A helping handbook

Working hard on an assignment usually results in a good grade and the satisfaction of a job well done. For International Development Studies student Katharina Gref, the talent and dedication she brought to a class project has her set to become a published author.

As part of a third-year Global Health course, Katharina researched and wrote a village health worker guide about obstetric fistula, a serious medical condition marked by tearing and tissue damage that can happen during prolonged, obstructed labour. She chose to focus her research on Nigeria, a country with some of the world’s highest rates of the condition.

According to Katharina, the impact of obstetric fistula is social as well as medical. “There’s a lot of social stigma around it,” she explains. “Women are excluded from their communities.

“It’s a horrible condition medically, but the social aspects of it are also devastating.”

In creating a handbook-style document designed for use by health-care workers from midwives to doulas to doctors, Katharina dove deep into her research.

“I looked at what regional factors and social conditions were affecting this and how to prevent it. Because it is very preventable if you can access proper prenatal and maternal care,” she says.

“I went through medical journals, starting in the '80s through to the present, analyzing cases of obstetric fistula. I analyzed a lot of dry medical journal articles with a lot of statistical analysis and tried to pull the social conditions out of that.”

The path to publishing

Professor Robert Huish took notice of her Katharina’s diligent work and sent it to doctors and nurses for professional review. Incorporating this input, Katharina sent her handbook to Berkeley, California publisher Hesperian Health Guides, which agreed to publish it. The handbook is available at Hesperian's Books and Resources site (title: "Working Together to Stop Obstetric Fistula").

“It’s for a village health worker, any person in the community who can use what talents they have to reduce health problems in the region,” Katharina says. “It outlines tools for prevention, but also what you can do if you have this condition, where to access resources.”

What’s more, Hesperian Health Guides has asked Katharina to expand on her work. Beginning in January, she’ll spend 12-18 months working with a women’s health editor to develop a more extensive handbook on obstetric fistula, one that looks at the condition from a global perspective.

A meaningful impact

The publishing opportunities thrilled Katharina, who says she’s always been interested in global and maternal health issues. But more than anything, she’s happy to make a practical contribution.

“The fact that this could be accessed and used and possibly save lives, you can’t ask for more than that,” she says.

“Something I made has the chance to make a difference.”