Birth Trauma Centre Overview
The tragedy of obstetric fistula in Ghana
This health problem is obviously unique to women. It is a condition that is not fully understood by women themselves, certainly not by men or communities in general. Among women there is often a sense of fatalism that simply some women are going to die during pregnancy and childbirth, and others will develop obstetric fistula. However, once women find out that the condition can be cured they will literally walk for days until they find the hospital that will treat them and then they will wait often for years for surgery. For them the closure of their fistulae is to restore them to life. Very little research has been done to find out why women should end up with the condition, and what the knowledge and attitude of men is to the problem.
There has been longstanding concern among health care providers in rural areas of Ghana about the level of maternal mortality and the prevalence of obstetric fistulae. MCI's partners in Ghana have long recognized the need for a specialised fistula centre and have tried for some years to establish such a unit without success. The actual incidence and prevalence of obstetric fistula in sub-Saharan Africa, particularly in Ghana, is unknown. However, the experience of the Department of Obstetrics and Gynaecology at the Korle-Bu Teaching Hospital, University of Ghana Medical School (UGMS), is that obstetric fistulae occur in all parts of Ghana, especially in rural areas of the north, at the rate of about 1-2 percent of all deliveries (approximately 8,000 cases annually). At the teaching hospital in 1990 there were two new cases seen per week, and there were two others already in admission for surgery. A postal survey of fistulae of Catholic mission hospitals throughout Ghana revealed that cases were spread out over the regions, and some patients were coming from other West African countries, namely Cote d'Ivoire, Togo, Burkina Faso and Mali.
The Project
The purpose of the project is to provide comprehensive obstetric fistula care in Ghana through the operation of a 40 -bed centre with an operating room with ancillary facilities, a treatment and rehabilitation ward, a building with accommodation for medical staff, training and administration. MaterCare International will provide treatment and rehabilitation for women with obstetric fistulae and training programmes for doctors and nurses in surgical repair and nursing management.
The location of the centre was carefully thought out based on the experience of other centres, the unique requirements for a centre in Ghana, and with advice from medical, nursing and government specialists. The centre is located on an 8.7 acres (3.625 Ha) site at Mankessim, a junction town, close to the sea, on the main road to the Central region of Ghana and Ivory Coast. It is 125 kilometres or a two-hour drive from Accra and half an hour from the region capital, Cape Coast. The birth trauma centre will be located in the same compound as a separate centre, providing maternity care for destitute women. The building of the maternity centre was completed in April 2003.
This will be provided for up to 200 fistula cases annually in the first two years, increasing to 500 patients annually once fully operational and then increasing according to demand and staff availability.
Project Ownership
The centre will be located in the same compound as a maternity centre, all of which is owned by the Archdiocese of Cape Coast. The centre will be operated in a partnership between the Archdiocese and MaterCare International
Sustainability and viability
As pointed out by the World Health Organisation, support for this women's health problem will be required for the foreseeable future since it has been neglected for so long and there is no funding in national health budgets where it is a significant problem to deal with it. However, the Archdiocese of Cape Coast has committed to supporting the project .
An experienced MaterCare field officer has been appointed to work with Ghanaian colleagues to develop measures to ensure sustainability. The input of women leaders from the community and those who have experienced fistulae and their families will be important considerations in long term planning.
Technical expertise
MaterCare's mission is to improve the health of women with obstetric fistula. It was established by an experienced group of health professionals simply because there were not enough trained health professionals or facilities in west Africa to provide services. This group includes surgeons and nurses recognised by their peers as the foremost experts in fistula surgery and management. Ghanaian colleagues have received extra training at the Addis Abba Fistula Hospital and this hospital has indicated its willingness to send their two women fistula surgeons to assist in the early development of the centre.
MaterCare, in association with other national affiliates which make up MaterCare International has developed the management and professional expertise to carry out this project and has obtained funding from a number of government development agencies and foundations in Canada, Ireland, the United Kingdom, Australia and the USA.
Progress to date
The Birth Trauma Centre at Cape Coast Ghana has been in the planning and development stage for approximately eight years.. Delay in getting the project underway was due to problems in getting funding sufficient to build the birth trauma centre and develop its programs. However, in 2004, funding from Ireland Aid, non-government organizations, including the Catholic Women's League, and a private benefactor, led to the start of the construction of the birth trauma centre in May 2004. Currently (May 2005), the first phase of the project, construction of the buildings, is well underway and the builders expect the structures to be completed by September 2005.
Birth Trauma Centre Photos
Birth Trauma Centre September Overview
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