Fistula surgery is not an easy job

The International Federation of Gynecology and Obstetrics (FIGO), in collaboration with a number of other organisations, is training surgeons to treat obstetric fistula in 19 countries of Africa and Asia through its Fistula Surgery Training Initiative. Collectively these surgeons have performed more than 6,560 fistula repair operations, helping thousands of women in these countries regain their lives from this devastating condition which if left untreated, leaves women permanently incontinent.

This year, on International Day to End Obstetric Fistula, FIGO spoke with one of these surgeons: Fistula Fellow, Dr. Nrinmoy Biswas, of Bangladesh, who explains:

“We know the suffering of Fistula patients who are sometimes tragically isolated from the society, from everybody. Sometimes she is forced to beg to survive. We also know that fistula can be prevented by ensuring the fundamental health rights and women’s access to proper maternity care. We cannot live in the society ignoring the needy people. Everyone has the right to have a healthy live. It should not be neglected.

I am honoured, I am excited to get the opportunity to be a FIGO Fellow. Obstetric Fistula surgery is not an easy job for the Surgeons. FIGO has taken the responsibility to make me a Fistula Surgeon with its quality Training and Mentoring. FIGO is a prestigious body in the world. I am blessed to be attached to FIGO as a FELLOW.

Initially I did the surgery of very simple cases. Gradually with the mentoring of FIGO I am now doing a good number of difficult cases also. In my working Division (comprised of many districts) I am the only surgeon who is doing fistula surgery very routinely. It is a great feeling for me that a good number of sufferers are leaving Hospital with their smile, with their blessing for us. You know that currently we are getting many patients from the Rohinga influx, displaced from Myanmar, with the help of UNFPA, IOM, MSF and Hope Hospital is the only centre for their treatment. It is a great honour for us to be the part of their treatment.

As fistula surgery is not an easy job and fistula patients are very poor, surgeons are not interested to be Fistula surgeon. Medical institutes do not have the programme to train fistula surgeons. Especially in the poor community, Fistula surgeons are very few in number. So to help this marginalized community we need more Fistula surgeons. But it should be supervised and it should be funded and it should be through an institute/organization that has a community network and a Fistula team comprised of dedicated people.

FIGO has taken the Fistula surgery training initiative worldwide and it is very successful. It has already reached a prestigious target (over 6000 fistula repairs) with the trainee fistula surgeons on the programme It is a great feeling for me being part of this programme. Thanks FIGO. I am so grateful to FIGO”.

Due to a global shortage of trained, skilled fistula surgeons, there is a huge unmet need to treat and repair the backlog of women suffering from this condition. Longer term solutions require ensuring well-functioning maternal health systems, including emergency obstetric care. But for the immediate future, it is absolutely essential that more surgeons are trained on fistula repair and more health facilities are able to provide holistic fistula treatment services, including rehabilitation and social assistance, to help affected women recover and re-build their lives.

Ask your leaders to invest in training the next generation of fistula surgeons in low resource countries through collaborative partnerships.

It’s time to end Obstetric Fistula and to ensure that no woman is left behind.