In rural, underserved areas of Kenya, a lack of access to timely cesarean sections leaves young women vulnerable to the trauma of obstructed labor. Beyond the tragic loss of the child, the resulting prolonged pressure on pelvic organs causes severe tissue necrosis and the formation of vesicovaginal and rectovaginal fistulas. Leaking urine and stool continuously, these women are often heavily stigmatized and ostracized by their communities.
In this episode, Dr. Sharon L. Stein sits down with Dr. Anna Spivak, Section Chief of Pelvic Floor Surgery at the Cleveland Clinic, to discuss Campaign 52—an international medical relief initiative providing free, life-altering surgical care to these vulnerable women.
Unlike top-down, Western-driven mission trips, Campaign 52 operates at the explicit request and direction of local Kenyan surgeons. Dr. Spivak shares how this collaborative, local-first framework allows a specialized task force of colorectal, gynecologic, and urologic surgeons to tackle an overwhelming backlog of complex pelvic floor conditions, directly target the exact procedural needs of the community, and systematically build lasting hospital infrastructure.
Global Surgery Best Practices:
For residents, fellows, and surgeons looking to participate in humanitarian work overseas, Dr. Spivak outlines a foundational rulebook:
- Do not establish a short-term camp without locked-in, long-term, perpetual aftercare. Campaign 52 ensures close, local, long-term clinical checkups, pelvic floor physical therapy tracking, and remote communication via the Fistula Foundation.
- Front-load your schedule. Round on 100+ triage patients on day one, and position the highly complex, multi-hour operations early in the week so patients have adequate time to recover safely before the traveling team departs.
- Do not show up to enforce what you think a population needs. Identify local clinical hubs seeking discrete clinical education or structural backlog reduction.
Key Takeaway for Listeners:
"In the United States, some equipment would be in the garbage a long time ago. Because they have very little, they truly utilize everything they have. Limitation begets creativity. When Dr. Mabeya fixes these complex fistulas, he is truly saving souls. He's giving these women a chance to be alive, to take care of themselves, and to contribute to their society." — Dr. Anna Spivak
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