Liberia Fistula Project Conducts Surgery on Women & Girls

Dr. John Mulbah, LFP Lead Surgeon_web.jpg

Surgeons attached to the Ministry of Health’s Liberia Fistula Project (LFP) are conducting surgery on patients suffering from Obstetric Fistula.

Members of the team commonly define this fistula as “pee pee and pupu sickness,” which only affects women and girls who develop it as a result of prolonged labor during childbirth.

The LFP team only looks out for Obstetric Fistula which, according to them, is prevalent in Liberia because most of the sufferers are mothers who attempt to deliver their babies at home instead of going to a recognized health facility.


The fistula team has earmarked 30 women for the current campaign, dubbed Tracking Fistula and Transforming Lives.

The campaign, which began on February 18, was expected to end on March 4.

However, the LFP surgical team, which has so far fixed the conditions of at least 14 women and girls from Bong and Grand Bassa Counties, won’t end its surgical operations

A staff of the LFP said at least five patients are awaiting the surgeons at the United Methodist Hospital in Ganta, Nimba County while another four are also waiting at the Liberian Government Hospital in Tubmanburg, Bomi County. Others are also said to be awaiting surgery at the Liberian Government Hospital in Buchanan, Grand Bassa County.

Ms. Marlene Tokpa further told our Health Correspondent that this campaign, which is divided into two phases, includes the surgical and preventive aspects.

The preventive campaign is expected to end on March 4, while the surgical aspect will continue whenever patients with this condition show up at any of the health facilities, including Phebe and Charles Burgess Dunbar (CB) Hospitals in Bong; Liberia Government Hospital in Bomi and United Methodist Hospital in Nimba.

Obstetric Fistula surgery on these patients is “absolutely free of charge” and candidates only have to go to any of those health facilities to be operated on.

Our Health Correspondent, who was embedded with the surgical team, witnessed the doctors fixing the conditions of 13 women and girls with Vesico-vaginal fistula and one with Uretero-vaginal fistula.

The last case—Uretero-vaginal fistula— was a bit complicated for the other doctors and it required the intervention of Dr. John K. Mulbah, Lead Surgeon on the Liberia Fistula Project.

Last December, Dr. Mulbah, who is a Gynecologist and also a professor at the University of Liberia’s A.M. Dioglotti College of Medicine, told the Daily Observer that the nation must brace itself for more fistula cases because more pregnant women were giving birth in their communities without the supervision of a trained and skilled birth attendant or doctors.

He had said that the women were not coming to the available health centers or most of them were being rejected at the health facilities and hospitals. This was due to the complete breakdown of the nation’s health sector because of the deadly Ebola crisis, which ravaged the nation and has taken the lives of at least 4,000 persons in Liberia.

The LFP lead surgeon told the Observer all of the 14 women and girls fixed last week at Phebe and C. B. Dunbar Hospitals were new cases of fistula and none was a recurrence case. 

“So we can see that the progress that we were making in reducing the back log of fistula patients has eroded and the new cases are going to again increase,” he said.

He praised the United Nations Population Fund (UNFPA) for providing most of the support for the work of the LFP.

In February 2013, Dr. Mulbah had told this newspaper that the LFP team had been able to fix the fistula problems of more than a thousand girls and women from Liberia, Guinea, Sierra Leone and La Côte d’Ivoire. He had also disclosed that Liberian women and girls fixed amounted to at least 92 percent, three percent Ivorians and the rest, Guineans and Sierra Leoneans.

However, he had stressed during that interview, that it was too early to celebrate the gains that were being made in trying to eradicate fistula from Liberia.


On the preventive aspect of the current LFP campaign against fistula, the team brought together, alongside the surgical operations, at least 80 trained traditional midwives (TTMs) from both Bong and Nimba Counties.

Alongside the TTMs, the team also included 40 other stakeholders, including youth leaders, driver union leaders and community leaders of both counties.

They brought these stakeholders together in each county in order for them to help disseminate the information that their daughters, sisters, wives and mothers should not be delivered in their communities and that they should prevail on expectant mothers to go to the nearest health facility to deliver their babies.

The LFP team is promoting the facility-based delivery as opposed to the home-based delivery so that when any complications arise, skilled birth attendants or doctors will be on hand to solve them.

Mrs. Anna K. Gbe, a member of the LFP team, encouraged TTMs, who are most times the first in the rural communities to begin treating expectant mothers within their villages and towns, to encourage pregnant women and families to utilize antenatal care services; identify danger signs during pregnancy and make referrals and prepare pregnant women and their families for health facility delivery.

At the end of the Nimba meeting, Mr. William S. Mandein, president, Sanniquellie Youth Association (SYA), expressed appreciation to the team and said he had only heard about fistula on the radio but didn’t know how humiliating it is for women suffering from this condition. He, like other participants, promised to mobilize their constituents to serve as ambassadors against fistula.

The LFP team also took their campaign to high school students in both counties. Their specific message to the students was the use of family planning methods to keep them from getting unwanted pregnancy while they are yet students. They encouraged the students, especially the females to use family planning in order to have their future babies “by choice and not by chance.”

About Fistula

One of the most serious injuries of childbearing is obstetric fistula, a hole in the vagina or rectum caused by labor that is prolonged – often for days – without treatment. Usually the baby dies.

Because fistula leaves women leaking urine or feces, or both, it typically results in social isolation, depression and deepening poverty. Left untreated, fistula can lead to chronic medical problems. It can be prevented, however.

Fistula can cause involuntary passage of urine and feces by its sufferers.  A woman with fistula cannot feel the urge to urinate or toilet. Both just come out anywhere at any time, leaving the woman very embarrassed and ashamed.





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