostol for abortion in Burkina Faso The place of traditional birth attendants in global maternal health Donor-driven maternal health programs in Tanzania Efforts to integrate qualitative evidence in WHO maternal and child health policy-making Anthropologies of Global Maternal and Reproductive Health will engage readers interested in critical conversations about global health policy today. The broad range of foci makes it a valuable resource for teaching in medical anthropology, anthropology of reproduction, and interdisciplinary global health programs. The book will also find readership amongst critical public health scholars, health policy and systems researchers, and global public health practitioners.
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