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FDSAs key intervention in the area of Medical Outreach is in conducting of surgical repairs for a condition known as Obstetric or Vesico Vaginal Fistula. This intervention is done in the form of VVF Surgical Medical Camps held periodically throughout the year in various hospitals.

Kenyatta National Hospital, being the largest VVF repair centre in the country receives over 400 VVF related cases each year, close to half of the 1,000 VVF cases nationally. The funding is earmarked for a project, run by FDSA aimed at reclaiming women’s dignity as well as protecting families and marriages from disintegration – a key consequence of VVF. A significant part of the project includes training of local specialist gynecologists, surgeons and registrars in fistula surgery as well as building capacity on the ground to handle Fistula.

Obstetric (or Vesico Vaginal) fistula is a devastating condition affecting poor rural women and girls. It manifests as an abnormal communication between the urinary bladder and vagina, which leads to uncontrolled, continuous leakage of urine and/or fecal matter. The condition most often occurs as a complication of obstructed labor but can also be caused by radiation, surgical trauma or accidents.

Inadvertently, majority of VVF incidences occur due to lack of access to qualified health care personnel during the labor period especially in cases of obstructed birth process.  The situation is usually worse off for new mothers, especially teenage mothers because their pelvis is still too small for the baby to pass through. Obstructed labor can therefore lead to injuries to the mother, child or both. This condition has perverse effects on the emotional well-being of the sufferer and completely destroys the individual’s social capacity. Obstetric fistulas affect women of all ages and account for 8% of maternal deaths worldwide.

The Flying Doctors’ Society of Africa (FDSA or The Society) was established in 1971, to raise funds for the spread of Medical Outreach in Africa through a membership scheme which guarantees free evacuation services to paid-up members. The Society also raises funds through fundraising activities, selling branded merchandise as well as donations. The Society is a charitable organization which puts to good use all unutilised subscriptions not spent on evacuations by funding Charity Evacuations and Outreach Programmes that ensure Medical facilities are accessible across the region. Since its inception, the Society has contributed the equivalent of 1 billion shillings to the spread of Medical Outreach in Africa.

FDSA works hard to ensure people all over East Africa have access to life saving medical attention. Part of the proceeds from membership subscriptions are used to help people like Rose. Become a member or donate today and help by being part of the solution.

Most people especially we East African locals only get to hear about this event on TV and the internet, and so we keep wishing that we could be part of it. Guess what! There’s a similar event in Kenya dubbed the “Mombasa carnival”, it takes place during the month of November and lasts for six days. How about having a “Rio carnival” away from Brazil.

As far as I know, Mombasa carnival is the best festival in Kenya. It’s an amalgamation of a number of activities which represent every race and cultural group in Kenya. Why not attend this festival hence get to enjoy the nice music (including traditional) and dancing, and also the brightly colored costumes that make everyone look different. It’s at this event you will happen upon artists and musicians of all kinds from all over Kenya, apart from enjoying their music, you also get to interact with them one on one. Every event usually has its highlights…the highlight of the Mombasa carnival is what intrigues me the most, there’s usually a lively street parade having people from all walks participating. What I have provided regarding the carnival is just a top line and so you need to attend the event yourself hence get to know what am really talking about. You will love and enjoy it.

Oh! Before this skips my mind. While enjoying all the things that the Mombasa carnival brings with it, head to the Muslim-run restaurants where you will get very nice/delicious and pocket friendly Swahili cuisine. Good luck while at it!

Planning an African safari is not an easy thing (at least not for me) and so, one might find themselves between a rock and a hard place especially if it involves two or more countries. For instance, let’s say you want to do a safari that involves visiting destinations that are located in two different countries say Kenya and Tanzania-am using these two countries as an example since they are the ones I have managed to tour in a single safari. Well, why not look for safari tours that visit both Kenya and Tanzania? This way, you will be able to kill many birds with a single stone! Plus, you are sure to find not only an ideal safari, but also that which will not exert too much weight on your wallet.

There are so many things one can enjoy while exploring Kenya and Tanzania. Usually, rather in my case, the safari departed Nairobi and the first stop was at the Masai Mara National reserve, commonly known to the locals as “The Mara”. In all honesty, I was amazed by this particular place-never knew it was such an intriguing place to be at. Just a sneak peek, Masai Mara is a large game reserve in South-Western Kenya which is marked by circles of trees, cloud shadows, savannas and scrubs. Here is where you will get a chance to witness the annual migration of wildebeest, zebra and Thomson’s gazelle which normally takes place between the months of July and October. I put it to you that this particular place is worth visiting, so why not mark it in your calendar and give it a try!

The next destination after Masai Mara was Lake Nakuru National Park then Amboseli National Park and finally Tanzania. The places I would recommend you visit in Tanzania are: Lake Manyara National Park, Serengeti National Park and the Ngorongoro crater which is full of wildlife. Did I mention that I had a bird’s eye-view of Mount Kilimanjaro’s snowy peaks? Oh yes I did, and it was spectacular! Guess if am to visit Tanzania again, then Mount Kilimanjaro would be my first destination.

Finally, we all need travel covers…just to be on the safe side while doing our travels. Flying Doctors Society of Africa provides you with this. Please click here to see the various membership packages.

Malindi has a number of historical sites such as Malindi old town, Gedi ruins etc, which are places worth visiting. Ever heard of dhow trips? Well, don’t worry if this sounds new to you because it did sound new to me as well, but that was before I visited Malindi…now I know better. A dhow is a traditional Arab sailing ship entirely made of wood, which has plied the waters of the East African Coast for more than a thousand years now. Its main purpose was to transport carpets and other goods between India and Africa. You need to check this out and while you are at it, you could do some sightseeing, have lunch or dinner cruises and also enjoy entertainment that includes limbo dancers, acrobats, fire-eaters just to mention a few…sounds fun huh!

Fishermen in Malindi, Kenya struggle to control a dhow

Everyone if not all love the beach, a place where you could relax and just do nothing or enjoy some “me” time or have fun with your friends and family…it all trickles down to enjoying yourself and having peace of mind! Who wouldn’t like this!?! Well, if this is what you are looking for then visit the different beaches in Malindi.

Last but not least, you need to visit the Marine National Park…this particular place is outstanding. The park is located to the south of Malindi town. What’s the hullabaloo all about? You ask yourself. Well, let’s just say Marine National Park is one of a kind as its gifted with fringing reefs, mangroves, high fish diversity, marine mammals…the list is endless.

A beach at Marine National Park, photo by Filip Lachowski

There are so many things about Malindi I would love to say! But trust me if I did, you will never get to hear (or should I say read) the end of it. So why don’t you just plan your travels and go experience all that I have mentioned, and even more.

We participated in the launch of the Kenyatta VVF camp on Friday 25^th May, 2012 and are happy to report that the next few weeks will see over 100 women receive this life-changing treatment. We will continue to fundraise so that the women of Kenya and East Africa with this condition can have their lives restored.

With this issue, we update you on the various ways that your membership contribution is helping change lives. Keep up the momentum as it is through you that we are changing lives!

I joined AMREF as the Outreach Manager for the Programme in November 2003. During my tenure, I have overseen the expansion of outreach in terms of number of hospitals and number of patients benefiting. Due to funding from FDSA, outreach has tripled in their projects (FDSA used to give 4 M in funding every year, and now they give about 14 M per year). We were only visiting a total of 35 hospitals in Kenya and Tanzania, but currently we go to over 150 hospitals in 8 countries. Outreach has grown from USD 700,000 in 2003 to USD 4M currently.

What are the key milestones for the Outreach Programme?

Expansion of outreach meant more funding and this was made possible after FDSA tripled their funding and our budget as well. VVF development centres were set up (e.g. in Kenyatta National Hospital) for reconstructive surgery, and Dr. Khisa (who is in charge of VVF) was hired and in turn trained a lot of doctors. About 5 hospitals used to be visited in Muhimbili (Tanzania) and now we visit 15 hospitals. From 2007, 1,000 patients get treated as compared to 200 and 300 from previous years. Not only do we repair a huge number of recently acquired Fistuli, but also Fistuli from decades ago.

What is the current VVF prevalence?  Give statistics.

An obstetric Fistula is the most devastating of all pregnancy related injuries and affects more than 100,000 African women each year. It is estimated that there are over 5,000 VVF cases reported in East Africa each year. This condition mostly affects poor women and girls who cannot afford skilled supervised health facility delivery. Over 90% of the cases are caused by difficult and prolonged obstructed labour. At Kenyatta National Hospital alone, 400 cases are reported each year.

What more do you feel can be done?

I feel that we need to prioritize disability repair and rehabilitation in both women and children. Because of distance, especially in reaching those who have no access to proper healthcare, we have to fly to reach our patients and that is very expensive as our programmes mainly depend on donors and well wishers. In addition, the population in Kenya has multiplied and exceeds economic growth. Demand for healthcare is therefore much higher.  If the government was to pay for health insurance (about Kshs. 2,000 per family), then majority would have access to clinics.

If given the ability, what would you change?

If given the capacity, I would invest in more reproductive health programmes which in turn would help reduce Fistula. These programmes include training (Midwives), Family Plannning and Ante-natal services, among others.

Which programmes or areas of intervention would you introduce if given the resources?

As mentioned earlier, there is a need to prioritize more on disability repair and rehabilitation in women and children. These areas include injuries, congenital malformations, burns, Cleft lip, Fistula and maternal child health.

What is your vision for the VVF programme?

Unfortunately, VVF is there to stay in Africa. Because of poor healthcare, many women are delivering at home. Fistula repair will continue to contribute to better quality of life and empowerment for the disadvantaged women of Kenya and Africa. There is a need to not only sustain the Fistula programme, but to also expand it. Currently, we are being invited to go to Mogadishu, Somali land, South Sudan, among other countries. The number of repairs awaiting reconstruction in Mogadishu alone is thousands, while there is no money (1 repair costs USD 300). Fistula repair is women’s empowerment-the, most important empowerment opportunity to offer women.

VVF FACTS

Vesico-Vaginal Fistula is an abnormal connection between the urinary bladder and the vagina, the result being constant leakage of urine. Recto-Vagina Fistula is an abnormal communication between the rectum and the vagina, the result being leakage of stool. These patients smell of urine or stool all the time. An obstetric Fistula is the most devastating of all pregnancy related injuries and affects more than 100,000 African women each year. It is estimated that there are over 5,000 VVF cases reported in East Africa each year. This condition mostly affects poor women and girls who cannot afford skilled supervised health facility delivery. Over 90% of the cases are caused by difficult and prolonged obstructed labour. Their pain is constant, and their shame makes them outcasts in the society. Most of the time, the child they struggled so hard to deliver will be still born.

At Kenyatta National Hospital alone, 400 cases are reported each year, with AMREF being the only organization which is currently involved in the surgical treatment of VVF patients in East Africa (since 1992) through their Outreach Programme. FDSA has been funding the Fistula repair activities-an initiative that restores the dignity of the affected women and improving their lives.

To learn more about the outreach programme click here