Dr. Charlotte Polle-Kaliti is a pioneer. She was the first person from her community to go into medicine, later becoming an obstetrician and gynecologist, then eventually a fistula surgeon. Out of 11 fistula surgeons in her home country of Kenya, she is the only woman represented.

In the years she has been practicing medicine, she’s broken barriers for herself, her community, and her patients.

Today, Dr. Polle-Kaliti is a gynecologist and an internationally accredited fistula surgeon through the International Federation of Gynecology and Obstetrics (FIGO). She chose this field to help the women who had qualms visiting male physicians about reproductive healthcare.

“In my community, a woman would have a reproductive concern and when they noticed it was a male doctor, which was almost always the case, they wouldn’t feel comfortable telling them what the problem was. So, they’d lie about having a headache or something else and leave,” she explains. But with Dr. Polle-Kaliti as the surgeon, many of these women can now have peace of mind while receiving the help they need.

Medicine, Calling, and Privilege

Dr. Polle-Kaliti’s passion started early. While growing up in a small village in Kenya, she noticed her community couldn’t always access the healthcare they needed.

“I remember seeing a lot of suffering and disease. A woman would be pregnant and while giving birth would die and that was all. It was so common.”

Dr. Polle-Kaliti explains that this lack of access was deeply rooted in economic and geographical factors. Most people had no access to healthcare – and when they did, they typically could not afford it. When her sister suffered chronic illness, this disparity hit close to home. Her father was the sole provider, and the family’s limited financial resources went towards exorbitant medical bills.

Seeing the challenges both at home and in the community sparked her inspiration to go into medicine.

“I kept asking why people had to go through this. Was there something that could be done?”

The idea simmered, and when it was time to pick a course for university, she launched herself into the rigors of medical school.

It wasn’t easy. Her father wanted her to have a back-up plan. At the time, careers in medicine remained predominantly male. The closest she had come to seeing female representation in medicine was her aunt, a nurse. She remembers visiting her aunt and marveling at how much the community relied on her as the only healthcare professional around. This further drove her desire to study medicine – specifically, a condition called obstetric fistula.

Treating Obstetric Fistula in Africa

Obstetric fistula (OBF) is an injury that occurs when women experience prolonged, obstructed labor during childbirth. Left untreated, the condition can cause incontinence and leave a woman leaking for the rest of her life. Today, an estimated 2 million girls and women in Africa live with a fistula.

“The women who suffer fistula are mostly always from poor backgrounds and cannot afford surgery,” says Dr. Polle-Kaliti. “These women often face discrimination and marginalization; some live in discomfort and shame for decades.”

The stigma and lack of awareness around fistula particularly frustrates Dr. Polle-Kaliti. “Because some communities don’t understand that fistula is as a result of obstruction and is a treatable condition, they ascribe it to myths such as witchcraft and curses.”

In such instances, she explains, the women are ridiculed and cast out: “It is a lonely and secluded life.”

Passing on Her Knowledge

Mercy Ships has performed a series of women’s health surgeries, including OBF, every field service going back at least 10 years. These operations take place free of charge on board the organization’s floating hospital ships, primarily located in sub-Saharan Africa.

Dr. Polle-Kaliti has volunteered to perform these surgeries three times: twice in Cameroon and recently in Senegal. During the 2022 field service in Dakar, the program ran for 6 weeks and provided 34 women’s health surgeries. Fourteen of these were fistula repairs.

“There are those who can give a coin, and there are those who can give their skills like us (surgeons),” she explains why she volunteers her time.

After a series of successful fistula surgeries, Dr. Polle-Kaliti joined the women for a Dress Ceremony. The hospital team holds this celebration, filled with dance and music, every time women’s health patients are discharged. The women are given new dresses so they can look their best, symbolizing their new beginnings.

While these are stories of hope, they are also stories of a tragedy: the fact that stronger health systems would have prevented these fistulas in the first place and the women would have gotten help earlier. Dr. Polle-Kaliti says a lack of adequately trained surgeons is one of the barriers to scaling up fistula treatments.

As part of Mercy Ships Medical Capacity Building (MCB) program, Dr. Polle-Kaliti recently had the opportunity to mentor Dr. Abdourahmane Diallo, a urologist from Senegal. They worked closely together, with Dr. Polle-Kaliti sharing surgical skills she had learned in her career. She believes this type of mentorship and training is just as important as performing surgery.

“You don’t want to just come and help a few women and leave, because these women will go and tell of their stories of healing and the others who didn’t know they could get help will come. The fact that we can train local surgeons to pick up the mantle, we have a pool of expertise who will continue with the work.”

Dr. Diallo works at Hospital General De Grand Yoff in Dakar. He says women, especially those in rural areas of Senegal, are constantly at risk of obstetric fistula due to poverty, limited healthcare infrastructure, and early marriages. His hospital sees several fistula patients in a month, but there are even more who don’t show up.

“Some live far from hospitals so they don’t come back after consultations because they can’t afford the cost of the trip and hospital costs. Some are so ashamed, so they don’t even consider coming to hospital.”

Dr. Diallo has been working as a urologist for 10 years, with a focus on urinary tract systems as well as reproductive organs. At the hospital he also does fistula repairs. In the past few years, he has become increasingly interested in minimally invasive surgery. He was excited to learn from Dr. Polle-Kaliti, whose stitching and suturing techniques impressed him: “She has flawless technique which I will be using on my patients.”

As Hospital General De Grand Yoff is a teaching hospital, Dr. Diallo says he will be bringing what he has learned to his colleagues and students. “That’s the beauty of this mentorship; it will have a trickle effect. I have learned so I will teach.”