Once a year, an extraordinary international medical event takes place, an event that puts women’s health ─ and women’s quality of life ─ front and center in Gimbie, Ethiopia. This collaborative project is made possible by the close partnership between providers in the OHSU obstetrics and gynecology department, the anesthesiology department, nursing and operating-room staff, and our community health-care providers.
As they have for several years, Renée Edwards, M.D., MBA, associate professor of obstetrics and gynecology and co-director of the OHSU Center for Women’s Health; W. Thomas Gregory, M.D., associate professor of obstetrics and gynecology, and Dr. Julio Gonzalez-Sotomayor, M.D., assistant professor of anesthesia helped me recruit the team and coordinate the surgical mission that took place in Gimbie in February 2014.
There, in partnership with Gimbie Adventist Hospital, we provided free surgeries to women with urogynecological issues, especially pelvic organ prolapse.
I grew up in Ethiopia, which led me to help found the nonprofit Footsteps to Healing, which supports and coordinates these trips and the surgeries. This year, Dr. Edwards, a co-director of the OHSU Center for Women’s Health, and I led a diverse team – which included three surgeons, two nurses, two surgical technicians, two anesthesiologists and three residents – who performed almost 50 advanced pelvic prolapse surgeries in just 10 days.
If that sounds like a rigorous schedule, it’s not one that really bothers any of us. I never imagined I would be educated in the U.S. Yet for some reason things kept falling into place. So I now have access to medical skills and treatments that are out of reach for most people in Ethiopia. It just felt natural to help give back to my homeland.
Pelvic-floor prolapse is a silent epidemic among Ethiopian women, deeply affecting the quality of their lives. Pelvic-floor muscles can be damaged during protracted childbirth where there is limited health care. In extreme cases, the damage can result in pelvic organs like the bladder, the bowel and the uterus to “prolapse” out of the body through the vagina. In addition, Ethiopian women experience a lifetime of strenuous physical activity—typically working 13 or 14 hours a day carrying wood and water over mountains—which makes the condition much worse.
A surgery to fix a prolapse costs about $200 in Ethiopia. And that’s 10 years’ income for a family there. So we lead these trips, with assistance from OHSU colleagues, including residents who assist in as many as six surgeries a day—more pelvic-floor surgeries in a single day than they might do in an entire surgical rotation.
This year, we also have some exciting news. The Gimbie program has been so successful that we are intalks to expand the program to a university hospital in the northern part of Ethiopia, College of Health and Sciences at Mek’ele University. We hope this new collaboration will allow OHSU providers not only to provide much needed service, but also to build health care capacity by teaching local providers, building on the successes in Gimbie.
Rahel Nardos, M.D. is an OB/GYN specializing in urogynecology at the Center for Women’s Health and an assistant professor at OHSU. She also holds a clinical position at Kaiser Permanente in Portland.