The V.V.F. (Vesicovaginal fistula) Specialist Surgeon (Dr. Thomas Raassen) reveals his experiences

St Francis’ runs a VVF program: a ‘miracle cure’ for women with a VesicoVaginal Fistula. Training of surgeons and support has been provided by specialist surgeon Dr Thomas Raassen (Netherlands).

Restoring the social status and pride of unfortunate women in the eastern province of Zambia.

Recently, Saint Francis Mission Hospital hosted Dr. Thomas Raassen, who has worked in Kenya for 35 years. After studying medicine at Amsterdam University, he came to Kenya in 1969 and worked as a General Practitioner (GP).

He returned to Netherlands to complete postgraduate surgical studies and came back to Kenya as a consultant surgeon. Why surgery? “Opening the body and fixing what is wrong! Seeing what you are doing! The result shows after some days”.

Since 2010, Dr. Raassen spends a fortnight every year at Saint Francis Hospital performing vesicovaginal fistula (VVF) repairs. So, what is a VVF? It is an abnormal tract extending between the bladder and vagina that allows the continuous involuntary discharge of urine/stool into the vaginal vault. As a result, women experience limited social interaction, as they lose their core function as mother and caregiver.

Dr Raassen states that statistics confirm that, “VVFs result from prolonged obstructed labour, not relieved in time by caesarean section, vacuum extraction, or symphysiotomy. The prevalence of obstructed labour worldwide is 2- 5 %. The median age in Eastern Africa when VVF occurs is 22 years, with a median pregnancy of 3. 9 % of the stillborn (2/3 of these are boys), and the mother’s height is usually below 155 cm”.

About > 13 % of VVFs are iatrogenic, caused by operating staff that are untrained as well as by lack of good infrastructure. He insists that “VVF closure should be accomplished in over 90 %of cases when the procedure is performed by expert hands. Between 80 – 85 % of these should achieve continence; incontinence is the biggest post-surgical issue”.

Dr Raassen states that specialists who want to perform VVF operations should receive training of 4 – 6 weeks. During his short visit to Saint Francis, Dr Raassen and his team of surgeons performed 25 VVF repairs. He remarks, “I go there for the women, to help them reclaim their social roles and status”. His return is highly anticipated.