HYDERABAD: Although she has turned 72 now, seasoned gynaecologist Prof Dr Pushpa is as energetic as ever to serve the women patients, especially poor coming from rural areas, who face RVF or VVF — the health and hygiene trauma that spoils patient’s life and makes her pariah within her home as nobody feels comfortable to sit or even interact with her — through surgical procedures.

Prof Pushpa has made it the cause of her life to rid women of this trauma. She has performed hundreds of such surgeries over the last 25 years.

She briefly shared her knowledge, performance and achievements after a session of guiding young doctors of a public sector medical university on Thursday in Shaheed Benazirabad district on how to deal with RVF (rectovaginal fistula or involuntary leakage of faecal) and VVF (vesico vaginal fistula or uncontrolled urine discharge). Primarily known as obstetric fistula, it remains an appalling condition for women.

Prof Pushpa had set up a Fistula Foundation at the Liaquat University Hospital (LUH) in collaboration with Dr Sher Shah back in 2007. After her retirement, she continued to render her services at a private tertiary hospital. Sixteen women undergo this surgical procedure in a month for which the foundation helps patients get medicines whereas the rest of expenses for medical care are not charged.

Dr Pushpa transfers knowledge and expertise to young and other fellow doctors to enable them to handle such cases efficiently.

“Just imagine, a 35-year-old man brought his mother to us a few years back for such procedure as since his birth, the woman had been suffering from VVF until she came to know about the procedure. His mother told me that she had performed prayers after 35 years,” shared the bespectacled gynaecologist.

When asked whether this disease had been incurable until recently, she said women largely believed so but when people started knowing more about its treatment, they started approaching doctors. “We call it a disease of poverty,” she remarked.

According to her, it is mainly mishandling of childbirth, performed by unskilled women in rural areas in the absence of quality maternal healthcare services.

“Never ending or uncontrolled leakage of urine or faecal keeps women’s clothes soak necessitating them to keep changing them. It becomes a burden, besides being a serious hygiene issue that contributes to other problems as well. And most difficult state is the smell caused by the disease to practically make them unacceptable to their own family. They face segregation and in some cases I have learnt they are kept in spaces close to cattle pens,” she says. Secondly, she said, adult diapers were unaffordable for them.

Primarily it is obstructed labour that leaves an abnormal hole in woman’s body which causes uncontrolled leakage of faecal and urine”, says Prof Pushpa after meeting a patient at the tertiary hospital. This abnormal hole at a particular area is the result of unnecessary pressure of obstructed labour on rectum or bladder. it eventually becomes a case of RVF or VVF. “There is a need for training more and more doctors to perform the procedure,” she stressed.

She has been imparting training to fellow doctors in other parts of the country as well.

Regrettably, such services being offered by the senior most gynaecologist are going unnoticed and unappreciated in society.

Published in Dawn, March 8th, 2024