Celebrating 10,000 Fistula Repair Surgeries

The FIGO Fistula Surgery Training Initiative, a state-of-the-art training system for fistula surgeons and holistic care teams, is celebrating a major milestone in the fight against obstetric fistula: 10,000 fistula repair surgeries.

Obstetric fistula is a neglected public health and human rights issue, but due to a global shortage of trained, skilled fistula surgeons, there is a huge unmet need to treat and repair the backlog cases.

FIGO is committed to closing the global treatment gap.

Gillian Slinger, Senior Project Manager, honoured all who have worked tirelessly to help the FIGO Fistula Surgery Initiative reach this moment.

“10,000 fistula repair surgeries is a huge achievement. Partnerships are central to the success of our game-changing initiative to train many more competent fistula surgeons, and through this collaborative approach, we are reaching substantially more women in need. 10,000 congratulations to our phenomenal FIGO Fellows and Trainers!”

For a woman suffering with obstetric fistula, surgery is a chance to reclaim her life from the incontinence, isolation and immense suffering this devastating childbirth injury causes.

Currently only one in 50 is estimated to have access to fistula treatment, even though the condition affects two million women in 60 low-resource countries.

Longer-term solutions require ongoing prevention efforts through well-functioning maternal health systems, including emergency obstetric care. In parallel, it is absolutely essential that more surgeons are trained in the surgical repair and management of women with obstetric fistula, and more health facilities are able to provide holistic fistula treatment services, including rehabilitation and social assistance.

For FIGO, this is a long-term commitment – one that takes time, partnership and vision.

Explained Dr Andrew Browning, expert fistula surgeon, FIGO Trainer and Chair of the FIGO Committee for Fistula and Genital Trauma, and head of the FIGO Fistula Surgery Training Initiative Expert Advisory Group (EAG),

“Fistula surgery is challenging. The learning curve is very long, and it takes sustained investment into a surgeon to be able to handle any fistula case. That’s what the FIGO Fistula Surgery Training Initiative is doing: investing in our Fellows – as well as their holistic care teams – developing their skills to become good and qualified fistula surgeons.”

As of this year, there are more than 60 surgeons – FIGO Fellows – enrolled on the programme. Coming from some of the world’s most disadvantaged communities, they are committed to improving the quality of life for women suffering from obstetric fistula.

Dr Peter Majinge, FIGO Trainer and head fistula surgeon at CCBRT Hospital in Tanzania, shared his joy:

“Reaching 10,000 repairs with the FIGO Fistula Surgery Training Initiative is personally a great success for me, as both a FIGO Trainer and a CCBRT staff member. But most of all, this programme is helping significantly more women affected by fistula, and this should be widely celebrated.”

Click here to learn more about the FIGO Fistula Surgery Training Initiative, our activities and partners, and the women they are giving a second chance at life.  

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Somalia commits to reducing maternal deaths and zero tolerance for GBV/FGM

The Federal Government of Somalia (FGS) on 16 October 2019 committed to reducing the overall maternal mortality rate across the country by no less than 25 percent by 2030 through the training and employment of 1,000 additional midwives. The Government also reaffirmed the need to accelerate progress towards achieving universal access to quality sexual and reproductive health services for all.

Ultimately, the Government will strive for zero preventable maternal deaths in Somalia. To achieve this ultimate goal, the Government commits to integrating comprehensive interventions on the reduction of maternal mortality into the national strategies, policies and programs, stated the Minister of Planning, Investment and Economic Development of the Federal Republic of Somalia His Excellency Gamal Mohamed Hassan.

The Minister was speaking in Mogadishu at the High-Level National Event where he signed Somalia’s Statement of Commitment for ICPD25.  This year marks the 25th anniversary of the groundbreaking International Conference on Population and Development (ICPD), which took place in Cairo in 1994. At that conference, 179 governments adopted a Programme of Action, recognizing that reproductive health, women's empowerment and gender equality are the pathway to sustainable development.

November, the governments of Kenya and Denmark and UNFPA are co-convening the Nairobi Summit on ICPD25, a high-level conference to mobilize the political will and financial commitments the world urgently needs to finally and fully implement the ICPD Programme of Action. These commitments will be centred around achieving zero unmet need for family planning information and services, zero preventable maternal deaths, and zero sexual and gender-based violence (GBV) and harmful practices against women and girls.

The FGS, in line with the Somali Women’s Charter, has also committed to zero tolerance for GBV and FGM by addressing vulnerability factors and through strengthening its policy and legal frameworks such as the Sexual Offences Bill (SOB) and FGM elimination policies, equipping officers with necessary resources enabling them to adequately respond to GBV cases by 2030. “In this regard, the Government commits to tackle core vulnerability issues in vulnerable communities, especially those in Internally Displaced Person (IDP) settings to prevent GBV cases from further exacerbating their plight,” stated H.E. Hassan.

Somalia Government recognizes the impact of population dynamics, reproductive health and gender on poverty, and considers women’s empowerment not only as a means of eradicating poverty, but also as a prerequisite for achieving the aspirations of the National Development Plan (NDP9) and the Global Sustainable Development Goals.

Our Government supports the demands made by Somali women and girls in the Somali Women’s Charter. In line with the Charter, we acknowledge and commit ourselves as a Government to pay special attention to the education of young boys and girls and achieving gender parity at all levels of education, said the Minister.

ICPD25 event in Mogadishu brought together hundreds of people including government officials, ambassadors from Denmark, Sweden and Italy, donor countries, UN agencies, civil society and youth groups including girls’ sports groups.

The ICPD25 Summit in Nairobi aims to bring everyone together: heads of state, ministers, parliamentarians, thought-leaders, technical experts, civil society organizations, grassroots organizations, young people, business and community leaders, faith-based organizations, indigenous peoples, international financial institutions, people with disabilities, academics and many others interested in the pursuit of sexual and reproductive health and rights

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Somali Bristolians come together to challenge mental health stigma in their community

Members of the Somali community in Bristol have started a campaign to challenge a crisis in mental health.

Culturally mental health issues are often ignored or dealt with in a very different way than in the west, and community leaders are starting a conversation.

As the largest ethnic minority community in Bristol, we have seen patterns of death and suicidal cases recently. We are at a crisis point.

The Break The Stigma campaign is led by Bristol Somali Youth Voice, who want to tackle and normalise mental health issues in their community in Bristol.

Somali mental health event - sport day held at City Academy Abir Shirdon, Shona Jemphrey (Labour Cllr candidate), Mohamed Elsharif, Mayor Jos Clarke, Mohmed Abdi Sayaqle, Moestak Hussain and Said Burale.

They want to educate young people to have the confidence to talk, and get symptoms diagnosed early before they reach crisis point.

The Easton based organisation held a football tournament at City Academy on Saturday October 19 to raise awareness of their campaign.

A report conducted in March 2017 by the Council of Somali Organisations in the UK, outlined what people in Somalis believe the different "causes" and "treatments" for people experiencing mental health to be.

It stated mental health conditions were predominantly seen as ‘God’s will, poor practice of religion, evil eye, evil spirits and sorcery.’ The traditional methods of treatment in Somalia were described as usually providing ‘religious and social support’ which included methods such as ‘ritualistic dancing, visiting local shrines and healing.’

The western model of psychiatry can be viewed with suspicion by elders in the community, and the report pointed at significant barriers Somali people faced when encountering mental health issues in the UK, with many traditional ideas still holding weight. This resulted in a culture of silence particularly amongst men; a stigma of being labelled; a fear of mental health services; and a lack of mental health literacy.

It also highlighted a lack of well trained Somali professionals in the sector of mental health, and suitable information about the availability of services leading to a cultural misunderstanding, from both sides.

In Bristol, this has manifested in a number of serious incidents, including ten related mental health deaths in the last few years. With settlements of Somali people in the city dating back to the mid 1990s, following civil war that devastated their homeland, the younger generation like many new migrants can feel trapped between two worlds. Some of the traditions and attitudes to mental health adopted from the elders are, however, being challenged by young people and supporting organisations. One is Bristol Somali Youth Voice , who have conducted some of their own research in the city.

The research revealed that as much as 40 per cent of British Somalis in Bristol say they have suffered from some form of stress or depression, but as much as 82 per cent are unlikely to contact their GP. In terms of the services available to them 96 per cent of the people they spoke to had not heard of CAMS (Child and Adolescent Mental Health Services) and Off the Record, a mental health organisation that supports young people.

Manager Mohamed Abdi Sayaqle said: “Mental health is a real issue that some of us deal with in silence without seeking proper help, especially ethnic minorities, and even more so in the Somali community.

“As the largest ethnic minority community in Bristol, we have seen patterns of death and suicidal cases recently in Somali community in Bristol. We are at a crisis point,” he added.

He sees the problem as two-fold as culturally their own community and the services themselves don’t always understand one another. He continued: “There is a big stigma, and culturally we feel embarrassed talking about mental health issues, and this has prevented a large number of community members using and accessing available primary mental health services.”

Mohammed wants to focus on young people , as he sees the next generation as crucial to playing a real part in changing things. He explained why: “We opted to work with young people predominantly from BAME background (majority from Somali background) who have less of a stigma, and are more open-minded than older generations. We want to involve them, and get them to lead a culturally appropriate awareness campaign about bridging and overcoming this stigma. About how to overcome the embarrassment attached to mental health illnesses and seeking help.”

One approach is using sport, especially football due to its particular popularity in the Somali community. He said: “We wanted to empower community members at grass root level to improve their understanding, and to normalise talking about mental health. So doing this alongside football makes sense, young people are mad on it. So we use it as a tool to engage, and kick start the campaign,” he added.”

At City Academy on Saturday October 19 up to 60 young people attended the tournament. It began with a series of talks about the issues of mental health in the community. One from Mohammed himself, Lord Mayor Joss Clarke , and Deputy City Mayor Asher Craig.

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Somalia kicks off construction of main blood bank facility

The Somali government has kicked off construction of national blood bank facility for the first time in three decades.

Hassan Ali Khaire, Prime Minister of Somalia who laid the foundation for the construction of the facility, said the critical project is being implemented through a partnership between the government and willing development partners.

Establishing a blood bank, therefore, becomes more urgent given our context, as it mitigates deaths as a result of bleeding. Providing reliable blood transfusion services will be fundamental to our health sector reform, said Khaire in a statement issued after the launch in Mogadishu.

He said the Horn of Africa nation which is fighting al-Shabab militant group that has resulted in many deaths and injuries some due to loss of blood did not have a functioning national blood bank for close to three decades.

This critical project will, upon completion, assuage dire blood shortages in the country. Phase one of the project is anticipated to store 10,000 units of blood, said the prime minister.

He said the launch of this project is a key milestone for the Social Development Road Map and coincides with the second anniversary since the infamous October 14, 2017, truck bombings in Mogadishu in which hundreds of Somalis lost their lives, many due to severe loss of blood. Some 587 people killed and 316 others injured during the bombing attack in Mogadishu.

Khaire said the government is committed to enhancing the delivery of essential services to the Somali people through the implementation of responsive and proactive policy initiatives, through collaboration with development partners. 

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Meet the Man Using Basketball to End Polio in Somalia

Abdullahi Mahamed Noor, hailing from Mogadishu in Somalia, wears multiple hats. By day, he is an experienced and dedicated polio programme zonal coordinator. By night, you can find him racing down the court as president of the Somali Basketball Federation.

Through basketball, Mahamed engages the community in his work to end polio. ©WHO/Somalia

Mahamed’s journey to end polio started in 1999, as a vaccinator in Adale District of Middle Shabelle in Southern Somalia. Since then, he has worked to combat multiple polio outbreaks in his country, including the current cVDPV outbreak.

Mahamed strongly believes that eradicating polio isn’t just about delivering the vaccine. To maintain high immunity levels, the programme must deliver a clear message about the safety and importance of the vaccine and help communities become better informed. To achieve this goal, Mahamed uses his sporting connections to combine basketball with innovative polio immunization messages, with the objective of increasing awareness throughout his community.

Last year, Mahamed took advantage of a Vaccination Week to deliver messages on polio eradication at several basketball games held in Mogadishu. “When people come to the stadium, they see messages on polio awareness and how important it is to vaccinate children to build their immunity against polio virus. They pass those messages to family and community members,” he explains.

From 1999 to 2010, a period during which Somalia suffered several polio outbreaks, the inaugural ceremonies of most of the major sports activities in Somalia would begin with statements encouraging people to vaccinate their children against polio.

Abdullahi Mahamed Noor is president of the Somali Basketball Federation, and a dedicated polio programme zonal officer. ©WHO/Somalia

Currently, Mahamed supports polio officers to develop comprehensive microplanning for immunization campaigns in Somalia. He emphasizes fostering trust between frontline workers and communities, since the polio workers in Somalia travel door to door to deliver vaccine. The basketball games that he organizes in his spare time help to increase acceptance of polio workers in the community.

“Part of my job is to convince the families who refuse to vaccinate their children. I quite often use my experience of being involved in basketball to educate them on benefits of polio vaccination and preventing disability related to poliovirus.”

Sportspeople are active in the fight to end polio the world over. Ade Adepitan, a British Paralympian, wheelchair basketball player and broadcaster, who is himself a polio survivor, is a strong advocate for polio eradication. In Pakistan, cricketers often promote polio eradication campaigns during the highly watched and well-attended matches.

In many parts of Somalia, poverty, conflict, internal displacement and weak health infrastructure often mean that vaccination levels remain relatively low. Amidst these trying circumstances, dedicated workers like Mahamed are playing a critical and innovative role in educating communities about polio and the absolute importance of vaccination to defeat the disease.

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Somali doctor is now directing the Seattle Harborview Medical Center’s Pediatrics Clinic

Dr. Anisa Ibrahim moved to the U.S. in 1993. Her family fled unrest from the Somali Civil War. She's now leading Harborview Medical Center's Pediatrics Clinic.

SEATTLE — A woman who came to the United States as a young refugee in the 1990s is now leading the Seattle clinic where she was cared for as a patient. 

Dr. Anisa Ibrahim was recently promoted to Medical Director of Harborview Medical Center’s Pediatrics Clinic. She said the promotion brings her story full circle.

“It's one that I'm honored and grateful for, but it’s also one that I've worked really hard, to be in a clinic that I am passionate for” said Dr. Ibrahim.

Dr. Ibrahim was brought to the U.S. in 1993 from Somalia when she was six years old. She said her family fled unrest from the Somali Civil War that began in 1992.

We got to Kenya in 1992, and by 1993 we were resettled to Seattle," said Dr. Ibrahim. "That is a very short amount of time. The average amount of time a person spends in a refugee camp right now is 17 years.

She said she remembers a tuberculosis outbreak at her refugee camp, and her sibling getting the measles. When she arrived in Seattle, she and her sibling were treated at Harborview Medical Center's Pediatrics Clinic.

It was those experiences that made her want to become a doctor. 

"I can say I know life is tough in a refugee camp," she said. "I know life is tough settling into a new country and not speaking English and not knowing where the grocery store is and being isolated from the rest of your family." 

Dr. Ibrahim attended the University of Washington's School of Medicine and graduated in 2013. From there, she continued to do internships and her residency at the UW Department of Pediatrics. 

Now, in her new position at Harborview Medical Center's Pediatrics Clinic, she gets to care for and do outreach for immigrant and refugee populations, with a focus on those from East Africa.

"It's amazing seeing children who I saw at three days of life now telling me about their first day of kindergarten," said Dr. Ibrahim. 

Dr. Ibrahim emphasized that representation is extremely important. She said one thing she wished she had when she was younger, as a Somali refugee wearing a hijab, was someone who resembled herself. 

Photo file: Dr. Beth Dawson-Hahn (left) and Dr. Anisa Ibrahim (right) study refugee children and nutrition.

"There are probably millions of little girls in refugee camps right now that are not being offered the opportunity to get an education that could probably be the next neurosurgeon," said Dr. Ibrahim. "It's the support that we're not giving them that makes them different from me, and it's not anything inherent to one particular person." 

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Intro. to Epidemiology in Global Health Course run by E-learning Dept. Global Health (Online)

An in-depth orientation to the field of epidemiology for those seeking to conduct research or work on research studies in a global health context.

Faculty/Lecturer: 

• Brandon Guthrie, PhD, MPH

    Assistant Professor, Global Health

    Assistant Professor, Epidemiology

Overview

Are you interested in understanding distribution of disease and what factors affect risk of disease? This course gives an in-depth orientation to the field of epidemiology research in a global health context. You’ll get an understanding of how epidemiological methods are used to understand the distribution of disease within populations and what factors affect the risk of disease. Learn about important epidemiologic concepts, including how to describe disease risk, common study designs, bias and confounding, and the importance of appropriate measurement in epidemiological research. 

Sylubbus-Topics to be covered

1)      Introduction to Epidemiologic Methods and Quantitative Research

Understanding how and why diseases are distributed in populations and what factors are associated with disease relies on a set of epidemiologic methods that can be applied flexibly to many different settings. This unit introduces the main concepts in epidemiology and reviews the methodological approaches to measuring diseases in populations and assessing relationships between exposures and diseases.

2)      Introduction to Statistical Decision Making

This unit offers an introduction to core topics in statistics for the analysis of health-related data with emphasis on analyzing the most common epidemiologic study designs.

3)      Epidemiologic Study Designs

Epidemiologists employ a variety of observational and experimental study designs to investigate the distribution and causation of diseases. The primary types of epidemiologic studies will be introduced with examples to illustrate how investigators determine which study designs are best suited to addressing a set of scientific aims. The strengths and limitations of each study design are outlined for use in planning studies and interpreting and evaluating findings from published results.

4)      Causation, Bias, and Confounding

To identify causal relationships between exposure and disease it is sometimes necessary to rely on observational data to assess causation, which introduces important issues of bias inherent in observational studies. Interpretation of epidemiologic data is often complicated by the fact that other factors may distort the relationship between an exposure of interest and a given disease. Factors that are associated with both exposure and disease can induce what is called confounding, and if not appropriately compensated for, can obscure the true exposure-disease relationship.

5)      Measurement, Classification, and Misclassification

To understand the distribution of disease in populations and identify causal relationships between exposures and disease outcomes, epidemiologist must measure both exposure and disease in the population under study. Researchers must understand how to measure exposure and disease, and how the research question dictates the approach to classifying subjects as exposed or unexposed, diseased or non-diseased. What are the implications of misclassifications? How can sensitivity, specificity, positive predictive value, and negative predictive value be used to assess measurement instruments?

6)      Data Management Practices in Health Research

Epidemiologic studies produce data in a wide range of formats and structures. To make full use of the information gained in these studies, researchers should consider how study data will be stored and managed. Decisions about data management will depend on how the data are collected, who will be accessing the data, and what types of analyses will be performed. What factors effect data management strategies and outline techniques for effective data management at the time of collection, storage, processing, and analysis?

7)      Interpretation of Epidemiologic Studies and Decision Making

Findings from epidemiologic studies guide clinical and public health policy decisions, but sound decisions depend on a thorough understanding of relative strengths and weaknesses of different sources evidence. Study design, selection of study subjects, and differences between populations can greatly influence how research results are interpreted in the context of applied settings. Real-world examples demonstrate how epidemiologic principles can be used to synthesize evidence from different studies to evaluate the strength of evidence linking exposure and disease and to inform decisions about how to implement this knowledge into public health practice.

8)      Multiple variable regression models in epidemiology

Multivariate regression is a common approach used to analyze epidemiologic data that allows the investigator to simultaneously adjust for multiple confounders. This unit provides an introduction to multivariate regression and an overview of logistic and Cox regression methods. Particular emphasis is given to how odds ratios and hazard ratios from regression models should be reported and interpreted in the scientific literature.

9)      Qualitative Research Methods

Qualitative research methods are an important complement to the quantitative methods used by epidemiologists. Qualitative approaches are used to develop strategies to implement public health interventions, understand health decision making, and to follow-up on findings from quantitative studies. An introduction to qualitative research methods will provide a background for implementation of qualitative methods into epidemiologic research and public health practice. Practical examples will be used to illustrate the use of phenomenology and grounded theory methods, with a discussion of sampling and data collection.

10)  Analyzing Qualitative Data and Public Health Applications

Qualitative research employs data collection strategies that differ in important ways from quantitative research. The analysis of qualitative data involves analysis approaches tailored to the unique data structure of qualitative research and allows researchers to interpret and apply the results for these studies. Practical examples will be used to illustrate key topics including data management, coding, data analysis, and writing.         

* NOTE: course content is subject to change

Format

This online course has pre-recorded video lectures, readings, discussion forums, quizzes and three assignments. Unique username and password will be issued to each participant to get access into online learning management system by the University of Washington after they successfully admitted into the course.

You can participate in this course as an independent participant or as part of a local site. The course is taught in English. Participants should be comfortable with written and spoken English.

Eligibility

To be admitted to the course you must have a Bachelor’s-level degree (or equivalent) and experience in a health-related field. Proficiency in algebra is required.

Certification

 For those who successfully completed the course will receive a formal printed Certificate of Completion on vellum paper with University of Washington seal mailed to them through DHL courier services. We will ship them all together to your Site Coordinator for distribution.

Sample of certificate of completion- scanned copy

Further Information

Any additional enquiry and questions about this program you should contact Dr. Mohamed Y. Dualeh, MD via his email: info@drmohameddualeh.com and if possible discourse with his on phone:(+252 63 4417945 by texting him in WattsApp) regarding how to register, getting an assistance in application process while he is exercising as an official local resource for our participants acting as Site Coordinator for Somalia, UW Global Health Department.
Official website of the University: https://edgh.washington.edu/