Meet FIGO Fellow Dr Iqbal and her colleagues
Building a global standard of care for women with fistula
In 2014, CCBRT was officially accredited by the International Federation of Gynaecology and Obstetrics (FIGO) as an international training centre for fistula surgeons – training more than 22 health workers since then. These FIGO fellows have spent weeks learning advanced techniques from our expert fistula surgeons Dr Peter and Dr James to support better quality of care for women suffering from fistula globally.
FIGO-sponsored surgeon Dr Iqbal and her three colleagues, Eastraf, Redha and Samira, are training at CCBRT for three weeks. They work at a UNFPA-funded medical facility in Aden – one of only two facilities that treat women with obstetric fistula in Yemen. Five years ago, Dr Iqbal, Eastraf and Redha began treating women with obstetric fistula. Dr Iqbal has encountered women living with fistula for decades and complex cases that required advanced fistula repair techniques. She applied for a FIGO fellowship in order to be able to help all women with fistula seeking care.
Repairing fistula through surgery is only one important step in treating a woman with fistula. At CCBRT we take a holistic approach to fistula recovery which includes a dedicated holistic care coordinator, physiotherapy, life skill and therapy sessions and continued follow-up after leaving CCBRT. Our fistula experts include this holistic care model when training FIGO fellows, which is one reason why we are so glad to welcome not only Dr Iqbal, but the very important health workers that will support the facility’s holistic care approach for women with fistula. Samira, a physiotherapist and Dr Iqbal’s colleague, has been providing rehabilitative care for children with cerebral palsy and adults needing therapy after receiving prosthetics or orthotics devices. Learning from Dr James and Dr Peter is Samira’s first training on physiotherapy support to women with obstetric fistula. When women experience obstructed labour, which is the cause of obstetric fistula, complications can also include foot drop and shortened lower-limb muscles and joints – making it difficult and often painful to walk. Physiotherapists like Samira give fistula patients exercises to help lengthen the muscles and joints in the lower limb after surgery. Samira is training with CCBRT’s physiotherapists to learn how to support women recovering from fistula in order to improve the quality of care she and her team provides in Yemen.
“Before the war there was information about fistula on the radio and other media. There was awareness around what fistula was and where to go for treatment. The number of patients we were seeing was increasing as awareness about fistula was rising,” said Dr Iqbal. In 2015 civil war broke out in Yemen. Since then, emergency healthcare has been the priority. Dr Iqbal explained, “Since the war, we are seeing less patients. We know many women have fistula because we find fistula while performing surgery on women for different health reasons. With the war, there isn’t always access to medical care, especially since there are only two facilities in the country that perform surgeries on women with fistula.”
This team of health workers in Yemen are trying to raise the standard of care for women with obstetric fistula during a civil war that has decreased access to care. Dr Iqbal explained that the cases they are seeing now are more advanced and she is very thankful to FIGO and CCBRT for this opportunity to learn to holistically support women with obstetric fistula in Yemen.