Dr. Nasra Ibrahim is a fistula surgeon who travels about seven times a year from Uganda to her home country of Somaliland to treat women with fistula, a devastating childbirth injury that leaves a woman incontinent and—more often than not—shunned by her community. Read what inspired her to do this work, and why she won’t stop until every woman with fistula in Somali-speaking regions is healed.
AS TOLD BY DR. NASRA
It breaks my heart to see a woman with a full life suddenly broken by one event—a horrific labor—that changes everything. Too often, she loses everything: her husband, her health, maybe even her uterus. That makes me so sad.
I am from Borama, Somaliland, and I work at National Borama Fistula Hospital (NBFH). My father, Dr. Qaws, is the founder of NBFH and one of the leading fistula surgeons in Somaliland.
He inspired me to become a fistula surgeon like him. When I saw the joy on the faces of the women he healed, it made me so proud. It inspired me to want to help women, too. Being a woman, I could understand what these women were going through. I wanted to help them.
About 80% of the patients who come to NBFH have been divorced by their husbands, who can’t stand to be with them anymore. The smell and the stigma drive them away. They seek new wives who don’t have this problem.
I remember one patient who was in the hospital after delivering her baby. She had developed a fistula. When her husband found out that she was leaking urine and feces, he left her right then and there.
A Special Place for Fistula Patients
My father built NBFH just for fistula patients. At his previous hospital, maternity patients did not want to mix with fistula patients who were leaking urine all the time. The fistula patients were ashamed, and stigmatized. Many of them stayed at home, alone, instead of coming in for treatment. It was easier to hide in their homes than to bear the shame that they felt at the hospital.
When NBFH opened, and women started returning to their villages fully recovered from fistula, other women—women who had been in hiding—learned that it was possible for them to heal, too. Because of my father, every woman in the region around NBFH has been treated. Fistulas still occur, but women with this condition no longer have to suffer for years without help.
I’m now studying in Uganda for a postgraduate degree in obstetrics and gynecology. Recently, I came back to Somaliland to take part in a treatment campaign at NBFH because my father was sick. I come to Borama about seven times a year to operate on patients for five days at a time.
Her Smile Is My Reward
I love my job because of the women. They’re like my daughters, my sisters. They call me “Sister” and “Auntie.” I don’t want them to feel like I’m their doctor. I want them to see that I am like them. I also want to encourage women in Somalia to educate themselves and not to marry too young.
It makes me so happy to see the smiling face of a mother who has been reborn again because she has been healed. I don’t see what I do as “treatment.” I see it as rebirth. It allows a woman to start anew. She can participate in society; she has freedom. Her happy face says everything. It makes me proud.
Empathy as an Edge
It’s great to be a female doctor in this field, because I can interact with women in the ward in a different way than my male counterparts. When patients see that I’m a woman, they call out to me. Because this complication could happen to me, I am able to help them emotionally as well as physically. As a woman, I can feel what this condition must be like.
When I explain to women with fistula what’s happening to them, I use myself as an example. It allows them to talk freely with me and to relate with me on a deeper level. I can gain their confidence and empathize with them. I can feel the shame that they must feel.
It’s important for me to have a connection with patients and not be superior to anyone.
I want the nurses and others in the ward to be friendly to one another and to treat everyone with dignity. They see me as a surgeon, and they’re inspired and empowered as women to reach higher in their own lives. When we’re training midwives, and they see me operating, I can be a role model for them.
It’s challenging to be a female fistula surgeon in a male-dominated field. But, when people question why I’m the one operating, it makes me rise to the occasion. I tell them that I can do what the men can do. And then I show them, and they say, “Yes, you can do it.”
A Vision for the Future
We’re still working to fulfill my father’s vision to eradicate fistula in Somali-speaking regions across the Horn of Africa.
NBFH focuses not only on treatment, but also on prevention. We train midwives, and we provide ambulances so that women can get to the hospital when they have a complicated or obstructed labor.
My dream is to become a full-time surgeon at NBFH. I want to perform surgeries for women suffering from fistula, and to carry out my father’s vision.
I’m so thankful for doctors like Tom Raassen, Andrew Browning, and Lauri Romanzi, who were my teachers. They trained me and helped me with complicated cases. I want to be like them and to teach other doctors. I’m also extremely grateful to Dr. Said Ahmed Walhad—the cofounder and current director of NBFH—for his ongoing mentorship and support.
Alone, we cannot do anything.
Lastly, I’m grateful to donors. Because of them, we have the facilities and instruments that we need to do this work. They also help with transportation costs so that patients can reach us.
Without donors, we cannot do what we do.
We have done so much, but there is a lot left to do. Until we achieve my father’s vision of eliminating fistulas across the Horn of Africa, I will keep working. I’m excited for the future—a time when all women will be free from fistula.