By Leocadia Bongben
Despite progress witnessed in the last years with obstetric fistulas repair some women are yet not aware that their situation can change from shame to shine if they speak out and consult.
Obstetric Fistulas Prof. Tebeu Pierre Marie, Gynecologist and Obstetrician at the University Teaching Hospital, CHU, says is a communication between the bladder and the vagina or between the rectum and the vagina meaning that urine comes to the urine bag and flows directly outside because there is a hole between the urine bag and the vagina and same for stool.
Obstetric fistula occurs at childbirth in a facility where there is no skilled staff or deliveries at home and there might have been need for a caesarian section and when this cannot be done, the head of the baby can compress the bladder or rectum for a long time, in the long run the tissue loses blood supply and dies off. Within five days to one week the dead tissue falls off creating a hole, Tebeu explains.
Pulcherie Maboulle like Manka Ernestine both operated at the Yaounde University Teaching hospital did not know obstetric fistulas could be repaired.
“It was complicated because we did not know the illness can be cured. I never knew that I could come to the hospital and get repaired”, Maboulle and Manka all say respectively.
Maboulle has just been operated upon and has spent only three days in the hospital, as she says, the operation went well. “I can move around, I was even in the other block and I pass urine normally now”, Maboulle says.
For Mankaa who has had three children living with condition of having stool pass through vagina with risk of infection, all is now well after the repair.
Maboulle narrates here ordeal with the disease of shame prior her operation. “It was hell and if your man does not really like you, then be sure to be abandoned. Even within the family, any time you sit with your sisters it is either the odor of urine or feces. It is discouraging, not a life to expose in society”.
It all started in 2014 when she delivered her baby in the hospital and thought after taking antibiotics everything was going to be normal, but after two years she had to come back to the hospital.
“I went to the Gyneco-obstetric hospital but I was told repairs were only done at CHU in the whole of central Africa, I did not even know such an illness exists, so when I got CHU and was consulted I was told the free surgery campaign was over and that I could come back in May”, she said.
Since 2009, CHU has been carrying out free obstetric fistula repairs twice per year to give women a new hope in life and this year the second campaign was on from May 26 –June 6. During the free obstetric repairs the women only have to buy drugs.
As Maboulle says, “Everywhere I went I was asked about FCFA 700,000 but with the free surgery campaign at CHU I have not spent any-money except to buy drugs after the free operation as even hospitalization is free”.
According to Prof. Tebeu, the patient will spend about 300,000 to 500000 to get the fistula repaired outside the free campaign but CHU has reduced the amount by half and humanitarian organizations can help easily now because if they have to spend to operate ten women that same amount can be used to operate 20 women.
Obstetric Fistulas are a public health problem worldwide, with about 2 million women affected and in Cameroon at least 10,000 women live with fistulas and since the campaign started in 2009 more than 200 women have been operated, 20 during each campaign and twice a year but not enough.
There are more women suffering from fistulas and it is estimated that there are 1000 new cases every year, Tebeu stated.
Initially fistulas were thought to affect mostly the northern part of Cameroon due to early marriage, but there are equally women who come from the centre region with fistulas. The Domestic and Health Survey, DHS 2011 indicate that 37 percent of women in the centre region still deliver at home.
Obstetric fistula repair is a technical procedure, the gyaenacologist-Obsterician closes the hole and the woman is able to contain stool or urine and pass it out when she wants.
The percentage of complete repair is estimated at 80 percent and Tebeu says the surgery can be repeated adding that a few women can get their fistula closed but have the flow of urine through the normal channel, a condition known as post fistulas urinary incontinence which can still be operated.
But, If the hole is so big or fibrosis too much and everything is destroyed with only bones left there is a palliative measure, “remove the pipe that take urine from the kidney to the bladder and put directly to the intestine and the urine is passed out with stool”, the expert says.
Women who have been repaired of fistula say after this shameful illness there is a life with a God-sent doctor at CHU. This illness comes in childbirth, which is complicated and difficult too. It is not witchcraft but a natural illness like malaria and they encourage women to get treatment in the hospital.
After about five years of free fistula repairs there is change, women came to consult after a long time after about 30 years of bondage with fistulas, but the time lapse is now about six months and a few years.
But, there is still need for more sensitization; send the information villages to bring more women out for consultation and repairs.
By Leocadia Bongben
Marc Arthur Zang, inventor of the Cardio-Pad-a heart diagnosis and monitoring tablet has won the Africa Prize for Engineering Innovation.
Worth about FCFA 21 million the prize designed by the UK based Royal Academy of Engineering was presented to Arthur Zang in the Tanzanian Capital, Dar es Salaam on May 26.
“The Money would be used for the new company I am putting up, Himore Medical in Yaounde, in the payment employees who have just signed their contracts, production of medical appliances being developed internally and to satisfy the needs of the enterprise generally.”, Zang said.
Meanwhile, during the ceremony, Zang commented, “This award has allowed me to measure myself against the best engineers in Africa. I was pushed to the limits, and it has made me a better scientist and a better entrepreneur. It has also grown my ambitions for the Cardio-Pad and my company, Himore Medical which I now aim to grow into a global leader in medical manufacturing. I am also very proud to win for my country. I hope it will help to restore hope to those who still doubt that Africa has a bright future”,
Zang competed with 11 other entrants among them finalists from Uganda-Eddie Aijuka who presented an electricity theft prevention machine, Felix Kamaru from Kenya with a website to save the lives of the mother and child, Matt Wainright with an electricity devise for rural electrification from South Africa who each bagged home about FCFA 10million.
The head Judge Malcolm Brinded on the occasion said, “I was very impressed by Arthur Zang and his team, which aims to help patients in communities where access to cardiac specialists is limited. We are very proud to have him as our second Africa Prize winner”.
Zang is the second winner of the Royal Academy Award, and was lucky to have first winner from Tanzania, Dr Askwar Hilonga present him the prize.
The Royal Academy Award encourages talented sub-Saharan African engineers, from all disciplines, to develop local solutions to challenges in their communities.
The Prize selects a shortlist of innovators from across the continent and provides training and mentoring to help turn engineers with incredible ideas into successful entrepreneurs.
Launched in 2014, the prize aims to stimulate, celebrate and reward engineers who have developed innovations that will benefit Africans.
The shortlisted Africa Prize entrants, from nine countries in sub-Saharan Africa, were provided six months of business training and mentoring during which they learned to develop business plans and market their innovations, received coaching on communicating effectively, focusing on customers and approaching investors with confidence.
The Cardio-pad is designed with an assembly of accessories such as cables fixed on the chest, knee and wrist of the patient.
Conductors are connected to the cardio-pad by Bluetooth and the data from the patient, processed and saved during the diagnosis or registration of the patient.
With a click of the button after registration, the information is sent to a cardiologist in town. With his phone or cardio-pad he can send back the diagnosis and prescription from town back to the village, Zang explains.
It suffices to insert the a sim card in the phone for the cardio-pad to be recognized in the system of selected cardiologists, he added
Nearly one in two Africans over the age of 25 has undiagnosed hypertension and an estimated 20 million Africans suffer from a cardiovascular disease. A further 80 million Africans are estimated to have abnormally high blood pressure, which can lead to heart failure.
In Cameroon it is estimated that there are only 50 cardiologists for a population of about 20million, with about 140,000 suffering from Heart diseases.
The Cardio-Pad created in 2011 would therefore contribute to the fight against heart diseases as early diagnosis could bring about treatment and avoid deaths.
Zang has set up, Himore Medical Limited- an assembly plant in Yaounde to vulgarization the Cardio-Pad already on sale in Cameroon, Gabon and India and Nepal.
The medical equipment plant will employ about 150,000 Cameroonians and Zang intends to use the profit from the sale of 43 Cardio-Pads sold at FCFA 2million each to offset the salaries of employees.
Parts of the device manufactured in China were expected in Cameroon in January and the first 100 would to be assembled would be reserved for Cameroonians.
In its early days of creation, Zang won President Biya’s Prize for innovation in July 2015 that permitted him to build the first Cardio-Pads sent to the regional hospitals.
The Cardio-Pad which Zang presented at the Health fair in Geneva won 2014 Rolex Award as the youngest laureate in applied technology and he been listed in the American Business Magazines, Forbes as one of the 30 entrepreneurs to change the future of Africa.