© Martina Bacigalupo
In Burundi, Médecins Sans Frontières (MSF) focuses on maternal health, providing emergency obstetric care and obstetric fistula repair.
Women are particularly affected by the limited access to healthcare in Burundi. According to the World Health Organization, 4,000 women die in childbirth and 1,200 develop an obstetric fistula every year.
Obstetric fistulas are injuries to the birth canal, and are most often caused by prolonged or obstructed labour. These fistulas cause incontinence, and women have to live not only with the debilitating physical consequences, but also, in many cases, with shame and social exclusion.
However, most fistulas can be repaired, and women who have successful fistula repair surgery are usually able to return to their normal lives and integrate back into society.
The Urumuri health centre
At the Urumuri health centre, in the city of Gitega, central Burundi, MSF offers free, around-the-clock treatment to women suffering from obstetric fistulas. Surgeons performed more than 370 fistula repair operations in 2011 and began training two Burundian doctors in the technique. MSF is planning to increase the capacity of the centre and expects the number of operations to rise to 450 in 2012.
If women are treated for fistula early, surgery can be avoided, and in 2011, MSF piloted a programme to do just that. For women who have developed fistulas within the previous six weeks, doctors in Gitega insert a catheter to drain the bladder of urine. This decompresses the bladder walls and allows the wounded edges to meet and join together, so that the fistula heals naturally.
Many women do not know that it is possible to treat or repair obstetric fistulas. To promote awareness of the options available, MSF has set up an information line, which people can call with any questions about the condition.
Skilled medical assistance during labour can prevent obstetric fistulas. In the town of Kabezi, in Bujumbura Rural province, MSF is managing an emergency centre for gynaecological and obstetric care (CURGO). The CURGO also offers neonatal services. An ambulance service transports women in need of emergency attention from 24 different health centres in the surrounding area to the CURGO in Kabezi. Almost 2,200 babies were born at the centre in 2011, and 446 of them were admitted for intensive neonatal care.
Responding to emergencies
Through regular contact with an extended network of medical authorities and organisations across the country, MSF’s emergency response unitmakes sure it has the latest information regarding the risk of emergencies in Burundi.
When measles broke out, the unit participated in an immunisation campaign, vaccinating more than 291,000 people. The team also assisted health authorities during an outbreak of cholera, providing treatment and follow-up for 1,072 patients, and treated over 6,100 people for malaria.
MSF has been working in the country since 1992.