Fistula patients in South Sudan recover on mattresses flown in by MAF

Published: 15 Dec 2020


44 mattresses destined for Amref’s Fistula Camp in Yambio, South Sudan

Mattresses are basic, yet fundamental, when helping patients recover more comfortably from fistula surgery. Such operations to rectify childbirth injuries in South Sudan cannot take place unless there are enough mattresses for the women undergoing surgery. MAF’s Jenny Davies finds out how 44 mattresses flown in by MAF are crucial to Amref's work…

Last month, MAF flew mattresses, a Ugandan consultant obstetrician and boxes of sterile medical equipment from Juba to Yambio in South Sudan near the DRC border for health charity, Amref. This 80 -minute flight spared MAF’s partner hours of dangerous travel by road.

Amref offers surgery to women suffering from obstetric fistula - a debilitating condition caused by prolonged and obstructed childbirth, often resulting in incontinence.

If left untreated, the stigma and social isolation of the condition, which causes women and girls to constantly leak urine and faeces, leads to economic hardship if they are unable to work.

Two million women are living with obstetric fistula

Such specialised surgery isn’t widely available outside of South Sudan’s capital, Juba, meaning that new mothers with the condition in remote areas will suffer without treatment.

Many have been waiting for years to be treated. According to the Fistula Foundation, a South Sudanese woman has a one-in-28 chance of dying from pregnancy complications.

The World Health Organization estimates that for every woman who dies in childbirth, 20 women survive bur incur life-changing injuries, such as obstetric fistula. Health NGO, MSF, suggests that 2 million women globally are currently living with this condition.

Obstetric fistula often results in stillbirth. Teenagers are high risk because their bodies are less developed and less able to cope with childbirth. 

At least 60 women have responded to Amref’s appeal

Amref’s Fistula Camp Co-ordinator, Julius Busiri - who supports Amref’s reproductive health programmes across South Sudan - oversees the cargo on MAF’s flight.

Their recent fistula radio appeal – in partnership with the UN’s Population Fund and South Sudan’s Ministry of Health - has been a success. Many women in desperate need of this life-transforming surgery, have responded.

Julius is surrounded by boxes of dignity kits for the women (soap and other hygiene essentials) and of course, the towering pile of essential mattresses. He explains the scope of the project:

‘We’re targeting around 60 women to be repaired, but it could be as many as 80. We’ll start with screening, triaging and prioritising cases. There’s a team at the hospital including a gynaecologist. The consultant doctor from Uganda will support the team for around three weeks. The hospital team will then continue to monitor the cases and discharge them.  

Some women live nearby and only travel one or two kilometres, but others may need to fly with MAF from Mvolo because the road may not be safe. We need to have them booked on flights - this is really important.’

‘Patients have started arriving, but the hospital has no mattresses. Without them we can’t do any surgeries!’

Julius Busiri, Amref’s Fistula Camp Co-ordinator


Transporting mattresses during a pandemic

Pointing to the pile of 44 mattresses, which almost reaches the freight room ceiling, Julius exclaims:

‘My priority is this one - patients have started arriving, but the hospital has no mattresses! Without them we can’t do any surgeries!’

Loading MAF’s Cessna Grand Caravan 5Y-BRE plane safely, is Duku Richard’s job – MAF’s Dispatch Team Leader. The challenges of transporting 44 mattresses are more to do with volume rather than weight. Even with the seats removed, the team can only squash 37 mattresses into every available space on one flight. Duku explains:

The whole cargo weighs less than 300kgs, but the mattresses that didn’t fit will have to be flown on future flights.’

Only 37 out of the 44 mattresses could squeeze into MAF’s Cessna Grand Caravan

Limited space is not the only challenge. Unfortunately, the pandemic has also delayed Amref’s fistula camp by eight months as Julius explains:

‘The opportunity for surgery doesn’t come every year. The last time was 2017 in Maridi and now we’re more than two years down the road in Western Equatoria. We were supposed to do this in April but because of the restrictions, we couldn’t fly the doctor in. This project is a priority - I really want this to happen!’  

‘We want to support as many women as possible’

Julius wants as many women as possible to receive the care that they desperately need:

‘If women keep coming, we’ll extend. We won’t pull out if there are people who still need help. We want to maximise this time and support as many women as possible while the doctor is available. We’ll just never know when the next opportunity will be.’

The number of obstetric fistula cases increases every year. In response, Amref not only runs fistula camps, but also tackles the root causes of associated sexual health issues such as early marriage, teenage pregnancy, high fertility rates and limited maternal healthcare. 

Remaining mattresses delivered

MAF flew the remaining seven mattresses to Yambio on 3 December on their 5Y-ESU plane. Several days later, Julius gave an update on the progress of the women:

‘The surgeries went very well, although some were complicated since some women had both vesicovaginal fistula (abnormal connection between bladder and vagina) and rectovaginal fistula (abnormal connection between rectum and vagina).

All women in this more complicated category have now been operated on and are recovering well. Four women have been successfully discharged and we continue to pray for the rest.’

Julius explains that without MAF, Amref’s work would have been very difficult:

‘The support from MAF was so timely and very instrumental in ensuring the comfort of the patients. Thanks once again.’