Brian Hancock is a retired colorectal surgeon from the University Hospital of South Manchester. 40 years ago, Brian worked as a general surgeon in Kamuli Hospital, Uganda where he first encountered obstetric fistulae and performed simple repairs helped by Chassar Moir’s classic textbook. He has made several visits to the Fistula Hospital in Addis Ababa to learn and later to help with complex recto-vaginal fistulae. Brian is a trustee of Hamlin Fistula UK, the UK branch of the Addis Ababa Fistula Hospital.
Since his retirement in 2000 he has spent three months each year in Africa making visits to several hospitals in Uganda and has worked as fistula surgeon and trainer with Mercy Ships in many West African countries.
In Uganda, as in other poor countries, many women deliver at home or far from any medical help. If a woman develops obstruction in labour she needs an emergency caesarean section. If this can’t be done she may die of a ruptured uterus or deliver a stillborn baby after days of agony in labour. If this were not enough she may find that she has no control of her bladder or even her bowel. The prolonged pressure of the baby’s head against the bony pelvis wears a hole between the bladder and vagina and sometimes the rectum. This is called a vesico-vaginal fistula. This will never heal, so she will be incontinent for life unless she can find someone to perform a surgical repair. Women with this condition will visit any hospital they can but rarely find anyone who can help so they return home to a life of misery and rejection. They also fear the fees that have to be charged by the voluntary hospitals or private surgeons. They are usually abandoned by their husbands and give up all hope of being cured.
In 2003, Brian was joined by Glyn Constantine, a gynaecologist from Birmingham, Mhari Collie, a surgeon from Edinburgh and Brenda Gray, a theatre nurse from Birmingham, to form the Uganda Childbirth Injuries Fund, a Registered Charity to provide free treatment for fistula patients and to provide training for local surgeons to be able to carry out fistula repairs. They visit a number of hospitals in Uganda, but their main focus is on Kamuli Hospital which they visit three times a year. When they are there, they can spend 10 hours a day carrying out operations, but in spite of this the number of cases is increasing. They regularly come across patients who have spent 20 years with this distressing condition.
Brian Hancock has spent the last 14 years improving the lives of many young women in Uganda. He continues to teach fistula surgery to younger surgeons. Brian’s local Rotary Club has awarded him a Paul Harris Fellowship for the work he has done in Uganda.
Brian with more grateful patients