OHSU team brings hope to Ethiopian women

SUBMITTED PHOTOS
Dr. Rahel Nardos,a native of Ethiopia, tends to one of the
49 women the team treated in its first visit last March.

Source: The Lake Oswego Review, Feb 10, 2011

Dr. Renee Edwards of Lake Oswego and the OHSU Footsteps to Healing team are mobilizing an international effort to improve women’s health in rural Ethiopia.

When Lake Oswego doctor Renee Edwards heard that the Lake Oswego Reads selection for 2011 was Abraham Verghese’s “Cutting for Stone,” she was thrilled.

“I found the book’s description of medical care for women in Ethiopia to be completely accurate.

“And the sad part is that it is exactly the same today as it was in the setting of the book – which I assume was around 1950,” Edwards said.

Rural Ethiopian women, most of whom are very young when they start having children, face alarmingly high – and preventable – maternal morbidity mortality rates. Prolonged labors are usually without care, and the physical exertion of delivery coupled with a lifetime of hard labor commonly results in such treatable impairments as obstetric fistula and/or pelvic organ prolapse.

Edwards, division chief of urogynecology and reconstructive pelvic surgery at OHSU, calls it a “silent epidemic,” and she is on a mission to do something about it.

“In simple terms, a prolapse is when the muscles and connective tissue in the pelvic area weaken and lose support. The vagina and bladder fall into places that they shouldn’t be,” Edwards explained. “A fistula is an abnormal communication between the bladder and the vagina which causes uncontrolled leakage of urine.”

Relatively common in Sub-Saharan Africa, these disfiguring disorders cause devastating physical and social consequences for the women. It limits their daily activities and basic bodily functions, and the women can be ostracized by their community and abandoned by their husbands.

“In the most severe cases, everything that should be tucked up inside a woman has actually fallen outside the body.

“But we can help these women. We can change their lives,” Edwards vehemently explained. “The reconstructive surgery for is just $175 per patient.”

Mobilizing the team

Edwards began work on the Footsteps to Healing: A Gobal Commitment to Improving Women’s Health in Rural Ethiopia project last spring. She mobilized a team of OHSU doctors and interns to work with two rural hospitals in Ethiopia, the Gimbie Adventist Hospital and Mota regional hospital.

“Our goal is to create a sustainable solution,” Edwards said. “We want to train Ethiopian health providers in obstetrics, midwifery and pelvic floor reconstructive surgeries. Too often teams of doctors swoop in to do good work, and after they leave things have not changed.”

Sharing the helm of the OHSU team is Rahel Nardos, M.D. urogynecology and reconstructive pelvic surgery. Nardos lived Ethiopia’s capital, Addis Ababa, until she was 17, and her insight to the Ethiopian culture and the people has been invaluable.

“It is impossible to do this kind of work in these rural communities without connections,” Edwards said.

The Footsteps to Healing team took its first trip to Gimbie Town, which is a 250-miles bus ride from Addis Ababa, in November of 2010. The team completed 49 surgical procedures for pelvic organ prolapse.

“The women brought their whole families to the hospital to help them through recovery. Each woman got a pair of Keen shoes, a new dress and bus fare so they wouldn’t have to walk home after surgery,” Edwards said. “They were beyond grateful – embarrassingly so. Most of them had been living with their disfigurements for years. They felt as though they had their lives given back to them.”

The Footsteps to Healing team plans to return twice yearly to Ethiopia, in November and April.

“We must continue training Ethiopian health providers. Plus we are working on extending our educational efforts on contraception and expanding the midwifery school,” Edwards said. “I can’t wait to go back.”

Join Edwards and Nardos to hear more about the

Footsteps to Healing project

As part of the Lake Oswego Reads program, Edwards and Nardos will be joined by Dr. Philippa Ribbink from Everywoman’s Health and Joni Kabana, photographer, to discuss their efforts in Ethiopia. The program will be held Thursday, Feb. 17, at 7 p.m. at Marylhurst University in the Commons-Hawthorne Room.

For more information on the Footsteps to Healing project visit www.ohsu.edu/xd/health/services/women/about-us/Ethiopia-mission.cfm.

Any financial assistance to this project is greatly appreciated. If you are interested in donating, contact Lori Slaughter at the OHSU Foundation at 503-418-0347. Global Soul International is another source for donating funds, and their website is www.globalsoulinternational.org.