Dr Andrew Browning says it’s hard to pick his most memorable patient, because there have been so many since he began working in Africa over two decades ago. “In the ward right now, I have a little girl who says she was born in 2006,” he says, “She was raped, got pregnant and tried to deliver in her stick-and-mud hut in her village. After two days, she was brought to hospital and had a cesarean by an inexperienced and poorly equipped doctor. Although she got a live baby, she came to us nearly dead. We had to resuscitate her. I operated, had to remove her uterus, and she is now gaining strength. She’s very lucky to be alive.”
Many of his patients are from war zones. “One was raped by 10 soldiers,” he says, “She was pregnant, so they cut her open in the forest, ripped out her baby and left her to die. When I treated her, she was so happy I asked how she could be. She said that God had bought people to help her.”
These are just two patients, but the Australian obstetrician and gynaecologist – who lives in Arusha, Tanzania, with his wife and their two sons – has been involved in the care of over 10,000 people in over seven countries. So, how did an Australian doctor end up in Africa on a mission to revolutionise maternity care?
“From a young age, I always wanted to be a missionary doctor,” says Dr Browning, “At the age of six, I heard a missionary nurse speak at my church Sunday school and I never looked back.”
As a medical student, he was stationed in a mission hospital in Tanzania and worked at refugee camps on the border with Rwanda at the beginning of the genocide. As a junior doctor, he worked in the desert of Ethiopia, before returning to Australia to study theology, then moving permanently to Ethiopia in 1997. It was the Ethiopian government that suggested he specialise in obstetrics and gyneacology (after rejecting his work permit).
With just 20 per cent of married women believed to be using some form of family planning, Africa has the highest birth rate of any region on earth, and some of its most impoverished areas. UNICEF suggests that the risk of stillbirth or death due to birth complications can be reduced by around 20 per cent with the presence of a skilled birth attendant. However, only 50 per cent of women in sub-Saharan and south and east Africa have such access.
Statistics like these drive Dr Browning’s work. Specialising in the treatment of fistulas, he is the founder of Maternity Africa in Tanzania – a not-for-profit organisation dedicated to helping women across Africa by making child birth safe – and runs maternity hospitals in Tanzania and Ethiopia, supervising the delivery of around 8,000 women a year.
His work is supported by the Australian organisations The Barbara May Foundation and The Mother Africa foundation, whose social enterprise sells leather nappy bags for men – a gap in the baby product market – with all profits going towards healing African mothers. The profits from two ‘Dad Bags’ enable a fistula operation and pay for two weeks’ accommodation with three meals per day whilst the woman recovers. They also sell Babes Blessing wine, in partnership with the Austrian winery, Soul Growers.
But, there are always more people to help. Maternity Africa is currently engaged in its largest project to date – building the Kivulini Maternity Centre in Arusha (Kivulini is a Swahili word meaning shade).
The complex includes 44 beds, a dedicated skills lab and staff hostel, fistula surgery, waiting areas and a café for patients. When at capacity, it will be able to safely deliver 2500-3000 women per year for free, in additional to 10,000 clinic visits, 2000 family planning visits, 150 fistula operations and train 60 midwives in clinical skills per year. They also plan to run outreach programs to villages teaching safe motherhood and reproductive health.
“We’ve already got a couple of similar, but smaller, hospitals in Ethiopia,” says Dr Browning. “The hospital in Arusha will cost nearly AU$1million to run per year. Ethiopia is cheaper. In our hospital in Barhirdar, Northern Ethiopia, we delivered over 2000 women and 7500 clinic visits last year for US$203,000. That’s very cheap when it includes all salaries, medicines, laundry, water, electricity.”
It’s proof that a relatively small donation can make a difference – even the cost of a men’s nappy bag. “My hopes for the future is that all women in Africa will have access to a safe delivery,” says Doctor Browning, “No woman should have to suffer unnecessarily.”
Visit The Mother Africa Foundation to support Dr Browning’s incredible work.