The MaterCare organisations were set up to give African mothers who have been shunned by their families over childbirth injuries a chance of a normal life, writes Anne Dempsey
'In Ireland, three mothers die per 100,000 births, whereas in sub-Saharan Africa, 800 mothers die for every 100,000 births, and often the baby dies too," says Eamon O'Dwyer, professor of obstetrics at NUI Galway.
A sprightly 81-year-old, who looks 10 years younger, O'Dwyer is having a busy retirement. Having first returned to college to study law, he now chairs MaterCare International and MaterCare Ireland, set up to change the lives of women behind such sad statistics.
"My law degree has come in very handy - I now act as legal adviser to the project too," he says.
It means that a birth trauma centre in Cape Province, Ghana, is nearing completion, dedicated to giving a second chance to mothers rejected by their families due to injuries suffered during childbirth.
"A long and difficult birth can lead to obstetric fistula, where a breakdown of tissues between vagina and bladder or vagina and rectum occurs. Eradicated in the western world at the end of the 19th century when caesarean section became widely available, the condition leads to single or double incontinence or both.
"As a result, these poor women smell, they are ostracised by the community and often abandoned by their husbands. They end up homeless, begging on the streets, and usually lose any children they have. They are treated like lepers," says O'Dwyer.
The centre will offer fistula repair to 200 women in its first year of operation, building up to 500 women annually (at a cost of $250 per patient care), with the goal of becoming a centre of excellence for training and research as well as prevention and curative care.
The idea began 10 years ago at a meeting in Rome when the late Pope John Paul 11 urged doctors and nurses to become more involved in Third World maternal health.
"He told us to stop talking and pontificating and start doing something," says O'Dwyer.
With four colleagues from Canada, Ghana, Switzerland and UK, he set up MaterCare International, which is dedicated to the care of mothers and babies through initiatives in the developing world. The organisation has raised the necessary funds for the building of its trauma centre.
In considering where to begin, the organisation set its sights on Ghana, a country of 18 million people, with some decades of stable government but a poorly developed health service.
"Nine out of 10 mothers give birth at home with the assistance of untrained traditional birth attendants [ TBAs] who don't know what to do if things go wrong.
"Many mothers are very young, aged 13-14, their bodies are still developing, they have a small pelvis. Labour can become obstructed in the case of a big baby if the head gets stuck in the pelvic area and cannot be delivered.
"Without the option of caesarean section, baby continues to push, breaking and tearing tissue and creating a hole, a fistula [ the word means false passage]. The baby is often stillborn, the mother also may die.
"If they survive, they have no control over passing urine or faeces and go to the end of the treatment queue because the condition is not seen as life-threatening."
MaterCare International established good links with the Ghana Ministry of Health and Conference of Bishops, and began its work by providing training for TBAs and midwives in a district mission hospital in rural Ghana.
A radio-controlled obstetric flying squad ambulance was bought and an Aids-free blood bank established.
"The aim is to train TBAs to recognise and refer high-risk mothers, to provide a safe and efficient way to transport women with obstetric emergencies to the district hospital and to provide a maternity blood bank. The results have already been encouraging," says O'Dwyer.
On a five-acre site donated by the diocese, MaterCare has built a 40-bed clinic, with operating theatre, outpatient department and doctor/nurse residencies.
"Many obstetric fistulas are relatively easy to repair, though some are more complex and may involve colostomy and use of plastic surgery, grafting skin from another part of the body. We're now fundraising to fund operational costs of €200,000 per year.
"Obstetric fistula is one of the most humiliating conditions a woman can have, and they also suffer profound psychological trauma resulting from utter loss of status and dignity. Rehabilitation is an important part of recovery.
"One simple yet effective thing we do is to provide her with a whole new outfit. Africans love clothes, they really enjoy vibrant colours and to have the patient looking really well again will help.
"We will also be embarking on a training programme for local communities to facilitate the receiving and acceptance of these women back amongst them."
website: www.matercare.org/lifesaver.html