In Lilongwe, Malawi, a 14-year-old girl is giving birth. She is hardly more than a child herself, and the baby’s head is too large to pass through the birth canal. He really needs to be delivered by Caesarean section, but unfortunately, that simply is not an option because the young mother does not have access to this level of care.
In excruciating pain, she must continue with her labor. For 75% of women in this situation, labor lasts for more than three days. For some, it can go on for a week. Pressure will continue to increase until the soft tissue in the pelvis compresses so much that it creates a hole, called an obstetric fistula, which will leave the mother completely incontinent.
After she gives birth, this new mother will be ostracized by her own family and by every part of society. She will not be allowed to participate in religious and social activities. The lack of voluntary control over her bladder and/or bowels renders her incapable of working.
In the United States—even in the poorest parts of the country—the condition is virtually non-existent. In sub-Saharan Africa, on the other hand, World Health Organization estimates indicate that there are approximately two million young women living with untreated obstetric fistula.
When Jan Duncan heard about women in Africa who were suffering from this heartrending childbirth injury and the subsequent neglect and poverty that results from it, she embraced the opportunity to help them. Her transformational gift established the Jan E. Duncan Global Women’s Health Initiative at Texas Children’s Hospital. With her help, women with obstetric fistula at the Area 25 Maternal Health Center in Lilongwe, Malawi, are receiving care that changes their lives.
“Jan’s support of our work was a godsend—an absolute godsend,” said Dr. Jeff Wilkinson, who holds the Jennifer and Wil VanLoh Chair in Global Obstetrics, Gynecology and Surgery. He has been caring for women and girls with obstetric fistula in Africa for more than 17 years, performing the relatively simple procedure that can correct the injury and restore health.
“Jan’s gift has equipped us to build an obstetric fistula program that addresses all aspects of safe motherhood. Her passion and generosity are restoring hope and providing a future for women and girls in Malawi. The whole community is better for it.”
Dr. Jeff Wilkinson
The Fistula Care Center where Dr. Wilkinson carries out his life work offers women much more than physical healing. At the center, women learn important job skills and receive the tools they need to start their own businesses. Emotional healing also comes to these women as they find new purpose for their lives and again become accepted and valued members of society.