Working to eradicate fistula in Pakistan

Earlier this month, we had the great privilege of visiting IMR partners in Karachi, Pakistan. Our team included our Executive Director and UroGynecologist Dr. Sleemi, her long time mentor Dr. Ralph Chesson, Nurse Midwife and IMR Managing Director Mayano Ochi, and Jacqueline Kirk, who was there to document the stories of the hard work that our partners in Pakistan have put in. IMR has been working in Pakistan since 2022 in our effort to end fistula.

On the outskirts of Karachi is Koohi Goth Women’s Hospital where we spent the majority of our time. Koohi Goth is an incredible facility dedicated to the eradication of fistula where they perform free surgical repairs for women suffering from fistula. Women come from all over the country in pursuit of a treatment that will end their daily suffering due to the urinary and fecal incontinence that fistulas cause. Throughout the week, Dr. Sleemi and Dr. Chesson performed surgery on the patients at the Fistula Center alongside our Pakistani colleagues. Many of the Pakistani surgeons expressed gratitude to have received high quality mentoring and instruction from these two experts.

One of the strong beliefs that Koohi Goth holds is that skilled midwives are the key to fistula prevention. Koohi Goth hosts a 2-year diploma program for midwife students that come from some of the most rural and impoverished areas of the country. They receive their education, along with room, board, and text books all for free. They are even given a small monthly stipend. All of this is in an effort to increase the midwifery workforce who will then return to their villages where they will help save women’s lives and prevent fistulas by identifying abnormal labor and determining when a C-section is necessary. We were honored to have had the chance to instruct these eager students who clearly had so much passion for their studies, both in the classroom and in the clinical setting, .

It was humbling to witness and learn about the challenges that the midwives, doctors, and the patients face in Pakistan. IMR is committed to helping alleviate some of the burden and look forward to returning again next year.

IMR Launches Our Urogynecology and Pelvic Floor Surgery Course in Pakistan

A return visit to Karachi earlier this year coincided with the launch of our urogynecology and pelvic floor surgery curriculum for residents and trainees as well as local physicians.

This introductory course occurred over a week and was very well attended.  In partnership with the faculty of Koohi Goth Women’s Hospital, this is one of several courses we’ll offer, bringing global and local expertise in the field to teach and provide hands-on training. We were honored to have Dr. Sherhah Syed, head of Koohi Goth and renowned women’s health advocate introduce and support our course.

In addition to the course, we were invited to tour one of the oldest maternity hospitals in the province of Sindh, the Sobhrag Maternity Hospital. The hospital was established in the 1920’s to serve the region’s impoverished families, a mission it carries on to this day.

We’re looking forward to a return visit later this year to continue our teaching curriculum for the next generation of vaginal and fistula surgeons.

Fistula Surgeries in Pakistan

March is Women’s History month and it also holds International Women’s Day on the 8th. It’s a chance to celebrate women’s health achievements and focus on ways we can work to increase equity and justice for women across the globe.

IMR started the month with a fistula surgery campaign in the Sindh region in Pakistan. A fistula is a preventable birth injury caused by obstructed labor or as we are seeing increasingly, from difficult cesarean sections in unskilled hands. Koohi Goth hospital is the country’s largest center dedicated to the training and care of women with obstetric as well as other fistulas. The center’s main fistula surgeon is Dr. Shershah Syed, an internationally known fistula surgeon and renowned advocate for women. He is joined by other skilled surgeons trained in repairs and a very capable team of scrub techs, nurses, anesthetists, and staff. The hospital is home to a 2-year midwifery training program that houses, feeds, and trains students from across the country. It’s truly a remarkable place full of dedicated professionals and supported by generous donations. Oh, and did I mention it is completely free. All surgeries, meds, deliveries, midwifery training, room and board, 100% free. All of it. While there, I worked with surgeons who came from across the country to further their vaginal and fistula surgery skills. 

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I was also invited to meet with staff and trainees at other hospitals across Karachi and performed prolapse surgery cases at the Jinnah Public Hospital. Later in the week, I traveled to the interior of Sind province to operate with the welcoming physicians at Sheik Zayed Women’s Hospital in Larkana, a historic city. The Sind province was devastated by historic flooding last year, and more than 6 months later, water still has not fully receded. Several fistula patients there needed surgery and it was an important opportunity to teach residents and students. 

Along the way, I was asked to share my thoughts with local TV and a national radio program. I used this opportunity to speak about health equity, human rights, and the vital role women, like our friend Dr. Shershah, play to advance these rights, especially for the poor and marginalized. I am thankful that IMR is able to partner with Koohi Goth hospital and other institutions that care for women with fistulas. In addition, I feel honored to help train the next generation of surgeons so that the end of fistulas may soon be in sight.

This Women’s History Month, a tax-deductible donation to IMR could go a very long way in our work to bring the best care to places that need it the most. Donate here.

Ambereen Sleemi

Executive Director, IMR