Dr Sohier Elneil PhD (Cantab.) FRCOG, author of the FIGO and Partners Global Competency-based Fistula Surgery Training Manual writes...
In the last few years many changes have taken place to promote better care of women and girls with obstetric fistula (OF). These include:
- Increasing the number of competent fistula surgeons
- Improving healthcare facilities in lower and middle income countries (LMICs)
- Improving advocacy for OF patients through specialized reintegration programmes
Despite these advances and possible reduction in the numbers of OF, evidence-based data of surgical management and data demonstrating the true number of OF in the community are lacking as are preventative strategies, cases of reducing iatrogenic-genesis of obstetric fistula and managing post-repair incontinence. In May 2017, the WHO called a meeting of experts to improve practice guidance and incorporate evidence-based care. The WHO's first guideline will focus on the bladder catheterisation after the surgical repair of simple obstetric fistula which has direct cost effectiveness in LMICs. The guideline will help guide the care of women affected by fistula by fistula surgeons.
Returning to Uganda
Mr Marcus Filshie FRCOG has funded a Fellowship programme to support the RCOG project, Excellence In: Obstetric Skills which focuses upon helping to prevent obstetric fistula in Uganda.
Marcus returned to Uganda to visit the project in 2016 to meet those involved and see how his support is making a difference to the initiative.
Returning to Uganda: funding a trainee Fellowship from RCOG on Vimeo.