Article by the AFU, the French Urology Association
DR. CHARLES-HENRY ROCHAT: 30 YEARS OF COMMITMENT TO OBSTETRIC FISTULA IN AFRICA
In brief: Dr Charles-Henry Rochat spoke at JAMS to take stock of more than three decades in humanitarian medicine, focusing on the management of obstetric fistula, a condition that is still often misunderstood and devastating.
In 1993, Dr Charles-Henry Rochat was contacted by a religious doctor, Frère Florent, who was looking for a urologist to teach endoscopic prostate operations. “That meeting at the Afangnan hospital in Togo marked a turning point in my career,” he says, even though he had already been involved in war medicine for several years. While pursuing his career as a urological surgeon, he began training African doctors to deal with complex cases and created a model of care in Tanguieta, Benin, where he treated patients with obstetric fistulas during surgical campaigns, working with local NGOs to recruit and provide long-term follow-up.
Avoiding the “White Savior Complex” at all costs
The doctor confides: “the human and technical dimension of obstetric fistula deeply concerned me: these women are ostracized from society”. In 1996, he organised his first surgical missions, financed out of his own pocket. Surgical workshops were also set up to train local doctors, with the emphasis on mentoring, raising awareness and learning how to deal with complex cases. Research and the scientific dimension were not neglected: it was necessary to develop skills locally.
Dr Rochat set up a partnership with Cotonou’s Faculty of Medicine to ensure a transparent, non-intrusive approach. In 2008, he was appointed associate professor, thus establishing a political-scientific network to sustain the effort and avoid one-off interventions.
To overcome the financial barriers, Dr. Rochat has adapted his approach by covering all hospital costs through public and private partnerships: “We couldn’t make patients and hospitals bear the costs of our interventions – it wasn’t possible in the long term”.
Over the years, Dr Rochat has helped to structure obstetric fistula care in Benin, creating manuals and training doctors to take over. His commitment is not limited to surgery. “We are involved in prevention, raising awareness in antenatal centres and advocating free caesarean sections paid for by the state (150 euros, equivalent to 2 to 3 months’ local minimum wage)”.
Dr Rochat is convinced that financial support, the sharing of medical equipment and training are essential if this effort is to move forward. He aspires to the creation of centres of excellence so that obstetric fistula becomes a flagship issue in hospitals, supported by sustainable partnerships and global awareness.
How can we help?
Financial support: Funds are needed to cover the costs of operations, post-operative treatment and long-term follow-up of patients. These funds can also help remove financial barriers for disadvantaged patients by offering free or low-cost care.
Recovery of medical equipment: Dr. Rochat stressed the importance of medical equipment, including endoscopy equipment such as cystoscopes and cameras. Donating or financing this equipment can improve the quality of care and enable local doctors to carry out more effective interventions.
Mission support: Medical missions to rural and low-resource areas are essential to provide specialist care for obstetric fistula patients. Financial support for these missions, including travel, accommodation and equipment costs, can help extend the impact of these interventions.
Partnerships and Networking: Collaborating with local and international organisations, universities and NGOs can help strengthen efforts to eradicate obstetric fistula. Institutional partners and political-scientific networks can provide resources and increased visibility.
Training successors: Investing in the training of local doctors is essential to ensure the sustainability of the effort. Supporting surgical workshops and mentoring programmes can enable more healthcare professionals to manage obstetric fistula.
Interview conducted in collaboration with Dr Charles-Henry Rochat, of the Générale-Beaulieu urology centre (Geneva)
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