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IOFWG meeting Maputo, 10-12 Oct 2011

IOFWG meeting Maputo, 10-12 Oct 2011. Re-cap of the first day. IOFWG. Partnership (50 countries, 60 partners) Prevention, treatment, social reintegration Decision body of the Campaign to Eradicate OF 5 sub-WG. Mozambique.

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IOFWG meeting Maputo, 10-12 Oct 2011

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  1. IOFWG meeting Maputo, 10-12 Oct 2011 Re-cap of the first day

  2. IOFWG • Partnership (50 countries, 60 partners) • Prevention, treatment, social reintegration • Decision body of the Campaign to Eradicate OF • 5 sub-WG

  3. Mozambique • P. Guzman, UNFPA Rep: national Campaign, increasing number of women treated, advocacy, social reintegration. Challenges in data collection. Needs for research • Deputy MoH: MMR>500. Girls and women protection. Quality services provision. Age at marriage, FP • Dr. Aldo Marchesini (Moz.) Reminder of surgeons working in complete isolation Hand-on training, camps followed with mentorship

  4. Campaign(Gillian Slinger) • 2003 • 12  50 countries • 14 new partners • Number of treatments?? • Social Reintegration: in 24 countries working with Fistula Advocates • UN resolution in Nov 2010. UNSG Report 2010 • Launch of training manual (FIGO, ISoFS & partners) • Training strategy • CHALLENGES

  5. Communication(Etienne Franca) “We always try to remove the barriers and make sure we make impact” Make visible what happens in the field Improving field work with better communication Participation Lessons learned www.endfistula.org International and national journalists

  6. ISOFS(Tom Raasen) 2007 2008, 09, 10 meetings Not yet registered On line journal. w.ww.isofs.org FIGO-ISOFS OF Surgery CB Training manual – 7 generic training skills, Log Book, 2 classifications Workshops Training strategy

  7. Training strategy • Master Trainers identification • Training centers identification • Workshops (using CBT Manual) • 6-8 weeks of training (in recognized high level standard training centers) + mentoring • Sponsorships • Harmonisation of the medical files/data collection • National and sub-regional strategies • Accreditation

  8. Holistic approach for complex human condition Addis Fistula Hospital - Center of excellence, setting standards, laboratory for innovations • 1959-2011 Satellites (access) • Closing 93% closure and continence at first attempt, 82% GREAT but not enough!! • Pre-surgery treatment and support (nutrition, TB, …) • Culturally acceptability and Quality of life - Blankets, Coffee ceremony, housing, literacy, languages, … • Physiotherapy • Education and training • Job opportunities (surgeon, aid nurse, physiotherapy, …) • DestaMender. Derivation. Cost. Social reintegration/community • Midwifery school: developing midwives as leaders; selected with the community; placement (orchestration++); financial net. First successes, to be documented (500 childbirth). Career path, girl empowerment ++ • Research. No prophylactic antibiotic

  9. C-S and Fistula 10-30% Iatrogenic? • Short update on Francophone network (4 countries)

  10. Incurable • Report of a recent meeting in Boston, EngenderHealth • Obj: to facilitate development of standardized approaches and guidelines for diagnosis and management of clinical, ethical, psycho-social and programmatic issues for women living with genital fistula that is deemed incurable • About 5%: ‘Women with complete destruction of the urethra, severe loss of bladder capacity and irreparable damage to continence mechanism.’ • Definition of success, patient perception • Who can decide? • Social reintegration/empowerment, self-estime + safety net: hostel, half way home • Follow-up: retreat, mobile phone

  11. Social reintegration • Women Dignity Project – Christine Matovou (Tanz) Speaking for themselves, dignity restored, from despair to hope Policy changes, institutional support Education. Media Campaign. Train local journalists, local leaders, engagement of health professionals. Policy-makers, implementers Communication Research on reintegration Partnership First consultative meeting of survivors. Micro-credit National campaign – 40 hospitals, 4799 treatments

  12. Working at community level – voices of survivors Musa Isa, Kano, Nigeria, 180 incurable women Dedication and support, experience One by One, Sarah Omega, Western Kenya • Fistula survivors + other women + men!! Identification, counseling, transportation, follow-up ++ and support • Local leaders, political level

  13. Challenges • Increase momentum on prevention: bladder catheter, follow-up • Notifiable condition • Secure national leadership and commitment to scale-up treatment services and ensure quality • Evidence base: strengthen date for strategic planning • Develop evidence • Reinforce partnership • Functioning of the 5 SWGs (how to keep momentum between the meetings) • International day

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