About Darius (Admin)

Darius (Admin) has written 25 articles so far, you can find them below.

2016 April – Trip Report – 67 Lives Touched

April 6, 2016

Dears Friends and Supporters,

We would like to report that we had a very successful 5 week trip during February & March.  Over 50 surgeries were completed.  I am copying a thank you note Paul Robinson our Facilities and Administrative Head sent to one of our donors in Sierra Leone and this message says it all!   Paul spends  85 % of his time in Sierra Leone.

“Just a short message of thanks, you are most likely sitting comfortably in your home or office with friends, family or colleague’s around you, the reality here is that the ladies that you have helped with your generosity just don’t have any of the comforts that surround you.

Many have leaked urine, and or feces for a long time, one of our recent patients suffered this horror for 44 years, now thanks to you and people like you she is now dry and clean, and so so happy.

Every day I see the anguish, pain and suffering of these ladies, some of them have had the indignity of being chained to a tree or locked in a shed, treated as witches and outcasts because of their problem known as fistula. And then after surgery the joy and smiles that say they have their dignity restored, and it’s thanks to you that this has happened.

It will be very difficult for you to imagine the prior life of these ladies, but believe me, you make a very big difference to their future lives, thank you so much.”

Paul Robinson
West Africa Fistula Foundation

We had the opportunity to film 2 patient testimonies and a documentary that was put on by the Fistula Patients and directed by our Matron Mariam Swaray.  I think you will enjoy every minute.  See below links:




2015 – October WAFF Trip Report

Dear Friends and Supporters,

Our most recent trip was the most productive and gratifying trip in the last 13 years I have been going to Africa. Due to the Ebola situation we were not able to return to our ward at the Bo Government Hospital. Over a year ago we leased an old HIV facility for overflow patients and Paul Robinson, our facilities manager, refurbished and had it up and going as a hospital in 6 weeks. For the first time ever we had electricity and running water for the entire trip.

Our staff is extremely proud of this facility and we believe we have the nicest facility in the country.

We performed 67 procedures, 8 exams under anesthesia. Unfortunately, we had 5 women we had to send to their villages to die because they had terminal cancer of the cervix.

I produced a power point that exemplifies the August-September trip. Below we have provided 2 possible links to view the power point.

We want to thank you for your interest and support during these very trying times for the Sierra Leonean people.
Darius R. Maggi M.D.
West Africa Fistula Foundation


WAFF – Tickets Booked. Bags Packed. Patients Waiting!

Dear Friends and Supporters,

Just a quick note to let you know plane tickets have been purchased and surgeries will begin again in August.  We are so excited to return, get organized and get back to the business of helping the women of Sierra Leone.

Our facilities manager, Paul Robinson (from England), arrived several few weeks ago and is already hard at work getting things put in order.

Kathi Beasley, an incredibly talented photographer/videographer, created this lovely video to highlight the work we do at WAFF.  Please take a look and let us know what you think!  We would love to hear from you.

Be sure to check out our Facebook page to watch our progress!  Be sure to  “Follow” / “Like” our page and also share with others!
Darius R. Maggi M.D.
West Africa Fistula Foundation

2015 – June WAFF News

Dear Friends and Supporters,

It has been several months since our last letter, and while I sincerely hope you and your families are doing well, I am sad to report the situation in Sierra Leone has continued to worsen. As most of you know, the Ebola scare dominated the news while there were infected patients here in the United States, but now it seems it has mostly passed as a just small blip on this country’s temporary news radar, almost forgotten by most. Unfortunately, the devastating effects of this disease are still being strongly felt in Western Africa, particularly in Sierra Leone. While the actual number of Ebola cases is decreasing, and the death tolls are not sky rocketing like they once were, the health care community of the country has been completely ravaged. We are VERY, VERY fortunate that we have not lost any of our direct staff, but there have been a catastrophic number of lives lost all across the medical workforce, including doctors, nurses, aids, and many others who had been participating in the care of these very sick people.

As you can imagine, the quality and availability of care has suffered tremendously just due to these losses alone, but even further, the psychological, mental, and emotional well-being of much of this country has been significantly altered, not only from the direct effects, but also due to the wide-spread changes implemented as a result of this epidemic. For instance, the government is trying to enforce a system for the handling of all bodies of people passing away at the hospitals. They are calling for specialized teams to come in, wrap the bodies in protective material, and haul them off to mass graves, so as to not allow for any family members or healthcare workers to be exposed to any potential contamination or spreading of the Ebola virus. This is regardless of whether or not the patient was diagnosed with Ebola-like symptoms. While I am not questioning these particular efforts of the government (as they have an enormous challenge in front of them), you can imagine the pain just this particular change is causing.

I am reluctant to confine this horrible situation to just one story, but below is just one brief account of one day, as experienced and told to me two days ago by Paul Robinson, our Director of the program, in Sierra Leone right now:

Good morning Dr. Maggi,

A child died on the maternity ward this morning (ward 6). Imagine the mother’s anguish at losing her baby and then having to suffer the indignity of seeing its lifeless body bundled into a plastic burial bag to be taken away to a mass burial ground. Ebola did not kill this child, yet the whole family were victims nonetheless. All dead persons are treated this way now, no matter what the cause of death.

Later today, I again heard the wails, shouts and screams of the same anguish – a young mother died shortly after giving birth. The child lived this time, but the mother is taken away in a burial bag to the same mass burial ground. Ebola is again not the killer, but the result is still the same, another family shattered!!!

The maternal care that is so badly needed is just not here. Midwives are in such short supply that maternal problems have increased dramatically. Nurses that could help to stem this increasing loss of young lives are just not here. Ebola has crippled these people in ways that you cannot begin to imagine. Can you imagine the pain of not tending to your sick child’s last needs, not having the last cuddle, hold, or touch? Then having to watch as it goes into a plastic burial bag and is hauled off, can you?

Another true story, one of our nurses, Vero, was ordered to go to Daru as part of the Ebola treatment team. She went, but she was the ONLY ONE of that entire medical team to leave that treatment centre alive.  All her colleagues died, every one DEAD! Thankfully she is back with us now amazingly, and as a skilled midwife, she will be invaluable to us and the people of Salone.


Again, this is just one tiny snapshot of the everyday reality the people of this country are facing. It is almost impossible for us to imagine, but it is so very real.

With that, you can see we have plenty of work to do. I am planning to go back over at the end of July or the beginning of August; meanwhile, Dr. Manna, Paul, and the entire team have done an incredible job keeping our program alive and relevant during this extremely challenging time. We have intentionally delayed as many non-life-threatening procedures as possible, but with your support, we have maintained our staff, maintained our patient flow, and maintained our facilities to enable us to stay in a position to help as many people as possible, as the situation permits.

Now, our patient load is enormous, and our needs are great. We have always been hesitant to directly ask for any donations or support in these “update letters”, as we have been amazingly blessed with the generosity of our supporters all these years. However, at this time, we would like to let you know your help is needed now as much as ever. There are three primary reasons we could use any extra support at this time. First and foremost, our operating costs are undoubtedly going to be higher for the foreseeable future – we have a very large number of patients awaiting surgeries, not to mention the increasing number of emergency cases that are showing up at our doors, looking for any help we can give them. So while our dollars can still do an enormous amount of good, the sheer volume of work is as high as ever. Second, the vast majority of our beds, fixtures, and supplies in our primary ward were sacrificed to help ease the burden of caring for all the Ebola patients at the hospital we share with the government. The influx of patients was incredible, and the space was very limited, so our ward was used as an overflow treatment area, and in turn, almost all of our beds and furniture has been lost or destroyed. Lastly, we could really use one or two more vehicles. We try to be extremely conservative with our spending and our use of any items like this, but they are a necessary part of the program. If there is any silver lining here, it is that the opportunity to acquire vehicles at a reasonable cost is better now than it has been historically. Due to a large number of organizations retreating from this very difficult environment, there is actually a decent surplus of good, used vehicles that are already in country. So these can be acquired reasonably without having the expense of shipping, importation, and all the other costs associated with bringing them in. While it’s a sad reality so many people are leaving, given our needs for a vehicle or two, this is actually an opportune time for us to get them.

I apologize for the length of this letter, but I wanted to try to convey the severity of our situation and let you know we very much appreciate each and every one of you, and we could not do it without you.

As always, please feel free to contact me if you have any further questions.

With Gratitude,

Darius R. Maggi M.D.
West Africa Fistula Foundation
3621 Pottsboro Rd #150
Denison TX 75020

2014 – December

Dear Friends and Supporters,

As we approach this Holiday season and are so thankful for all of our blessings and good health the situation in Sierra Leone for the last several months has been very trying for these wonderful people. Despite all of the deaths and devastation from the horrific disease of Ebola our staff and their families have avoided contracting this disease so far.

I was informed yesterday of the death of Dr. Tom Rogers due to Ebola at the Connaught Hospital in Freetown. I first met Dr. Rogers at the Bo Government Hospital in November 2002 which was my first visit to Sierra Leone. I will never forget his enthusiasm when I first met him and his dedication to the patients as this was immediately after the war. He will be missed by all that knew him. His nephew Benjamin Rogers worked with us several years bringing patients to our hospital that he gathered from the bush.

Unfortunately the incidence of obstetrical fistula will be on the rise because the health care system has been saturated with Ebola cases. Because you have been so generous we have been able to continue supporting our staff there with salaries and helping them avoid unnecessary exposure to the virus. They are very loyal and ready to get to work hopefully when things settle down as we will be overloaded with cases of all types.

I wanted to give everyone an update to let you know the situation as it exists today and that we are eager to get back to Sierra Leone. Again we cannot thank you enough for your prayers and support during this time of crisis.

We want to wish everyone a very Merry Christmas and a very Prosperous New Year.


Darius R. Maggi M.D.

West Africa Fistula Foundation

3621 Pottsboro Rd #150

Denison TX 75020

2014 – September

Dear Friends and Supporters,

I wanted to give you an update as to what is going on in Sierra Leone and had hoped by waiting a few weeks it would be good news, but unfortunately the Ebola outbreak has just escalated.  We were scheduled to go back to Sierra Leone July 29 and operate on several patients but because the majority of the surgeries we do are elective and not emergency cases we elected to suspend doing surgeries and avoid unnecessary exposure to our health care workers and patients to the Ebola virus.  The morgue and holding area for the Ebola patients were just a few feet from our ward and the possible mixing of our patients was concerning to us.  This virus is extremely wicked and as all of you know very lethal to the majority of the people that contract it.

We have 32 Sierra Leonean employees that work with West Africa Fistula Foundation and are extremely loyal and dedicated to caring for the patients.  We have assured our employees and their families we will continue to support them because the cost of food and basic necessities have gone sky high due to the disruption of the economy this unprecedented disease has caused.

I have been on the phone with our staff almost on a daily basis and have been told of numerous unbelievable stories of people dying from this disease.  One particular story ismind boggling in that one of the nurses at the Bo Government hospital contracted the disease, subsequently passed it onto all 10 of her immediate family members – including her husband, children, siblings and parents – and every one of them died.  Below is an example of a text I received from Aminata our Nurse in Charge for WAFF:

I am saying a very big thank u to u for taking care of us at this time that EBOLA is in our country.I am greatfull.God will bless u and your family.people are infected every day.but by his grace we will live to tell the story. Ebola has entered freetown and it is killing people more than were it started.i am so worried.so many nurses have deid in freetown.A nurse that was like a sister to me died here in Bo of Ebola now her family is no more every body is died inculding her two years old daughter.this is serious.oh GOD have mercy  – Sent from my iPhone
We are committed to continue helping the people of Sierra Leone, and this horrific disease reaffirms that our vision for better health care facilities is so much needed. I am telling you that helping these people is the most gratifying experience one could imagine. We are asking for your prayers and appreciate your continued support. Feel free to call or email me if you have any questions.

With gratitude,
Darius R. Maggi, MD

West Africa Fistula Foundation

West Africa Fistula Foundation
3621 Pottsboro Rd #150
Denison TX 75020

Find Us On Facebook!


WAFF Staff assisting a patient.

WAFF Nurse – Rachel
Sierra Leone cooking
WAFF Staff – Kadiatu

Dr. Mannah with Kabba (WAFF Maintenance)

2014 – May

Dear Friends and Supporters,

Well I know I am late but we have had a lot going on. Our last trip was Feb. 2, 2014 and we had many patients anxiously awaiting the surgery that would change their life back to normal and fortunately we were able to successfully help 85% of these ladies as the other 15% had had multiple surgeries previously or were deemed irreparable until we get our new facility which will allow us to have a 100% success rate on these ladies.  We also were able to operate on many women and young girls for Gynecological conditions including a lady that had a 22lb. tumor that was fortunately benign (not malignant).  Unfortunately we continue to see many women with cancer that if seen earlier would have a very good chance of survival.  We had a 14 year old girl with severe complications from FGM (Female Genital Mutilation) we were able to repair and restore her to a near normal condition.

To give you an idea how life changing surgeries can be we had 2 ladies that had had urine running down their legs for 50 years and 34 years respectfully that walked out of the hospital completely dry.

Dr. Susan Hardwick-Smith continues to amaze all of us with her efforts in fund raising as she again competed in the Iron-Man competition in New Zealand surpassing her previous record by raising $33, 593.60 which was donated to the West Africa Fistula Foundation by many of her friends and patients.

During this trip we were honored to have the Restore Hope Foundation associated with the First Baptist Church in Arlington, Texas and several of their board members and spouses visit our facility as they also have projects in Sierra Leone. We also had Mr. Steve Pfieffer, a board member of Project Hope, come and tour our program.

A few weeks ago a group of ladies from the Gateway Church in Southlake Texas visited our site and had prayer with the patients on the ward. We very much appreciate all those that contribute to the physical and spiritual needs of our patients and their families.

Bottom line we continue to make great strides with each member of the WAFF team very dedicated to helping the less fortunate and with the Good Lord’s Blessing we will prevail.
We again appreciate your support to make a difference in this world.

For those of you that shop with Amazon.  AT NO ADDITIONAL COST TO YOU, Amazon will donate 0.5% of your eligible purchase to WAFF if you will go to www.smile.amazon.com to do your shopping.  It is the same products, same price, same service.   When you log in just be sure to change the charity to West Africa Fistula Center Foundation.  Even better, at checkout, there is a place for you to spread the word that you have donated to WAFF via social media!

With gratitude,
Darius R. Maggi, MD

West Africa Fistula Foundation

West Africa Fistula Foundation
3621 Pottsboro Rd #150
Denison TX 75020

Find Us On Facebook!


Dry for the first time since 1964

Josephine preparing potato leaf for the patients’ meal.

Happy patient after surgery! !

Sierra Leone cooking
Sierra Leone children with homemade toys.

Creative recycling with a gas can, tomato cans, sardine can and pop bottle lids!

2014 – January

Dear Friends and Supporters,

To All of our WAFF Followers and Supporters,

Once again, we are greatly humbled by the kindness and generosity so many of you have showed over the past year. Our program continues to positively impact so many lives in Sierra Leone, and we are extremely grateful that this is all made possible with your help.

The year ahead will bring more challenges to be sure, but as you have proved so many times, these challenges are met and exceeded by the compassion of our supporters. Just this month, we received an amazing donation from one of the neatest, most encouraging sources we have encountered to date: a pair of 14 and 16-year-old sisters. These young girls, operating under a non-profit called Pretty Purposeful, show a sense of caring and maturation way beyond their years and are a tremendous inspiration to all of us. I would encourage you to learn more about their story at www.prettypurposeful.org.

One of our own team members, Dr. Susan Hardwick-Smith, is also leading an effort in raising funds and awareness for our program, and we have attached a letter she recently sent, outlining her impressive commitment.

There are obviously many more stories, and no effort – however large or small – goes overlooked or unappreciated. The women of Sierra Leone are so appreciative for each and every one of you, and we feel very blessed to be able to continue to help them with your assistance.
Thank you for your continual support, encouragement and involvement with our organization.

With gratitude,
Darius R. Maggi, MD

Here is complete information about Iron Man Fundraiser Dr. Susan Hardwick-Smith is involved in:

Dear Family and Friends,

Most of you know about my involvement with the West Africa Fistula Foundation (WAFF) in Sierra Leone, West Africa. In 2013 I had the opportunity to make three trips to Sierra Leone and was part of a small team that operated on over 50 women and girls (like 15 year old Gitta pictured below) suffering with chronic urine and fecal leakage due to obstetric fistulas. As you know this horrific problem is caused by unattended childbirth and is completely preventable with education and the availability of basic obstetric interventions. This year I plan to make a similar commitment as it has truly the most rewarding experience of my life.

WAFF is a small organization, funded entirely by our friends and private followers as well as the physicians themselves. Donations fund operating expenses including the salaries of 15 full time local staff in Sierra Leone who care for our current patients and admit new ones to our dedicated fistula ward, and our administrative services in the US are all donated. If you have ever wanted to do something to make a difference in the developing world but were not sure how to do it or whom to trust, helping to support some of the most unfortunate women in the world through WAFF is a great opportunity to bring about real change in a cost effective way.

While fundraising is not my passion, I have learned through my own giving the wonderful things that grow from generosity, so I invite you to be a part of this cause knowing the great satisfaction that you will gain from it. To make it fun, I have once again committed to an enormous personal challenge this year and invite you to sponsor me to compete in the Ironman New Zealand race on March 1, 2014. Through my first Ironman race in 2012 I was able to raise over $30,000 for WAFF and plan to exceed that amount this year. Every penny of sponsorship goes directly to WAFF and is carefully used to fund our local operation in Sierra Leone, including the surgery itself as well an average of 12 weeks of housing, nursing care, treatment of active conditions including anemia, malaria and parasitic disease as well as vocational training and nutritional support.
On my last trip to Africa in October 2013 I was joined by my friend and professional photographer Kathi Beasley, who made the short (8 minutes) video below to kick off our fundraising drive for a new hospital which is being designed and built by WAFF. Please take a look at this video to see the work we are doing and please consider sponsoring me to complete this race and help some of the poorest women in the world.

Realm of the Free – West Africa Fistula Foundation and their Good Works for Women

Since the Ironman race covers 140.6 miles including a 2.4 mile open water swim, a 112 bike ride followed by a 26.2 mile marathon, my suggested sponsorship levels this year reflect that magic number! While no donation is too small, sponsorship is suggested at one of the following levels:

Level 1- $70- 50 cents per mile, will pay a registered nurse’s salary for 1 week; or 2 weeks of food, housing and vocational training for a fistula patient

Level 2- $140 – $1 per mile, will pay a registered nurse’s salary for 2 weeks; or 4 weeks of food, housing and vocational training for a fistula patient

Level 3- $560- $4 per mile, will pay a registered nurse’s salary for 2 months; or 4 months of food, housing and vocational training for a fistula patient or patients

Level 4- $1400- $10 per mile, will pay all expenses for a single woman to be cured of her fistula.

Donations may be made directly to WAFF at www.westafricafistulafoundation.org (Please note “IRONMAN” in the comments line) or checks made out to West Africa Fistula Foundation may be delivered directly to me at 2725 Albans, Houston TX 77005.
WAFF is a registered 501 (c) 3 organization and all donations are tax deductible.

Thank you so much for your support, and follow my race progress live beginning on Friday February 28th at noon (Houston time) at http://www.ironman.com/triathlon/coverage/live.aspx#axzz2qtftb8ba

In gratitude, Susan


Dr. Susan Hardwick-Smith
West Africa Fistula Foundation
West Africa Fistula Foundation
3621 Pottsboro Rd #150
Denison TX 75020

2013 – November

Dear Friends and Supporters,

Dr. Maggi asked to share a report of our recent trip to Bo in October, and some of you may know this was my third trip with WAFF this year, so I am honored to feel like a real part of the team. As usual we arrived to a joyful greeting of song and dance, illustrating to me the hope that our visits bring to these women who have been counting the days until our arrival. Many of them were cured on this trip but some were not, and I could feel the weight of their prayer to be one of the lucky ones on that first day. The joy in the ward is something that is hard to explain amidst all the suffering, and the hopeful and faithful spirit of these women is truly amazing.

We were excited to bring along a professional photographer on this trip. Kathi Beasley is an incredibly talented photographer/videographer in Houston and volunteered her time and talent to capture images of the WAFF mission to help us raising awareness and funds. You can click on a link to her amazing video at the bottom of this newsletter.

We are happy to report that there were fewer fistula cases on this trip than usual, hopefully confirming that the trend towards more accessible obstetric care is a real one. In all we did 15 fistula repairs as well as several other gynecologic cases. Dr. Maggi is patiently training me in fistula repair, which is a surgery we never do in the Western world, and I was excited to perform some of our easier cases with his skilled assistance.

As usual, on this trip we witnessed a number of deaths from things that should never have happened, highlighting the urgency of getting this hospital built. We were asked to see a young woman around 20 years old who had delivered at home the previous day and was in septic shock. We attempted to treat her with fluids and antibiotics but it was too late and she died that same day. Another young patient had arrived several weeks earlier with a spinal cord injury from a car accident, and was 30 weeks pregnant. Prior to our arrival she had not seen a doctor, and had not even had an x-ray. We did all we could for her but unfortunately she and her baby both died. These events are all too common and are part of normal daily life for these people, which is why the new hospital will hopefully offer not only fistula repair but general medical and surgical care as well.As someone quite new to the experience of practicing medicine in the developing world, each trip is still a roller coaster of emotions. The prevalent emotion is joy, at being part of a team that is literally restoring the hope of a normal life to these young women and girls, and at elevating healthcare in general for this incredibly needy country. The other prevalent emotion is the immense gratitude that I now have for all the things that we have in our wonderful country.  Thank you all so much for your continued support.Please look at the video below made with loving care by Kathi Beasley.



Dr. Susan Hardwick-Smith
West Africa Fistula Foundation
West Africa Fistula Foundation
3621 Pottsboro Rd #150
Denison TX 75020

Find Us On Facebook!


waff-1Dr. Susan Hardwick-Smith and Dr. Darius Maggi working together on a fistula surgery.
Fanta, age 16, was admitted a few days prior to our arrival, unable to walk due to nerve damage and close to death from infection. After some simple treatment with antibiotics and some loving care including a teddy bear donated by my daughter, she is smiling again and will have surgery on our next trip. As a mother myself, it’s hard to escape the reality that these girls are just children themselves.
WAFF_2Several of our patients, as usual, were teenagers. Gitta, age 15, had a second surgery on this trip, which thank goodness this time was successful.
waff-4One of the highlights of each trip for me is “ice cream day”, when each patient is served some ice cream which is an expensive delicacy in a country where electricity is a luxury The hospital continues to have no running water, which is hard to imagine, and electricity was spotty and unreliable.
As in our past trips this year, we spent some time in Bandejuma just east of Bo, at the site of our new planned hospital. Dr. Maggi’s vision of a new hospital with western quality healthcare for the people of Sierra Leone will hopefully soon be a reality, and our focus back at home is on planning and fundraising for this project.

2013 – September

Dear Friends and Supporters,

I apologize for this letter being late, as I am actually heading back over for another trip now and realized I had failed to get this update out from our last trip. However, upon returning this last time and having multiple meetings about the current WAFF situation and our goals moving forward, I keep coming back to the same feeling: our team is doing an absolutely amazing job despite conditions that are almost incomprehensible, BUT there is still SO much to be done…

First, the good. This last trip we had two Fistula patients that our nurses found and literally rescued from the brink of death. They were discovered malnourished, dehydrated, and so emaciated that they would have undoubtedly died had our nurses not found them – all because of the stench resulting from their fistulas. They had been isolated and shunned from their community because of their condition, and our nurses found them disoriented and confused. Now, due to the great work of our team, these two ladies will not only survive, but they will be able to start anew with their fistulas fully repaired.

Now, the challenge. I would like for you to take just a few minutes and really try to imagine:

  • Having your own son, healthy and normal, suffer a seemingly minor broken leg, but then he has to have that leg amputated because it became so infected after being treated by a traditional healer in the village

  • Being in an automobile accident where six of your friends were killed and now you lie in the hospital with unknown head and abdominal injuries but haven’t been seen for over 18 hours because there is no physician around

  • Your daughter lying in a hospital bed for 5-6 days, left extremely anemic from having malaria, but because there is no blood bank for her to get blood, she will probably end up dying

  • Your father having a simple hernia that resulted in his bowels being blocked and ruptured just because he could not find anyone to see him

  • Having a sister seemingly paralyzed from the neck down in car wreck, but when she arrives at the local hospital they have no x-ray machine, no neck brace, and no way to transport her in a stabilized position to the closest hospital that has such items, which is 5-6 hours away… So, she has to ride, sitting up in an ordinary taxi cab

  • Your wife or daughter dying from a pregnancy in the tube just because when she arrived at the emergency room there was no one there to see her

  • And finally, having your small child with pneumonia hooked up to oxygen, but because the machine supplying that oxygen is powered by a generator that runs out of diesel, your child dies

These might sound like some kind of terrible stories out of a bad book or movie, but I personally witnessed every one of these events with my own eyes, either as they happened or right after. So, while I am incredibly proud of the great work our team is doing (and I want to emphasize they ARE doing great work), it is so hard not to think about how much more has to be done. As many of you know, we have been and will continue to be focused on the care of women with fistulas and/or gynecological/obstetrical issues in general, but we will hopefully soon be announcing some more defined goals and plans for accomplishing those goals with your help and support. As you can see, there is so much to do.


Darius R. Maggi M.D. 
West Africa Fistula Foundation
West Africa Fistula Foundation
3621 Pottsboro Rd #150
Denison TX 75020


Dr. Susan with Sierra Leonean Children
Paul Robinson tracking vehicle maintenance
WAFF Staff getting ride in van to hospital
Andrea & Paul Robinson going over  the day’s duties

2013 – May – Dr. Susan Hardwick-Smith raises 30K for WAFF

Doctor runs triathlon to save women a world away

Posted: Saturday, February 16, 2013 2:15 pm susan hardwick-smith

On Saturday Feb. 16, Dr. Susan Hardwick-Smith, a Houston-area obstetrician/gynecologist (OB/GYN) and founder of Complete Women’s Care Center, will make her first trip to the West African country of Sierra Leone. Dr. Hardwick-Smith will make the trek in conjunction with the Texas based West Africa Fistula Foundation (WAFF), to help bring an end to the devastating effects of Obstetric Fistula.


“As a doctor in this wonderful country I am constantly aware of how very lucky we are,” said Hardwick-Smith. “While many of us complain about our healthcare system, most of us have access to at least basic healthcare. We expect a safe, good outcome from normal events like having a baby. But for many women in Sierra Leone in West Africa, having a baby is a truly dangerous business with maternal and neonatal death rates among the highest in the world. Horrific complications such as fistula formation?the development of a hole between the bladder or rectum and vagina? causing permanent and constant fecal or urinary leakage, are common.”

Many of the 2–3 million women who suffer from fistulas worldwide are ostracized by the communities that they live in and their husbands often abandon them to fend for themselves.

“I feel passionately that I have a duty to help these women with the skills that I have developed as an OB/GYN in this country,” said Hardwick-Smith. “And that includes helping to educate local healthcare providers in Sierra Leone to understand how to prevent fistula formation as well as how to perform the surgical repair needed to help the women already suffering.”

Hardwick-Smith pays for her own travel expenses and donates her services –but she wanted to do more.

Even with services and travel donated, the surgical procedures cost nearly $1,000 per woman, plus the WAFF provides not only badly needed medical treatment, but also a working staff within the country to establish local care and treatment for this terrible condition.

Funds donated to the WAFF help to provide:

  • Treatment for ongoing cases
  • Preoperative hostel for waiting patients
  • Education to help prevent fistula
  • Postoperative treatment and care
  • Reintegration into society through vocational school or enterprise training

To say that Dr. Hardwick-Smith is driven is an understatement. When she does something, she does it BIG. She is the founder of a busy ten-provider OB/GYN practice, is a renowned obstetrician and gynecologic surgeon, wife, mother of three (two of the three are twins), marathon runner and now Ironman triathlete.

“I decided to train for the Ironman to raise awareness about the plight of these women in Sierra Leone,” said Hardwick-Smith. “Let’s face it, training and competing in an Ironman triathlon event (2.4 mile swim, 112 mile bike race and a 26.2 mile marathon) could rank up among the most selfish activities in the world.

Months of training upward of 12 hours a week mean those hours are taken away from friends and family. But thinking about those women and their incredible suffering fueled me, my family, my friends and my associates. Doing something really challenging, overwhelming and often painful to help others is a spiritual journey–one we were all willing to take.”

On November 18, 2012, sporting a shirt she had made featuring the West Africa Fistula Foundation logo, Dr. Susan Hardwick-Smith crossed the finish line in 12 hours, 45 minutes having raised more than $31,000 and carrying in her heart the hopes of millions of women that they would not be forgotten.


2013 – May – York Post article

York couple move to Sierra Leone to provide care to women in childbirth

8:44am Tuesday 14th May 2013 in News By Gavin Aitchison, gavin.aitchison@thepress.co.uk


A COUPLE from York have moved to Sierra Leone to help provide vital care for women giving birth.

Andrea and Paul Robinson, both 55 and from Dringhouses, are heading up an American organisation in Bo, the country’s second city.

The west African country has one of the world’s highest infant mortality rates and many women die in childbirth or are left injured due to poor care.

Andrea, who was a nurse in Wakefield then worked for the North Yorkshire and York Primary Care Trust before retiring, said: “We had been on holiday to Africa, and married in Kenya. We had seen so much poverty and hopelessness and we wanted to use our skills. We are not missionaries; we are not religious; but we saw there were opportunities to improve conditions for a lot of people.”

She said she wanted “somewhere warm where I could use my skills,” and found work with Voluntary Services Overseas.

“This job description fitted well and we knew it would be very colourful, and they have made us very welcome,” she said. “There is a lot of malaria and tropical illness but the people are very friendly.”

The couple are working with the West Africa Fistula Foundation, established by Texan obstetrician Darius Maggi to repair fistulas in new mothers – internal tears caused by obstructed labour.

Sierra Leone has a severe shortage of skilled medical staff, with many leaving during the 1991-2002 civil war and others being lured away since to better jobs.

Mismanaged labour often leads to the baby and/or mother dying, or the mother suffering a fistula. Women suffering the condition face lifelong incontinence unless it is treated, and are often ostracised by their community as a result.

Dr Maggi has repaired 1,000 fistulas and the organisation seeks to treat more victims and prevent avoidable new cases, through education and medical provision.

Andrea is now working as the Foundation’s head of operations, with Paul as head of facilities and transport, focusing on building a Surgical Centre of Excellence in Sierra Leone to help reduce the shortfall of medical staff.

For more information on the Foundation, visit www.westafricafistulafoundation.org


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