Driving birth injuries out of Africa

Cate Swannell
Med J Aust || doi: mja2.50205
Published online: 24 May 2019

DR Andrew Browning AM, co-founder of the Barbara May Foundation and renowned fistula surgeon, comes from a family strong with the altruism gene.

His grandmother, Barbara May Browning (1916-2004), the inspiration for the Foundation, placed “little value on material possessions and always looked to improve the lives of others”.

His aunt, Valerie Browning AM, has lived among the Afar people of Ethiopia for over a quarter of a century, working to improve maternal and child health, and literacy, and seeking to eradicate practices such as female genital mutilation.

His father, Dr David Browning OAM, another co-founder of the Foundation, is a retired obstetrician and gynaecologist who has served the Bowral region for 31 years (3).

His uncle, retired Bishop George Browning, was Bishop of Canberra and Goulburn from 1993, was awarded the Centenary Medal in 2000 was Chair of the International Anglican Communion Environment Network from 2003-2011.

Andrew Browning, however, never felt any pressure to follow the family business, either medically or geographically. Instead, it was through the church that he found his path.

“I was 6 years old and at Sunday school we were visited by a missionary nurse from Tanzania, and listening to her talk about her life and work, I knew that this was what I wanted to do,” Dr Browning tells the MJA.

At 14 he became a Christian and by the time he had graduated from the University of Sydney’s medical school he knew that he wanted to be a missionary doctor.

“I had spent my elective term at Murgwanza – a hospital in northern Tanzania, close to the border with Rwanda. It was the summer of 1993-94 and the genocide in Rwanda was just starting, and suddenly we had 20 000 refugees land on our doorstep.”

Back in Australia Dr Browning quit his RMO1 year at Gosford Hospital and studied theology for a year, realising along the way that he was “much more of a surgeon than a theologian”.

In 1996 he returned to Ethiopia to visit his aunt Valerie and Dr Catherine Hamlin at the Fistula Hospital in the country’s capital, Addis Ababa. An invitation to work there followed and after completing his OB/GYN training back in Sydney, a permanent move to Africa ensued for Dr Browning, his wife Stephanie.

After 17 years running fistula and maternity hospitals in Ethiopia, as well as fistula camps in Malawi, Sierra Leone, Kenya, Chad, Uganda, Congo and Togo, Dr Browning and his family are back in Australia while their two sons, William and Christopher, complete their schooling.

Dr Browning returns for regular 3-week visits to Africa, however.

“I’m just about to head back,” he tells the MJA. “I’ll be spending a week in Barhirdar (at the first regional Hamlin Fistula hospital) troubleshooting and seeing what needs doing, then a week in Uganda where there are 30 fistula patients to see, then a week at our new maternity hospital in Tanzania where there are another 30 fistula surgeries on my list.”

Fistula – a birth injury with lifelong consequences if left untreated – is a direct result of a lack of surgeons trained in caesarean sections.

“When I arrived in 1997 in Ethiopia, there were many cases of fistula,” says Dr Browning. “By the early 2000s if we put an announcement (of a fistula clinic) on the radio, many women would come.

“It’s not quite like that anymore, so we have made progress, but there is still much more work to be done.

“We see a lot of iatrogenic fistulas,” says Dr Browning. “That’s because surgeons [and midwives] are not getting trained properly.

“So, we take them into our hospitals for 6 weeks for clinical training to update their skills.”

Future plans include building a new maternity unit on a parcel of Ugandan land.

In 2009, Dr Browning, his father and his uncle founded the Barbara May Foundation in honour of the family matriarch, as a way of funding Valerie and Andrew’s work in Africa. According to the Foundation’s website, “Valerie works through the Afar Pastoral Development Association based in Mille (Afar), Ethiopia”, and Andrew “works through Maternity Africa, based in Arusha, Tanzania, and the Vision Maternity Hospital in Barhirdar”.

The Foundation’s mission is to provide “free high-quality medical care and sustainable development” by:

  • advocating for women’s health and well-being regardless of race, religion or financial standing;
  • providing education and information on modern women’s healthcare while remaining sensitive and respectful of local traditions and culture;
  • implementing systems to train local maternal health providers in sound clinical skills and competency; and,
  • driving the improvement of available medical facilities, and, where required, the provision of additional infrastructure.

The inspiration for Dr Browning remains his aunt.

“For all that Catherine Hamlin is a shining star, Val is the most extraordinary person I’ve ever met,” he says.

  • Cate Swannell



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