Dr Yeshineh Demerew from Hamlin Fistula Ethiopia and he has over two decades of experience. Dr Yeshineh has become one of Ethiopia’s most respected obstetrician-gynaecologists and is a FIGO-certified (The International Federation of Gynaecology and Obstetrics) trainer in obstetric fistula surgery.
According to Dr Yeshineh, there is an equally devastating gynaecological condition affecting almost 1 in 4 women in Ethiopia: Advanced Stage Pelvic Organ Prolapse (POP). He explains why this severe condition is different to the prolapse usually sustained by women in countries like the United States.
“In general, pelvic organ prolapse is the downward descent of the contents of the pelvic organ. Internal organs like the uterus, the urinary bladder and the parts of the bowel descend through the genitalia. Most of the time this condition is not life threatening but it can have a devastating impact on a woman's quality of life."
Who is at risk of pelvic organ prolapse?
In developed countries like the United States, pelvic organ prolapse is much more common among older women, with prevalence increasing with age.
In Ethiopia, however, Dr Yeshineh says unassisted childbirth predisposes many women to pelvic organ prolapse. Heavy and prolonged physical exercise like working in the farms can also lead to the condition.
He adds: "Because women in Ethiopia can't easily access medical care, when they are eventually seen they often are already at an advanced stage with accelerated symptoms."
The impact on women's health
The problems associated with Advanced Stage POP are largely centred on urinary incontinence. Some women experience pain and discomfort walking, or they may find it difficult to empty the urinary bladder and the bowel.
For young women, it can also have a devastating impact on their ability to have children, says Dr Yeshineh. "The chances of getting pregnant are very, very, very unusual with a prolapse. If they get pregnant by chance with a prolapse, it is very likely that problems will occur early in pregnancy.”
Treatment options available
Dr Yeshineh and his clinical team across all six Hamlin fistula hospitals provide a range of gynecological treatments to women, including obstetric fistula and advanced stage POP surgery. Their treatment is offered free, thanks to generous donors from around the world.
He says: “Our centres specialize in urinary incontinence, particularly in the treatment of incontinence related to childbirth. Our surgeons are specialists in treating pelvic floor disorders. We have been doing this for many years and we have managed to transform the lives of hundreds of women.”
Click here to read about Fozia who lived with Advanced Stage POP for eight years before receiving life-changing treatment at Hamlin’s Metu Fistula Hospital.
