Imagine living your life with an organ the size of a grapefruit, that should be inside your body, hanging outside instead.
Millions of women in Third World countries suffer from utero-vaginal procidenta, or prolapse, where the woman’s uterus falls outside of their body.
Issaquah urogynecologist Dr. Julie LaCombe traveled to Bangladesh from April 19-26 with Drs. Tracy Capes and Nabila Noor, a midwife, a nurse and an anesthesiologist and performed 25 prolapse procedures in three days.
“We operated from 7 a.m. to 10 p.m. each day,” LaCombe said. “Seventy-five women showed up. We need to go back.”
The area they visited has a population of approximately 1.6 million.
LaCombe traveled with A Stitch in Time, an organization founded by Capes. The two doctors became friends through the close-knit group of urogynecologists in New York.
This was LaCombe’s first time to Bangladesh, but she has been to Honduras, Ecuador, and Bolivia on international missions when she was a medical resident. In turn, she mentored five resident physicians while doing her fellowship at the University of Vermont. She said Stitch in Time has done international work for years.
Genetics, poor nutrition and childbirth contribute to the problem, but also the fact that the women often work in a squatting position, which leads to stretching and weakening of the pelvic floor muscles, so the uterus slips down and protrudes.
“Plus they chew betel leaf, which is like a tobacco, which damages collagen, a major support for pelvic structure,” LaCombe said.
Patients with the condition can develop urinary retention or kidney failure. Also, husbands often leave them, beating them and accusing them of adultery.
Just getting there to help is difficult. LaCombe flew from Seattle to Dubai, then Dubai to Dhaka, Bangladesh on Emirates airline. From there, a seaplane, Flying for Life, took the team to the one of two floating Friendship Hospitals, also donated by Emirates, in northern Bangladesh. The entire journey takes three days. LaCombe said Emirates (airline) allows customers to donate frequent flyer miles to help pay for the doctors’ trips.
“Northern Bangladesh has a lot of large sandbars where they (the people) set up small communities until the sandbars go away, then they move,” LaCombe said.
The travel is so difficult that Stitch in Time is now the only group going to Bangladesh to perform these procedures.
The ship had two operating rooms and a post-op area. The team only had to pay for their room and board on a dormitory houseboat behind the hospital, and antibiotics for the patients, which she said were inexpensive in Bangladesh.
If you’d like to help Stitch in Time visit www.astitchintime.org.
From left, Dr. Tracy Capes, Dahlia White, Dr. Nabila Noor and Dr. Julie LaCombe perform a surgical procedure on a patient in Bangladesh to repair a uterine-vaginal procidenta.
The floating Friendship Hospital in Bangladesh was donated by Emirates.