VVF TREATMENT AT BUGANDO MEDICAL CENTRE Girls and women suffering from VVF (vesico-vaginal fistula) or RVF (recto-vaginal fistula) usually pass urine, feces or both through the vagina. The condition, which does not allow women to urinate or defecate through the normal passages, is known as incontinence. They have no control over the situation and find themselves in an embarrassing situation. Victims of the condition often are abandoned by their husbands and friends and even by their relatives. The consequences are a life of shame and loneliness due to the smell. There are several causes of the condition. Obstructed labor during childbirth is a major cause of VVF in Africa. In addition, lack of proper obstetrical care by a qualified health provider and teenage pregnancies can result in VVF. Frequently the mother is unable to deliver the baby because of the baby’s size. VVF or RVF are not hopeless medical conditions. A woman who suffers from this condition can be helped by a doctor who specializes in treating patients with this problem. The doctor will ascertain whether the patient can be helped by surgery, catherization, physiotherapy or a combined treatment. Bugando Medical Centre is one of the hospitals that treat VVF or RVF in Tanzania. It has specialists in surgery and physiotherapy. More than 2,000 women have successfully been treated at Bugando since 1997. The head of the program, Dr. Gumodoka, commented that many of the sufferers of VVF are poor and have no access to a hospital for delivery of their baby. The treatment of VVF or RVF is free of charge at Bugando Medical Centre through the general help of donors such as AMREF, the Women’s Dignity Project, The Ministry of Health and One by One. Dr. B. Gumodoka, Dr. Ng’walida and Dr. Marietta Mahendeka perform the surgeries at BMC. Twice each year, two expert surgeons, Dr. Tom Raassen of AMREF Kenya and Professor John Kelly of the United Kingdom, come to train operating staff and they also do the most difficult cases. Dr. Mahendeka published and read a paper at the Geneva Foundation for Medical Education and Research. Her paper revealed many of the new and updated treatments for VVF or RVF that have been developed at Bugando Medical Centre. Her paper was warmly received and provided a new model for the surgery.