A day observing surgeons repair fistula

In December, last year, Barbara Margolies, the executive director of International Organisation for Women and Development (IOWD), suggested that I attend a fistula surgery when her team of volunteers visits the country in February. 

Sunday, March 16, 2014
Blair (C) and Star (R) carried out a fistula surgery that our writer observed. Left is Dr Nicole. Courtesy.

In December, last year, Barbara Margolies, the executive director of International Organisation for Women and Development (IOWD), suggested that I attend a fistula surgery when her team of volunteers visits the country in February. This was said in the spur of the moment by a woman animated about women and child health. But my curious was whetted.  

On the third day of my encounters with fistula patients at Kibagabaga Hospital, I reminded Margolies to seek approval of the hospital director, Dr Osee Sebatunzi.

Hours later, Dr Alphonse Umugire, a clinical director, was asked to show me to the theatre, where he introduced me to Dr Venant. Venant was taken aback by what he had been told. He sat me down and repeatedly asked if I was serious. He said surgeons are animals, and that I would see too much blood and stuff to make me sick to the stomach, with risks of fainting. 

Dr Star Hampton, emerged from Theatre One and confirmed with Dr Sebatunzi. Minutes later, scrubs, masks, sandals and a cap were duly delivered. That’s when I realised that the best cure for constipation is not exercise but the theatre. I rushed to the toilet to ease my palpitating bowl.

After I had changed into the gear, Venant had a stool stationed at the entrance to the theatre. 

"When you start getting dizzy in there, just walk here and rest,” he said.

I walked in when the team was busy with hologic process using a hysteroscopy—a gynecological procedure used to diagnose and treat many intrauterine and endo-cervical problems—machine. Three IOWD surgeons, two anaesthesia nurses, a Rwandan urologist (Dr Albert) and two other local gynaecologists are in the theatre. It is 9.30am.

The hysteroscopy on Dorethe Mukakanani done, Dr Blair Washington drew the iKnife (intelligent knife). For a tool just devised in July 2013, I was surprised to see it in use in Rwanda, or Africa for that matter. Cut-after-cut, and suture-after-suture, the tummy gave way.

To imagine that the human body has such thick layers of muscles, flesh and other tissues between the skin and internal body organs is a story itself. The surgeons would deliberate among themselves and agree on a spot to delicately incise. 

Dr Venant’s ideas that I would feel dizzy proved hot air; instead, I got a lot of camaraderie. The feeling was chalked up by Dr Star’s endless reassuring winks (at me), while the others would urge me to get closer and see. One chewed gums. 

Are surgeons "animals”? No. They are the coolest guys out there; nothing is cooler than a human touching delicate internal body organs and stitching one part after another –to save a life.

By the time the colostomy was done, my knees were tired from two straight hours of standing. Dr Venant’s stool had to be used, so I stepped out. Strangely, these surgeons had been standing for all those hours paying maximum attention to the iKnife and the tissues being cut.

Six hours after I entered the theatre, the stitching was done and anaesthesia machine turned off. Throughout the time, anaesthetic nurses Jessica and Kathryn changed shifts in monitoring the machine.

Outside, packets of food and bottles of drinks awaited. Someone had said I would not be able to eat for days. I enjoyed food!