At the end of a bumpy eight-hour jeep ride to south-west Uganda, women wait eagerly on the grass outside the hospital for the arrival of a group of Brisbane surgeons.
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Many have been camping outside for days, waiting for a bed to free up inside.
These women are outcasts, suffering the pain and humiliation of horrific gynaecological conditions. One has been bed-bound for three years. Witchcraft is blamed for the condition of others.
The plight of these women has inspired one of Brisbane’s most respected gynaecologists, Barbara Hall, to give up her thriving practice six years ago to become a volunteer surgeon in Africa. Her husband John Taylor, a retired general practitioner, has joined his wife as her surgical assistant.
Some of their patients have endured days of obstructed labour without medical help which has left them with holes leaking urine and sometimes faeces, known as an obstetric fistula. These are rarely seen in Western nations since the end of the 19th century.
“If you have an obstructed labour in Australia, it is not a problem because you just have a caesarean and everyone is fine but if you are out in the bush somewhere and can’t get access to medical care, they labour for three or four days,” Dr Hall said.
The babies are usually stillborn.
Other women suffer from a prolapse, where their uterus has fallen out of their vagina and is dangling between their legs.
Dr Hall has fixed about 400 prolapses since she began visiting Uganda in 2013. The team has done more than 1000 operations in that time.
"Not only is a prolapse uncomfortable and disfiguring, but a lot of the women think they have been struck by witchcraft and quite often their husbands think they are turning into a man and leave them," she said.
“They are very socially ostracised.”
Dr Hall and Dr Taylor have teamed up with long-serving Brisbane volunteer doctors Hannah Krause and Judith Goh to help these women.
“I couldn’t retire and do nothing and I knew Judith was doing this in Africa, so we thought it would be a very rewarding thing for us to do,” Dr Hall said.
The team operate at St Paul’s Health Centre in Kasese, eight hours from Uganda’s capital, and Kagando Hospital, an old leprosy hospital about 40 kilometres out of Kasese.
Dr Hall and Dr Taylor have visited Uganda 10 times since 2013.
They pay for their airfares and accommodation to perform life-changing surgery on women who often can’t even afford a bar of soap.
“It is pretty incredible. You get over there and treat these women and they are just so incredibly thankful for absolutely anything you do for them," Dr Hall said.
But performing surgery in rural Uganda does present significant challenges never faced in the private hospitals of Brisbane, according to Dr Hall.
For starters, they often have to operate with battery powered head torches because the power cuts out all the time. The volunteers decided to pay for a generator.
And when the local council turns the water off without warning to conserve supplies, the surgeons have to scrub using buckets out the back of the hospital.
“It is pretty confronting. It really is the third world,” Dr Hall said.
“We are eight hours away from the capital Kampala, so it is very, very rural.
“The power goes out multiple times a day. We stay at the hospital guest house and we didn’t have power for at least half of the time we are there.”
The Brisbane doctors have just arrived home after another trip to Uganda.
Two paraplegic women – one with prolapse and one with a fistula – were among more than 100 patients treated during the visit.
One patient had dragged herself along the ground to the ward, the other was carried in by her daughters. She had been lying immobilised on a mattress for three years - "never seeing the light of day, or breathing fresh air".
Apart from relieving their gynaecological problems, the Brisbane team found two wheelchairs to boost women's independence.
The volunteer group also pays the hospital for every operation they perform to cover patient transfer, staff and a cook. The cost is almost $350 for every prolapse and about $415 for every fistula operation.
“There is no kitchen at the hospital, so if you are a patient there, your relatives have to bring food in to feed you. When we are there we pay for a cook," she said.
"These people have absolutely nothing, a lot of them spend hours getting to the hospital on the back of a boda boda, which is kind of like a motorbike.
"They will sit outside the hospital grounds for three days waiting for you to get there and operate on them. It is just incredible."
To donate head to www.hada.org.au/donation/medical-training-in-africa-asia
