Helping African Women from Both Sides of the Operating Table

In the United States, conditions such as female incontinence and pelvic organ prolapse are embarrassing and sometimes debilitating. But here, there is treatment. In Africa, women are often shunned or expelled from their family or village because healthcare for these conditions are limited, ruining a young women’s life forever.

Briana Walton, MD, director of Female Pelvic Medicine and Reconstructive Surgery at AAMC, has made it apart of her life’s mission to help those women. Dr. Walton spends two weeks every spring in Rwanda conducting surgeries and training her Rwandan counterparts in treating and managing urogynecological conditions, such as bladder control, bowel symptoms, and pelvic discomfort.

She volunteers with the International Organization for Women in Development, which focuses primarily on treating African women with obstetric fistulas and the issues that arise from trauma and female genital mutilation, both of which are common in that part of the world. A fistula, which causes incontinence, is most often caused by prolonged, obstructed labor and it’s not uncommon in places like Rwanda, where girls marry and become pregnant in early adolescence. In this part of the world fistulas may also develop after cesarean sections, an issue the team is addressing through training for their Rwandan counterparts.

This past April, Dr. Walton and her colleagues saw 134 patients with these complicated issues over the course of three or four days. They conducted 40 surgeries and assisted their Rwandan counterparts in establishing the infrastructure and medical plans to manage many others after they left.

It’s important to Dr. Walton that the organization focuses on development through partnerships as well as relief. “Part of our mission is to make sure that we build a sustainable program that they can take over,” she says. “We’re not just helping the women that show up, but we’re teaching our Rwandan counterparts how to run a program and build the infrastructure.”

Helping young women with fistulas has a special meaning for Dr. Walton. As the result of Crohn’s disease, she developed a fistula at the age of 12 and understands the emotional difficulties these girls face. “I’ve seen it from both sides,” she says. “Being a provider, but also being a patient and knowing what it’s like at a young age to feel really embarrassed, and to feel like you’re being betrayed by your body.”

She feels a special connection to these women and realizes they have a much more difficult experience because they lack access to health care, education and family support. “They can’t read. They can’t work. They essentially get kicked out of their communities. They’re relying on help and, sometimes prostitution, in order to feed their family—if they have a family, because sometimes they’re babies die.”

Dr. Walton says her greatest reward comes in the one on one interaction with her patients. “I’m there to help a patient understand what their condition is and be able to share my own story and let them know that they’re not alone—to not only give them hope in terms of their medical condition, but also give them a glimpse of inspiration. I’m an African American woman who is a physician and that’s not something they see every day.”

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