Maternal Health

Maternal Health

The Passing of Dr. Leonard A. Wall, MD, 92

The Worldwide Fistula Fund is sad to note the passing of Dr. Leonard Wall. Dr. Wall was the father of the WFF’s founder Dr. Lewis Wall and WFF’s current treasurer Dr. Terry Wall. In his memory, WFF has established the Dr. Leonard Wall Memorial Fund. Dr. Leonard Wall was a long time advocate for women around the world and a tireless supporter of the Worldwide Fistula Fund.

Dr. Leonard A. Wall, MD, 92, of Leawood, KS, passed away on December 24, 2013. Dr. Wall was born on March 20, 1921 in Domby, Oklahoma. His early education came in a one-room country schoolhouse. After graduating from high school, he enrolled at the University of Oklahoma to study biology with the hope of eventually fulfilling his life-long dream of becoming a doctor.

His education was interrupted by military service in the US Army Air Corps during World War II. He married his childhood sweetheart, Evelyn Balzer, just before he was shipped overseas to fight the Nazis. Stationed in England, he was a co-pilot flying B-17 bombers when his plane was shot down over Germany in early 1945. He was the last man to make it out of the dying aircraft before it exploded. Listed as “missing in action,” he was presumed dead. In reality, he had become a German prisoner-of-war. After his POW camp was liberated by Gen. George Patton’s Third Army, he was reunited with his young wife and resumed his education.

Dr. Wall graduated from the University of Oklahoma School of Medicine in 1951 and subsequently undertook residency training in obstetrics and gynecology at the University of Kansas. He was a pioneer in laparoscopic surgery, fetal monitoring and urogynecology. After completing his residency training, he became the only obstetrician-gynecologist in central Kansas, practicing in the university town of Manhattan. Two years later, he moved to Kansas City where he was in active practice for 35 years. He became known as “the obstetrician’s obstetrician.” He pioneered the use of fetal monitoring, obstetrical ultrasonography and the development of regional referral centers for high risk pregnancies. He served on the Missouri Maternal Mortality Committee and was the President of the St. Luke’s Hospital staff. Quiet, humble and unassuming, he was noted for his dedication to medicine, his compassionate care of patients and his service to his community. Years after his retirement, St. Luke’s Hospital recognized his contributions by naming the hospital urogynecology laboratory in his honor.

Dr. Wall was also the founding member of the board of directors of the Worldwide Fistula Fund (WFF). He made trips to Nigeria, Ghana and Ethiopia to further work among women with obstetric fistulas. He took great pride in the opening of WFF’s Danja Fistula Center in southern Niger in 2012. In recognition of his contributions, the outpatient clinic at that institution was also named in his honor.

A lifelong learner, Dr. Leonard Wall took special pride in medical education and was beloved by his residents who did their clinical training under his guidance, regarding him as the model physician. His two sons, Leonard Lewis Wall and Terry John Wall, both entered medicine.

Dr. Leonard Wall was preceded in death by his loving wife of 65 years, Evelyn. Survivors include his two sons, Dr. Terry Wall and Dr. Leonard Lewis Wall, his daughter-in-law, Helen, and his two grandsons, Jimmy Wall and Thom Wall.

Memorial contributions may be sent to the Dr. Leonard Wall Memorial Fund at Worldwide Fistula Fund, 1100 E. Woodfield Road, Suite 350, Schaumburg, IL 60173 or online at Fond memories and condolences for the family may be left in the comment section below.

Two October Days That Resonate for Worldwide Fistula Fund

The international community is increasingly using a designated ‘day’ to highlight issues that need greater global attention. Two of these days had particular resonance for us here at the Worldwide Fistula Fund─International Day of the Girl – October 11th, and The World Food Day – October 16th.

International Day of the Girl reminds us that in many parts of the world, girls do not have the opportunity to go to school, determine when or who they will marry, when to have children, or even whether they can seek medical help during labor.  Giving girls the opportunity to grow up before they are married, to be children before having children, and to learn in schools surrounded by their peers benefits everyone.

One of the tragedies of Obstetric Fistula is that it is an injury suffered by girls. Girls who are married young, sometimes as young as eight, can be pregnant by age 12 or 13, before their bodies have grown enough to give birth. A girl of 13, suffering through a painful, prolonged labor without skilled medical attention can develop fistula, a condition that will impact the rest of her life.

We hope that someday soon, International Day of the Girl will no longer be necessary, and girls will be able to grow up and take ownership of their bodies and lives, without needing a day dedicated to giving them this basic human right.

World Food Day is a day devoted to the knowledge that many people around the world suffer from a lack of access to food. It is estimated that about 840 million people suffer from chronic hunger—not having enough food to be able to live an active and healthy life. To put this into perspective, there are approximately 317 million people living in the US, the third most populated country in the world, and yet, that total population would have to more than double in size in order to reach the number of people that are suffering from chronic hunger worldwide.

In areas with food insecurity or scarcity, it is often women and girls who have less access to healthy foods. When hunger is sustained, it can lead to malnutrition, which leads to women and young girls having more difficulties with pregnancy and childbirth.

At the Danja Fistula Center in Niger, patients are given free, nutritious food. Patients who are too weak or malnourished to undergo surgery upon arrival, remain at the Center until their bodies are strong enough to endure the repair surgery, as well as the recovery process. It is important in the recovery of these women, not to have to worry about where their next meal will come from and instead, spend their time focusing on healing.

Obstetric Fistula is a very specific type of injury, yet, providing holistic, multi-tiered care for women with fistula is one of our core values. We understand that there are many problems faced by women and young girls that are universal, and fistula is just a part of these. We are happy to recognize and celebrate every day that promotes the wellness and well-being of women everywhere!

We need your help. Please help Worldwide Fistula Fund remain on the Top-Rated list of by writing us a positive review of what WFF means to you. Please click on the below link and write your review today. We only need 10 more to achieve this award!


The Legend of Dr. John Kelly

Dr. John Kelly

Photo Courtesy of Fistula Care/EngenderHealth

It is with great sadness that Worldwide Fistula Fund has learned of the death of Dr. John Kelly, who had been, for so many years, a storied champion in the battle against obstetric fistula in the developing world. His commitment began in 1967 when he traveled to a hospital in rural Nigeria, where he preformed his first fistula surgery. Since that first surgery, Dr. Kelly provided care to over 9,000 women. After retiring from his practice in England, Dr. Kelly devoted nine months of the year to fistula surgery and traveled to some of the poorest countries to provide fistula care, including Sudan, Pakistan, Angola, Ethiopia, Ghana, Kenya and many more. For the women he helped, he offered the opportunity to rebuild their lives free of the difficulties and stigma that having a fistula can bring. His surgical work ethic and stamina were utterly remarkable.

Dr. Kelly believed that it was as important to teach communities how to prevent fistula as it was to teach surgeons how to repair them. He trained many surgeons and medical professionals throughout the world, and was dogged in his determination that it was as necessary to work to create policies to prevent fistula in the first place. He once said, “Some people may say you’ll never prevent [fistula]. But we must prevent it! It’s the only complete cure we have.”

His life was spent helping others in need. He will be remembered for his warm smile and his amazing commitment to those who needed him the most.

Nicholas Kristof Visits Danja Fistula Center

Thanks to all the work and incredible generosity from all our supporters, Worldwide Fistula Fund was able to realize a dream last year in the opening of the Danja Fistula Center in Niger. Several years ago Nicholas D. Kristof first wrote about Worldwide Fistula Fund and recently returned to the center to write a new op-ed for his column in the New York Times.

The fistula center was the dream of Drs. Steve Arrowsmith and Lewis Wall, and in keeping with the original vision of having the center be run by Africans, Dr. Itengre Ouedraogo, a surgeon from Burkina Faso, has been trained to be its medical director. Danja Fistula Center handles some of the toughest cases of obstetric fistulas in the region and offers so much more to its patients than just surgery, with the reintegration program teaching women skills that will ultimately help them become better prepared and educated to what they can achieve in life.

Operating Room

Nicholas Kristof highlights the story of Hadiza Soulaye who doesn’t know her age and was married off to her uncle before she started menstruating. A year after marriage, she was pregnant and developed an obstetric fistula during three days of labor. Not only did she lose her baby but when she returned home she was ostracized from her community and kicked out of her home by her husband. Recently, Hadiza learned of the Danja Fistula Center and received the surgical treatment that would allow her back into her life and community without the humiliation she had previously endured. However, on her return home, her husband summoned her to bed, and even though Dr. Arrowsmith had warned her not to have sex for six months after surgery, Hadiza was left with no choice and had the fistula torn open. As a result she was again thrown from her home by her husband and returned to the fistula center with hope that this injury can be mended again. Hadiza vows not to return to her husband this time. This kind of story exemplifies the need for education, which Worldwide Fistula Fund sets high among its goals to not only offer surgery but to help prevent surgery from ever being needed.

Without the generosity of our donors none of the work Worldwide Fistula Fund do would be possible, and we would like to thank everyone for their continued support.

Click here to read Nicholas Kristof’s full op-ed!

Busy Days at the Danja Fistula Center

The Danja Fistula Center in Niger officially opens on February 11 . . . and we are so excited! Our staff is already on site in west Africa making sure that everything is ready to hit the ground running for the first surgeries. The doctors and nurses are trained, the medicines have been stocked, the equipment have been set up, and the wards and treatment areas are sparkling clean to accomodate our eager guests.

Because the need for obstetric fistula treatment and care is so great, the first clinic and admittance day is actually on February 6 — five full days before the opening celebration. The Minister of Health will tour the facility and cut a ceremonial ribbon to mark the event. Surgery will begin on Tuesday and the grand opening will follow on Saturday.

Our executive director, Mark Shaker, wrote that there are already 42 women at the facility awaiting treatment. One woman in particular has been living with a fistula for 15 years and told the staff that she just cannot take it anymore. Although she knew the Danja Fistula Center wasn’t opening until February, she left her home at the end of December. It took her 30 days to travel the roughly 600 mile-distance to the hospital grounds. She ran out of money on day five and begged for food and rides until she got there. Mark wrote, “She could not stop hugging and thanking us.”

It is women like this — and supporters like you — who inspire us every day. Please continue to watch this space for further updates and donate today to help fund the Danja Fistula Center and bring an end to this horrific condition.

New Report Finds Maternal Health Care Desperately Lacking in Niger

Findings from the United Nations’ recently released report The State of World’s Midwifery 2011: Delivering Health, Saving Lives are as sobering as might be expected: to fully meet the needs of women around the world, we need 350,000 more skilled midwives (112,000 in the neediest 38 countries surveyed). The report’s analysis of the maternal health situation in Niger, home to the Worldwide Fistula Fund’s new fistula hospital, is equally upsetting:

  • Average life expectancy is 51 years and 63% of the population live below the poverty line.
  • The country has a high fertility rate (7.8 births and 7.1 children per woman), high child mortality rates (198 per 1,000), high infant malnutrition and an insufficient number of skilled workers.
  • Nearly 83% of deliveries occur outside health facilities. While large urban-rural discrepancies exist, 81% of these women receive no postpartum care. Only 18% give birth with a skilled birth attendant present (0.5% with a physician), and 53% receive no antenatal care.
  • Access to health care is highly correlated to women’s wealth.
  • There is one midwife per 1,000 life births.

There is good news, however. While still incredibly high, maternal mortality rates have lessened rather dramatically in the last 20 years:

Trends in Maternal Mortality

Further, a recognized definition of a professional midwife exists, a government body regulates midwifery practice and a licence is required to practice midwifery — all of which helps spread the practice and profession of midwifery and help ensure women receive qualified, professional care.

How to Help

While the report shows that some progress has been made in Niger (and other sub-Saharan African countries), there is still an enormous amount of work to be done to provide all women with maternal health services before, during and after giving birth. In coordination with the opening of our new fistula hospital, the Worldwide Fistula Fund is developing a full-scale fistula prevention campaign to educate women in rural villages about the warning signs of obstructed labor and how to seek help. Among other outreach initiatives, our prevention campaign will also fund bush taxi service to deliver expectant mothers to hospitals as well as pay for the medical treatment the women receive at the hospitals.

Please help prevent the formation of fistula and lessen the rates of infant and maternal death by giving what you can to the Worldwide Fistula Fund. If you’d like to donate specifically to our prevention campaign, please visit our new giving catalog and choose “Fistula Prevention Outreach” from the options given.