FISTUL-AID

Dr. De Backer, who had been participating in Médecins sans Vacances missions in Kimpese (Bas Congo, DRC) since 2001, had witnessed these wounds—obstetric fistulas—and the possibilities for treatment. With the help of Professor Paul Hennebert, founder of the Surgery Department at Lovanium University in Kinshasa, and Professor Jean de Leval (ULG), Fistul-Aid was born.

Many patients come from far away and without warning. Their general condition is often worrying, and there is not always immediate space available at the Fistula Clinic. After the operation, it is not advisable to let them undertake long and difficult journeys, which is why the convent of the Sisters of Mary in Boma, located 500 meters from the Fistula Clinic, has been renovated and new premises built to accommodate patients in comfort and dignity. They are housed, fed, and cared for by Sister Bernadette Nzemba, her fellow sisters, and Mama Anna, a fistula survivor who chose to stay to help those with whom she shared her suffering. All costs are covered by Fistul-Aid.

Due to the circumstances surrounding Covid, there were no Fistula Aid missions to Kinshasa in 2020, but we tried to improve working conditions at the Fistula Clinic, particularly the water supply system in the operating theater and hospital wards. The information and recruitment missions usually carried out by Dr. Paulin Kapaya could not take place. However, in 2020, 90 operations were performed with excellent results by Dr. Dolorès Nembunzu and Dr. Paulin Kapaya.

Creation of a new hospital ward with 15 beds exclusively for patients with obstetric fistulas. Within the Kabondo General Reference Hospital (Kisangani), FIKIS has become a unit like any other (internal medicine, emergency, pediatrics, etc.). Two missions took place in March and June. A third took place in November. A Fistul Aid team, composed of Dr. François, Dr. Cassano, Dr. Barelli, Dr. Dolorès Nembunzu, and Dr. Ange Mukiliboy, performed fistula surgeries in Kisangani and Kisantu. The mission in Kisangani was a real challenge given the election fever and associated logistical problems in this very isolated city. In addition, the rains were heavier than usual, making the roads more difficult to use. The conversion of the former radiology pavilion into a hospital ward for FIKIS has progressed well. The ward is equipped and all patients who underwent surgery stayed there. We have now appointed Dr. Agnès Kombozi (see photo), a doctor at Kabondo Hospital in Kisangani, as the person in charge of all FIKIS premises. The mission in Kisantu (Bas-Congo) was carried out in collaboration with our Flemish colleagues from SOLFA (Solidarity for African Women). We operated on a total of 29 patients, 22 of whom had fistulas and 7 had urological problems. 27 of the 29 patients were cured. At the end of 2023, there was a significant change in the composition of the board. Prof. Jean De Leval (president) and Dr. Emile De Backer (secretary) decided to step down from their positions. Dr. Philippe François took over as president, while Dr. Jean-Hubert Maquet became secretary. However, the two founders remain closely involved with Fistul Aid. We extend our sincere thanks to them for the passion and energy they have devoted to this cause and greatly appreciate their commitment to continue supporting us with their wisdom. The new board has chosen to include urology in the association's statutes. This decision is based on two major factors: on the one hand, the expertise already present within our team, which is largely composed of urologists; on the other hand, strong local demand for this type of specialized care.

In 2025, two missions took place. The first mission took place in February in Kinshasa (FIKIN), where the FIKIN team, led by Dr. Dolorès Nembunzu, warmly welcomed Dr. Agnès, who came to complete a skills enhancement internship. In June 2025, the mission organized in partnership with the Kabondo General Reference Hospital (HGK) enabled 20 fistula cases to be operated on, several of which were particularly complex. Of particular note was a remarkable advance: for the first time, general anesthesia with a respirator was performed in Kabondo, thanks to the preparatory work carried out by Jean-Marie during the November 2024 mission. This anesthesia was supervised by Justin Kimbien, who has been faithfully present on every mission since 2022 and whose expertise has become indispensable to the smooth running of the operations. L’organisation des missions, le travail chirurgical et le suivi post-opératoire gagnent en fluidité et en efficacité, grâce à une implication croissante des partenaires locaux. In Kinshasa, the Fistula Clinic at Saint Joseph Hospital (FIKIN) remains the national referral center, with more than 2,000 cases operated on since its creation. It continues to receive and treat patients throughout the year, between surgical missions.