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Rebecca Coombes
Supporting surgery for obstetric fistula
BMJ 2004; 329: 1125 [Full text]
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[Read Rapid Response] Addis Ababa Fistula Hospital
Joanna N. Raeburn   (15 November 2004)
[Read Rapid Response] Fistula Hospital Page 1125 BMJ 13 November
Clive Hewitt   (18 November 2004)
[Read Rapid Response] Gynaecological camps in Sindh Pakistan
Abdul H Jokhio   (4 December 2004)

Addis Ababa Fistula Hospital 15 November 2004
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Joanna N. Raeburn,
Associate Specialist, Diabetes
King's College Hospital, London, SE5 9RS

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Re: Addis Ababa Fistula Hospital

I would like to echo the comments of the author about the above hospital and add my personal perspective.

Two years ago, I visited the Fistula Hospital and found it the most inspirational place. I am not personally a religious person, but the atmosphere there of love and peace testified to the faith of the Hamlins who set up the hospital 30 years ago and moved me greatly. Everywhere was pervaded by a quiet sense of purpose, commitment and, yes, love; from the staff at all levels as well as the patients. It was one of the cleanest hospitals I have ever been in and the standards there would put many UK hospitals to shame. The care provided looks after the physical, psychological and social needs of the women to an extent that we could all learn from.

I would urge any of BMJ's readers who are inspired to contribute financially to support the work of the Fistula Hospital to do so - they can do so at the following address: www.charitynet.org/~HCCF

I have some wonderful photos taken at the hospital - one that stands out is of a beautiful young mother who, having suffered a fistula with her previous pregnancy, now repaired, has returned to the hospital to give birth safely to her second baby. I would love to attach it to this letter but there does not seem to be any way to do so!

Competing interests: None declared

Fistula Hospital Page 1125 BMJ 13 November 18 November 2004
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Clive Hewitt,
Hon Treasurer
Hamlin Churchill Childbirth Injuries Fund B69 4PA

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Re: Fistula Hospital Page 1125 BMJ 13 November

Dear Rebecca

You might remember contacting me at Hamlin Churchill Childbirth Injuries Fund for access to Dr Catherine Hamlin, and I gave you her email address.

Our Chairman, John Kelly FRCS who has read your article called me last night concerning the figure quoted to cover the cost of a fistula patient's cure at the Fistula Hospital.

I don't know where your information came from, but the cost is about GBP 500 per annum.

During the last 10 years I have been helping the hospital develop financial management techniques - and this after nearly 40 years as a partner in a leading firm of Chartered Accountants in Birmingham in the UK. I have visited the Fistula Hospital almost 30 times in the last 10 years.

Yours sincerely

Clive WT Hewitt FCA
Honorary Treasurer
Hamlin Churchill Childbirth Injuries Fund Exclusively supporting the Addis Ababa Fistula Hospital

Competing interests: None declared

Gynaecological camps in Sindh Pakistan 4 December 2004
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Abdul H Jokhio,
Coordinator Medical Research
Medical Research Centre, Liaquat University of Medical & Health Science Jamshoro, Sindh Pakistan

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Re: Gynaecological camps in Sindh Pakistan

Gynaecological camps in Sindh Pakistan.

It is quite good to know about “End Fistula” campaign in 30 countries including Pakistan for equipping the hospitals to help poor women with fistulae. However Dr Shereen Bhutta, chief of obstetricts at the Jinnah postgraduate Medical Centre is not the only person mentioned of doing fistula work in Pakistan even we have not heard how this centre is dealing with the problem when this problem mostly occur in rural areas with poor obstetric health services.

It was first time in the year 1999 that Sindh Doctors Association Uk with the help of Dr A H Jokhio and Dr John Kelly a well known foreign surgeon from UK sponsored a gynaecological camp for fistula surgery in Larkana district Sindh province Pakistan a very remote rural area in which around 30 cases were operated during ten days. After that we are conducting similar types of camps in rural areas for fistula surgery regularly every year after fund raising.

Since 1999 so far we have conducted five camps with the help of known local Gynaecologists Dr Rafia in Larkana, Dr Pushpa and Dr Amna in Hyderabad and Dr Razia Khairo in Nawabshah in which we have seen 30 years old fistula cases living with miserable life and we repaired them with 92% success rate. Next camp is due on 7th January 2005 at Hyderabad.

We go in very remote areas well in advance and conduct pre- clinics for recruiting the fistula cases. These camps are absolutely free to the patients including investigations, total hospital stay, treatment and return home travel fare.

Dr John Kelly visits regularly and we also invite other surgeons like Dr Sher Shah to come and join our hands with training to local gynaecologists. The trained surgeons have now started repairing fistulae in the remote areas and the burden has decreased.

Moreover, a fistula opation costs over £500.

Dr A H Jokhio

Competing interests: None declared