Physicians Across Continents have extensive experience in working in Africa and have country offices like Nigeria, Sudan, Somalia, Uganda, Kenya, Mali, Niger to name but a few. African countries for decades have under invested in its health care system and with effects of climate change the danger of water shortages and famine are ever present. Coupled with regional conflicts, wars and political instability, many Africans do not get the opportunity to develop their own countries.
Many Africans face acute healthcare crisis and without a free National Health Service at the point of use, most cannot afford to pay for treatment. The healthcare provisions in most cases do not meet international standards and this can lead to further complications.
Physicians Across Continents – Somalia
Physicians Across Continents has been established in Somalia since 2011, by providing primary and secondary health care services in Benadir Hospital which is the largest mother and child hospital in Somalia.
Since then we’ve gone on to expand our work across the country, working alongside Governmental, International Organisations and NGOs to improve coverage of health services, strengthen health systems, and provide medical equipment support across Somalia.
Community engagement conducted by our outreach teams are an integral part of serving local communities which has led to increased numbers of patients attending our health facilities. This includes preventative and health promotion activities such as screening, immunisation and sensitisation. Last year a total of 42,631 patients received treatment and consultations as a result of our outreach work.
Internally Displaced Peoples
In the last quarter of 2017, over 4,000 households (over 24,000 individuals) have been evicted from their makeshift settlements. Physicians Across Continents brought the emergency needs of the evictees to the attention of the cluster groups and other stakeholders, ensuring proper sharing information and delivering humanitarian aid on time. PAC provided MISP referral, supplementary drugs and health education and also increased the number of mobile clinic teams to save the lives of these marginalized people.
Immunizations for mothers and children have been actively implemented throughout Daynile District, Physicians Across Continents providing all types of vaccines in its health facilities. The immunisations campaign targeted children of different ages, from 0-2 years old, during the period of January to December 2017. This was our largest and the most successful prevention campaign ever undertaken in Daynile district; which was preceded by many awareness sessions done on EPI among the communities residing in the district.
Sensitisation for People Living with HIV/AIDS
The sensitisation targeted 268 beneficiaries, including PLWHs and their relatives, which will enable more HIV positive patients access services. PAC aims that this service will continue to target more PLWHs in the future, who will benefit from the treatment, counselling and to promote client self-management.
Voluntary Counselling and Testing 1169 individuals (men and women) have been voluntarily tested and received counselling. PAC enhanced coordination with stakeholders involved in HIV programs, including other NGOs working in HIV sector in both Mogadishu & Kismayo. This facilitated improvements in the patient referral mechanism, as well as enabled PAC to initiate advocacy meetings with the Jubaland local authorities to increase the level of community awareness of the program.
5th Obstetric Fistula Campaign – #EndFistula
Our 5th Obstetric Fistula Campaign took place last year, 2017, where we treated 113 patients with the fistula repair surgery. This campaign aimed to expand the provision of continuous, high-quality fistula care in Mogadishu, giving hope and dignity to the many women suffering from obstetric fistula all over Somalia. PAC is proud to continue to be at the forefront of the campaign to #EndFistula.
Of the 113 patients, 8 were under the age of 18 and 33 of the women were divorced as a result of the effects of obstetric fistula and its complications. The patients were from several regions across the country and PAC funded the transportation and accommodation of the women coming from outside Mogadishu for the entire duration of their treatment.
It’s devastating to note that 22% of the patients lived through the ordeal of the condition for more than 6 years without any medical intervention. PAC managed to relieve the suffering of these poor mothers and provided them with the opportunity to start a new life with dignity.
This year we want to reach more as we continue to expand our Obstetric Fistula Campaign and train local staff while treating 1,000 women across 5 countries including Somalia
5th Obstetric Fistula Campaign – #EndFistula
Making A Difference Documentary – An Insight into Physicians Across Continents in Somalia
Follow Ayaan Baudouin as she travels back to her birthplace in Somalia alongside Physicians Across Continents and discovers that for some childbirth can feel like the end of a life rather than the beginning of a new one.
An insight into her own personal journey and the journey of many women suffering from Obstetric Fistula.
“What man wants a sick woman? I am leaking urine and sick all the time. Even sitting down is painful for me. His parents told him to leave me and he didn’t argue, he felt the same”
– Katuma (16)
“No-one helped me. My child passed away and as soon as he (my husband) saw the problem, he divorced me – straight after the birth. I have been in pain and alone now for 2 years.”
– Shukri (27)
Living with fistula was extremely difficult for Fadumo, who had been divorced and abandoned by family and friends.
“I have not been able to take part in any public gatherings or events like weddings in the last 13 years”.
– Fadumo Mohammed (40)
WHO estimates that 50,000 -100,000 women develop obstetric fistula every year; and that there are currently 2 million women living with the condition, mainly in Asia and Sub Saharan Africa
One of the worst countries for maternal health indicators in the world; where fertility rates and infant and maternal mortality rates are high; malnutrition is common, early marriage is widespread, and most deliveries are conducted at home without a skilled midwife. Women in Somalia live in a very insecure context where health care infrastructure and maternal health programs have been disrupted by conflict and limited for decades.
Health facilities tend to deteriorate, basic equipment and medicines are inadequate, and there is a shortage of trained medical personnel throughout the country. All of these factors indicate a high incidence of maternal morbidity such as obstetric fistula. Due to the nature of healthcare services provided, there is virtually no data on the prevalence of fistula, although anecdotal evidence suggests that with its limited health infrastructure, Somalia will have some of the highest prevalence rates of obstetric fistula in the world.
Obstetric fistula is estimated to affect 1% of all women in Kenya, equivalent to 250,000 women, according to the Kenyan National Bureau of Statistics. However only 3,000 women and girls receive obstetric fistula treatment each year.
It is estimated that between 140,000 and 200,000 Ugandan women of childbearing age (14-49 years) have obstetric fistula, with an estimated 1,900 new cases every year according to the Ugandan Ministry of Health’s information for World Fistula Day 2016.
It is estimated that one out of every 50 women has fistula, but only 1,500 fistula patients have been repaired each year, which means that it will take at least 80 years to treat all cases at the current rate.
The Democratic Republic of the Congo
Prolonged conflict over four decades has ensured that the economic indicators place the Democratic Republic of the Congo as one of the poorest developing nations. The combination of the poor economic situation, the failing health infrastructure and the limited road systems have led to high mortality rates in the Democratic Republic of the Congo, especially amongst the most marginalized communities. Estimates of maternal mortality are very high, at 549 deaths per 100,000 live births. More than two-thirds of women are reportedly born in health facilities, with 74 per cent of births assisted by trained professionals.
It is not surprising that 24% of women begin pregnancy during their teens. Finally, growing attention has been given to the trauma of sexual violence in the war-ravaged eastern region of the Democratic Republic of the Congo, where Fistula is caused by rape as well as obstructed birth. It is likely that some of the fistula repair cases may be as a result of sexual violence as well as obstructed birth.