By Jane Munyua
Amina lives in Kitunda region in the district of Masasi in the Mtwara region of southern Tanzania. She is a housewife who engages in subsistence farming to feed her family.
The second wife in a polygamous marriage, Amina has been married for two years. Sadly though, she has not been able to conceive. Her co-wife, on the other hand, has several children.
“I feel like I have let my husband down,” she says sadly. “I do not understand why I cannot conceive.
Early in April this year, Amina heard an announcement that a team of “madaktari bingwa” (specialist doctors) was coming to the Mkomaindo Hospital in two weeks’ time, and that women with female health issues should go to the hospital for free screening and treatment.
The “madaktari bingwa” were part of AMREF’s Clinical Outreach Programme, which provides specialist medical services to rural and disadvantaged communities across eastern Africa. The programme’s Muhimbili circuit covers Mtwara, Masasi, Lindi, Kilwa, Tosamaganga, Nachingwea, Mchukwi, Lugala, Ifakara, Iringa, Mafia, Berega, Turiani and Dodoma. The programme sends specialists in 25 different medical fields to hospitals in these areas, where they spend up to two weeks treating patients that the hospitals do not have the capacity to handle. The specialists range from obstetric gynaecologists, paediatricians, and orthopaedists to radiologists, anaesthetists and reconstruction surgeons, and are sent to the hospitals depending on need.
The team that went to the Mkomaindo Hospital consisted of an obstetric gynaecologist, Dr Efrem Mrema, and an anaesthetist, Dr Angela Muhozya. A total of 41 female patients, turned up at hospital, where they were screened to determine what their conditions were and how to treat them. The complaints included lower abdominal pain, excessive bleeding and inability to conceive. Some had been diagnosed earlier with uterine fibroids but had been unable to afford the surgery. Others had primary or secondary infertility caused mainly by untreated infections that had blocked their fallopian tubes.
Out of the 41 patients who were screened by the AMREF doctors with the help of Mkomaindo hospital staff, eight were identified for surgery. One of them was Amina, who was found to have a large myoma (uterine fibroid) and an ovarian cyst. Her treatment would include a myomectomy, the surgical removal of the fibroid from the uterus, and marsupialisation of the cyst, which involved making a slit on the cyst and stitching the edges of the incision to create a permanent opening that lets the cyst drain freely. The operation took about one-and-a-half hours. In order to build the skills of local personnel, the AMREF doctors were assisted in the operating theatre by the hospital’s deputy medical officer, theatre technicians and anaesthetist technicians. Clinical officers on internship at the hospital also watched the surgery. Teaching sessions were conducted during the ward rounds as well when Dr Mrema and Dr Muhozya reviewed the patients after surgery.
Lying in her hospital bed the following day, with the morning sun streaming in through the window, Amina felt a renewed sense of hope. Despite the pain from the operation and the discomfort of the catheter and intravenous drip, a shy smile played on her lips as she softly voiced her thoughts:
“I am very grateful to have got this opportunity and I am thankful to the AMREF doctors and to all those who made it possible. I hope that now I will be able to get pregnant and that I will be able to keep the pregnancy to term. This is my greatest prayer.”
AMREF is a transparent organisation distributing funds of up to $85 million per year.
