VOA标准英语2010年-Freetown Hospital Works to Repair Chil

Freetown, Sierra Leone   02 November 2009

Each year, half a million pregnant women in the developing world die of complications during labor 1, and about six million children are stillborn or die within a week of birth. For the next three weeks, we’ll be looking at some of the factors that affect the chances of an African woman having a safe pregnancy 2 and a healthy child.

This week, VOA’s Chinedu Offor, who recently visited Sierra Leone, tells about some of the problems facing women during birth, including obstetric obstructions 3 and the lack of trained attendants and clinics that can handle complicated deliveries.

Death during pregnancy and childbirth is common in Sierra Leone, which has the highest maternal 4 mortality rate in the world: 2,100 deaths out of 100,000 live births. Most of the deaths occur from complications like uncontrolled bleeding in the mother, or an obstructed 5 birth that may kill the child.

When such births don't kill, they do cause extensive damage, including fistula, a tear made by the baby in the wall of the birth canal, rectum or bladder through which urine and feces may leak. Fistula and other results of obstructed labor are common in young girls who marry early, before their pelvis is full formed.

Women with fistula are often very young, rural and illiterate 6. It's not unusuasl for them to be rejected by their husbands, separated from their children and ostracized 7 by their communities. It is estimated that every year in Sierra Leone there are 5,000 new cases of Vesico-Vaginal Fistula (VVF).

Funding and resources 

Dr. Ibrahim Thorlie is in charge of the fistula repair program at the Princess Christian 8 Maternity 9 and Child Health (PCMH) clinic in East End, Freetown. He says the facility is overwhelmed with patients seeking help but the facility is not able to help everyone because of funding problems.

“We have a ward 10 where we used to have them operated on and kept for some time until [they were well enough to go home]," says Thorlie.

"We closed it because [we lost donor 11 funding], and now we don’t have the money we need to maintain the program.”

These patients deserve special attention, he says, despite limited resources.

“[These are] women we really need to be taken care of because they are normally neglected even though it is not their fault. We’ve tried a lot, we’ve treated a lot, we’ve operated on over 800 cases here,” he says.

“But we still have others. The ones we have in greater number are those whose conditions have become so difficult that their bladder cannot be repaired.”

Improved training

A citizen of Freetown, Seku Sesay, says the incidents of fistula can also be traced to traditional birth attendants [TBAs] who lack the skills to recognize when pregnant women need prompt medical attention.

In his view, “We need to train more nurses [in Western medicine], build infrastructure 12 for hospitals [and] clinics, bring in more instruments and medicines and then invite educated non-governmental organizations or any outside educated doctors or nurses.”

USAID is providing financial support to an international NGO called Mercy Ships (http://www.mercyships.org/the-experience/our-field-services/sierra-leone) which provides a fleet of hospital ships that help train surgeons and provides surgery for fistula. Four years ago, the group opened the Aberdeen West Africa Fistula Center in Freetown. The hospital can hold up to 44 recovering patients as well as two dozen others preparing for surgery.

Talks are underway to see if the center can be incorporated into the national health system or whether another organization can take over operations.