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 – April


Dear Friends and Supporters,

We again had a very successful trip to Sierra Leone and have a lot of good things that are happening.
First of all I want to tell you about a young Doctor that contacted me several months ago and became very interested in helping the “Poorest of the Poor”. Dr. Susan Hardwick-Smith of Houston Texas and head of a very large Women’s Group of Ob-Gyns decided to go to Africa with me but not only did she go but before she went she trained several months for the “Iron-Man” and dedicated all of the proceeds and donations in excess of $31,000 for the Women of Sierra Leone. Dr. Susan was hooked after she went to Sierra Leone and has graciously accepted to be on West Africa Fistula Foundation’s Board. We are very privileged to have someone of her stature to be joining our organization.
This is the link about Dr. Susan and her race along with her dedication to WAFF:http://vimeo.com/63447062
There continues to be a lot of good news in that the number of Fistulas is definitely declining in Sierra Leone but there is still so much that needs to be done because of the true lack of medical care in the Country. We continue to do many surgeries and care of patients in need and without your support this would be impossible to accomplish. When these patients go home dry or we are able to save a life we thank God for allowing us to do his work.
We have decided to not move to the Holy Mary Hospital and feel we are called to start the first phase of the Medical Center of Excellence that we have dreamed. We have several volunteer architects, engineers and other wonderful people all coming together to make this Center in Bo, Sierra Leone a true referral center for all of West Africa.
We continue to network with many different organizations so we can share knowledge and use this synergism to be more efficient. This last trip Dr. Gary Gilkeson and Dr. Tasha Ruth from Medical University South Carolina brought their team of people and are doing research on Lupus. Willa Finley from Lubbock Texas with Africa Business Jubilee visited our place in Bo and brought with her Elizabeth, a colleague that resides and works in Ghana with her.
Paul and Andrea Robinson of England have been made life much easier in administration and physical facilities management and have added invaluable experience to WAFF through their dedication and hard work.
Dr. Mannah has been showing improvement since his very unfortunate auto accident where 12 people were killed and is extremely helpful in the care of the patients. Our staff is truly dedicated and they do a wonderful job taking care of the patients.
We will keep you updated as we progress and with this transition to another facility over the next 12-18 months and are very excited about what can be accomplished.


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

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Dr. Susan Hardwick-Smith
Dr. Susan with Sierra Leonean Children
Sierra Leone water
Villagers use as Bathtub during the Dry Season
Andrea & Paul Robinson in Sierra Leone

Andrea & Paul Robinson
Sierra Leone cooking
Fatmata Cooking for Patients on the WAFF ward
Sierra Leone drinking water
Village waterhole used for Drinking Water during Dry Season

2011 – November

Dear Friends and Supporters,
I am a little late getting this newsletter out after our last trip in Sept.-Oct. 2011,but I feel we once again had a very productive journey. As we have reported in the past, we are experiencing a bit of a transition in Sierra Leone, where we are seeing fewer total numbers of Obstetrical Fistulas, but the ones we are now seeing are the more difficult ones. This is obviously good news in that the overall fistula numbers are diminishing, but unfortunately, there is still a tremendous amount of Maternal Mortality, with Sierra Leone ranking as the 2nd worst in the World at this time. On this front, we have made an agreement with the government to further assist in the care of more of their general Obstetrical and Gynecological patients. In return, we have been given access to a larger portion of their facilities to help them in this area. This important collaboration allows us to keep our expenses more focused on care, rather than the brick and mortar expenditures until those can be justified. I continue to promise you that our funds that have been so generously donated by all have been and will be utilized to the fullest.

Drs. Gary Gilkeson and Natasha Ruth joined us for about a week and are doing studies on Lupus at the University of South Carolina Medical School . Nurse Patty Hoskin accompanied us and helped tremendously with skills training and general welfare of the patients.

We had a significant number of successful surgeries and are pleased to say a large number of these women went home dry to their respective villages. Beyond these surgeries, we had an increased workload in the Obstetrical and Gynecology area, but there are still way too many Maternal Deaths that could easily be prevented.
We are enclosing a number of pictures of the patients and kitchen facilities that we use, as our studies continue to show nutrition is extremely important in being able to have successful Obstetrical Fistulas.

Additionally, we are extremely pleased to announce that we have proposed a STAGING of OBSTETRICAL FISTULAS that we hope will be used worldwide to be able to predict success rates of the surgeries. This is very much like the way staging of cancers is used. Our staging was accepted and published in the International Journal of Obstetrical Trauma in the first Journal publication.

Finally, we want to wish everyone a Happy Thanksgiving, a very Merry Christmas and a prosperous New Year.We also would like to once again express our appreciation for all that continue to support the Women and Children of Sierra Leone and others we treat in West Africa.


Darius R. Maggi M.D.
West Africa Fistula Foundation

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Patients in new gowns awaiting surgery.
Kitchen facilities – Cooking Rice and Casava Leaves for the patients
Malnutrition is very common.
Patient eating while waiting on the ward for upcoming surgery.
Placing child on scales to see how much he weighs.
After many years of being “wet” Fatmata is pronounced “dry” after successful surgery and gets to return home !

2011 – August

Dear Friends and Supporters,
We again are extremely pleased to report another very successful trip to Sierra Leone for the month of June 2011. We were very fortunate to have another new group of volunteers this time, including Dr. Rob Kester from Auburn, Maine, Dr. Jim Caputo from Rochester New York, medical students Eric Gruber and Hemang Acharya from U Mass medical School, Boston and Yewande Adisa from England.  We also met up with a dedicated volunteer group from Long Island University in New York.  Dawn Kilts, Dean of Nursing, Dr. Mohamed Grighria, Dean of Business School and Dr. Suzanna Gim, Dean of Pharmacy were all gracious enough to come to Bo to offer their help. The Long Island team has made many trips to Sierra Leone, bringing lots of student volunteers (over 14 this time), and they are partnering with us in our efforts to help the people of Sierra Leone. They have been very instrumental in assisting us in many facets of day to day work, as well as aiding us in our future growth plans.As usual, our first and foremost concern was our fistula patients. While we are quite pleased to report the sheer number of these patients appears to be slowing down a bit, there are still a tremendous number of difficult cases to be done. During this trip alone, we can gladly report we performed 51 successful surgeries overall (38 of which we consider Major cases and 13 Minor cases). To give you just one example of what is all too common in Sierra Leone, Elfreda Manley is a 48 y/o Sierra Leonean Lady that had had the fistula since the age of 17 yet had not found anyone able to fix her. She came to us with unfathomable 31 year history of leaking urine uncontrollably down her leg. Elfreda is a very intelligent lady that reads, writes and speaks English extremely well, yet she has been ostracized numerous times because every time she gets a job, it is eventually discovered that she leaks urine, and she is immediately fired. She had felt very depressed initially because she had been discriminated against for so long; however, she experienced some real hope upon arriving to our ward, where she saw numerous patients with the same problem. She had been staying with us for 6 months in order to get physically and emotional ready for the surgery, so we had gotten to know her extremely well and were very excited about her time finally arriving. Since her surgery, she is now 100% DRY and like a whole new person. Along with her having such a great skill set, we have decided to hire her to join our staff because she is such a positive and caring person. Below we will show you a picture of Elfreda Manley.While stories like Elfreda’s and our dream to help these fistula patients has brought this program to where we are, we continue to see an overwhelming need for Obstetrical Care, General Gynecology care and obviously many other services that we in the U.S. take for granted. One such example is a 24 y/o young lady that was in an automobile accident which killed her 7 y/o daughter. When we were making rounds on another ward early one Sunday morning, she called out to us to evaluate her. Here she is lying in a bed, unable to move her legs and upper extremities (obviously paralyzed from the neck down but without a neck brace on because there are none), and her 7 y/o daughter’s body is in the Morgue 30 yards away. Her family has been standing around her bed asking for someone to help her, yet with no one able to help, they are forced to load her up with zero cervical or neck support into a small taxi to take her to Freetown (4+ hours away) to see if they can get her some help there. While this is extremely hard for many of us to understand, this is one example of the tremendous needs that are pervasive throughout this entire country.  

But to stay positive (and you must in countries like this), the bottom line is we have a unique opportunity in that we can do SO MUCH FOR SO LITTLE in this Country, and THANKS TO PEOPLE LIKE YOU we have, and continue to be fortunate enough to aid these people and give them a chance. Unlike many of the situations in America, where people want a HAND OUT, these people would like just a little HAND UP to get them jump started. With our volunteers from all over and our Sierra Leonean administrative costs so low, we are able to do a lot of these surgeries at an out of pocket cost of 500-1000 dollars, where in the States most of these would cost in the tens of thousands of dollars. So, we truly appreciate your support and want you to know your help has gone a LONG way.

Dr. Phillip Koroma, the only Obstetrician and Gynecologist in the Provinces outside of Freetown, continues to allow our program to function in the Bo Government Hospital, and this allows us to keep our operating expenses to a minimum where we can function until we are able to obtain a larger facility for the increasing load we are experiencing.

We want to thank each and every one of you for allowing us to continue to help these people. If you have any questions, please be sure and feel free to call and/or email.


Darius R. Maggi M.D.

Visit our NEW and updated website:


We now are offering Handmade Surgical Caps made by the women of our ward!


 Grandma had a fistula for over 40 years and woke up the next day after surgery and said “Oh My God My Bed is Dry”. Jo Jo Coker the nurse with her is a former Fistula  patient and has finished Nursing School and now works with WAFF.

The Patients are fed  3 times a day  and placed on iron and vitamins  in order to get them nutritionally sound for surgery.

 Elfreda Manley the lady with the fistula for 31 years looking out after a patient’s baby.  She is now dry and will be joining our team.
 Betty Vandy had  a fistula for 17 years and is happy to be dry after having surgery this June.

2011 – March

Dear Friends and Supporters,
Again we are happy to report a very successful trip to Sierra Leone. We had a TREMENDOUS group of Volunteers this time that were extremely helpful in growing our program. Wade and Sarita Robinson of West Virginia came and brought in excess of 50 water filters for the women we operated on to take back to their villages for use. The filters they brought are very user friendly and will help prevent one of the most deadly causes of infant morbidity and mortality, Typhoid Fever along with other water borne illnesses.
Patty Hoskin from Buxton England, a nurse, health educator, tutor and lecturer was very instrumental in many areas of the program. Patty interviewed, counseled and interacted with all of the patients but has become very involved in Skills Training of the patients. She has taken on a project that she will be introducing in the near future that we think will  benefit the patients and the program.
Last but not least was Dr. Alexandra Rogers a 4th year Resident in Urology from the Mayo Clinic in Jacksonville, Florida. Dr. Rogers was extremely helpful in the day to day surgeries, rounds and has the energy of the Booster Rockets of the Discovery. It was extremely gratifying to see a young up and coming physician/surgeon get involved in Humanitarian work. Hopefully this will be the first of her trips to Sierra Leone. Behind every good lady is a strong man, Alex’s husband Shawn Graft has been a God send to this program as I call him the Bill Gates or Steve Jobs of WAFF. Shawn spent countless hours in helping train the Administrative staff of WAFF in Computer skills, fixing and updating computers, removing his type of viruses that attack the computers plus taking  numerous outstanding pictures including surgical procedures to enhance the program. He has facilitated putting all of our patient charts on the computer. They took 2 weeks of their vacation time to come help the people of Sierra Leone.
As I have reported on almost every trip we continue to see very advanced Cervical Cancer in many of the patients that think they have Obstetrical Fistula because their symptoms are sometimes identical to the Obstetrical Fistula patients. 
We continue to see many obstetrical fistulas and hear the same story of how these women have been in labor for days and days. We have many patients that walked through the doors of our ward with towels between their legs holding the urine and/or feces from dripping down their legs walking out of those doors dry without those towels and a smile on their face. 
I omitted one case from our last visit which was a lady in excess of 65 y/o that had a fistula for over 40 years. The day after her surgery she reached down and touched her bed and for the first time in 40 plus years  said “Oh! my bed is dry”.
We have so much more to do and still have the dream to build the Charity Hospital of West Africa 4 miles east of Bo so the people of Sierra Leone will have what we so take for granted in the United States of America an opportunity for a normal life.
Helen Weld, one of our first volunteers with WAFF and a lady very dedicated and instrumental in our move to Bo 3 years ago likes to remind us of the quote:

“Never doubt that a small group of thoughtful committed citizens can change the world —– indeed it is the only thing that ever has”.

Thanks again to all that support us in your own way.
Darius R. Maggi M.D.
P.S.  We are now on Facebook as West Africa Fistula Foundation!
Find Us On Facebook!Stay tuned…..We are currently working on updating our website:


WAFF Staff

Several of our dedicated team members.

WAFF Patients
Women at the ward awaiting treatment.


Water of Life

Bucket filtration system project:  Two of our volunteers, Wade and Sarita Robinson (West Virginia, USA), brought water filters and distributed them to our patients.  Wade and Sarita sourced the buckets locally and drilled, sanded and assembled 50+ of these bucket purification systems.   They also traveled by boat to several remote villages to deliver these water filters and share their knowledge of water filtration.


2010 – March

UPDATE – March 2010
Dear Friends and Supporters,
We are pleased to report another extremely productive trip. What a rejuvenating experience to see the Sierra Leonean team step up and work very efficiently and hard to help the underprivileged people of Sierra Leone. We performed over 40 surgeries this trip and have some very happy women and children.

As most of you are aware we are in the process of building a Medical Center that will serve all of West Africa. We now have approximately 40 acres of land we have purchased to build on. We were very fortunate to have Mike Henderson one of the founders of www.heartofafrica.org accompany us. Mike has volunteered to help us through all phases of the building project in Bo. His major challenge will be raising the money to build the Medical Center we have all dreamed. My son Deno and son-n-law Colby Crenshaw also made the trip and was there for the first week of our journey and had a great time. Dr. Dahan Sheref who continues to support, facilitate and promote our project in many different ways.
Saleh Yahya a Sierra Leonean has joined our team and has offered to volunteer his time to help oversee the financial arm of WAFF in Sierra Leone. Saleh has a kind and beautiful wife along with 5 wonderful children and is dedicated to seeing the completion of the Medical Center.
We are uniting with Maternal Life International via Dr. Bob Scanlon, Dr. George Mulcaire-Jones and Ray Rogers to plan for the West Africa Medical Center (WAMC).

We were very pleased and surprised to hear that we (West Africa Fistula Foundation) were awarded the BEST NGO in the Southern Province of Sierra Leone for the year 2009. Dr. A. Philip Koroma our Medical Director was named the Doctor of the Year in Sierra Leone. Congratulations to Dr. Koroma.

WAFF also received a “CIVIC AWARD” from Bo District Development Association (BODDA) for “Charity Organization of the year 2009.

We cannot rest on these laurels as we have ONLY BEGUN because we continue to see so much NEEDLESS suffering in Sierra Leone and conditions that are so easily treated for very little money or very advanced conditions that could have easily been prevented. Something that just makes me sick is the number of women that continue to come in with very advanced cancer and unfortunately all we can do is send them back to the village to die because we do not have the facilities to treat these women.

We will end on a very pleasant note. Jim Stewart my friend since childhood in Wilburton, Oklahoma continues to fund ice cream for the children near our residence in Bo, Sierra Leone. This last time we had 97 children receive ice cream, many for the first time in their life.

Our thanks go to Jim who continues to say “every child should at least have an Ice Cream”.

Bottom line we appreciate your continued support and concern for the people of Sierra Leone and want to tell you thanks for allowing us to continue to serve the poorest of the poor.

Darius R. Maggi M.D.
dariusmaggi@yahoo.com www.westafricafistulafoundation.org 903-463-9400

“Never doubt that a small group of thoughtful committed citizens can change the world —– indeed it is the only thing that ever has”.

2009 – November

UPDATE – November 25, 2009

Dear Friends and Supporters,
Our last trip to Sierra Leone reaffirms our mission. Despite our primary goal of taking care of the Obstetrical Fistula Patients we saw a tremendous number of men, women and children that came to the hospital very late in their illnesses and died. There were numerous young children that died of Typhoid Fever which is so easily prevented and treated if caught early in the course of the disease. Many of these patients did not come in because they could not afford medical care which only costs a few dollars and if they could the facilities are so deplorable their chances of survival are low.
On the positive side Dr. Gary Gilkeson an internist research physician from Medical University South Carolina accompanied us to further his research on Lupus Erythematosus that is quite prevalent in South Carolina among the African-Americans. Most of these people have roots in Sierra Leone and Dr. Gilkeson is trying to determine if this is an inherited disease or acquired by comparing the incidence in Sierra Leone. Dr. Tasha Ruth, a Pediatric Rheumatologist accompanied Dr. Gilkeson and had a great experience seeing and treating pediatric diseases in Sierra Leone. Dr. Bob Scanlon an Ob-Gyn from Huntington New York and a very dear friend of mine came for several days and helped out with the patient load and in surgery. Dr. Scanlon has been to Africa numerous times and in one of his most recent trips gave a week long course on Maternal Mortality in Sierra Leone. Dr. Scanlon received very positive feedback how his lectures had helped save many mothers since his last trip. Jennifer Bennett in her 2nd trip to Sierra Leone a Head Surgical Nurse and Midwife from Australia also accompanied us and was a great help in continuing to teach the nurses and provide patient care.
We continue to progress toward our dream of developing a Medical Center in Bo as we have now acquired several acres of land just east of Bo and have had this cleared off in hopes of starting our project in the very near future.
We performed many fistula surgeries plus numerous other surgeries that required immediate attention but this reaffirms our need for better medical facilities and access to care for the people of Sierra Leone.

We want to thank you for your continued support and encouragement. Be sure to visit our website www.westafricafistulafoundation.org

If you have any questions we will be glad to visit with you. I wish you a Happy Thanksgiving and a very Merry Christmas Sincerely,
Darius R. Maggi M.D.

3621 Pottsboro Road #150 Denison, TX 75020 903-463-9400 Office 903-819-7250 Cell

2009 – August

UPDATE – August 18, 2009

Dear Friends and Supporters,
We had an extremely successful trip this last month to Sierra Leone. This trip had a very unique and exciting meaning to it. I was accompanied by two young and aspiring students from the United States, that plan on becoming doctors. Preston Spindle and Taylor Reed traveled along with me for their first adventure to Africa. Preston will be starting medical school this fall and Taylor, a recent graduate from Denison High School, also plans on becoming a physician. I was fortunate enough to have delivered both of these youngsters while practicing in Denison, Texas.
Besides Taylor and Preston, two Scottish med students, Lorne Mitchell and Natalie Smee, were also in our camp. With these 4 youngsters helping and active in the care of the patients, hopefully a seed will be planted that will bear fruit for the people of Sierra Leone and other countries that are in such desperate need of medical treatment.
I will never forget when Dr. Jack Robertson, a World Renown Urogynecologist now living with his lovely wife Janice in Santa Ynez California, planted that seed within me some 33 years ago when he shared his experience in helping women with obstetrical fistula during my training at Charity Hospital New Orleans, Louisiana.
We saw and treated many women with obstetrical fistula and other illnesses but also accomplished what I consider a coup. Dr. Dahan Sheref, a Sierra Leonean born gentleman who has been in the United States for the last 36 years, has volunteered to lead the program. Dr Sheref has returned to Sierra Leone to help his people and has the exact dream that our Foundation has and that is to empower the Sierra Leonean people to take command of their own destination and with a little help from outside, develop a Medical Center in West Africa that will be second to none.
Staff physician Dr. Philp A. Koroma the only Obstetrician/Gynecologist in the Provinces will assist Dr. Sheref in this dream.
I will not go into details about our last trip, but we continue to be very encouraged by the enthusiasm of the Sierra Leonean run team we have in place. We had numerous surgical cases and successes and feel so fortunate when these women are able to return to their villages dry and no longer an outcast.

Again thank you so much for your support and encouragement and most of all your prayers.

Darius R. Maggi M.D.

3621 Pottsboro Road #150 Denison, TX 75020 903-463-9400 Office 903-819-7250 Cell

2009 – January

UPDATE – January 7, 2009

Dear Friends and Supporters,

I am happy to tell you we have just completed another trip to Sierra Leone.

As you are aware we have moved our program to Bo, Sierra Leone which is up country so we can be closer to the people that need our services the most. West Africa Institute (WAI) our newest project which has a broader and more encompassing goal is starting to grow little by little. Dr. Bob Scanlon and Dr. George Mulcaire-Jones from the U.S.A. will be coming the last week of February for a 4 day seminar for the health professionals of Sierra Leone dealing primarily with Maternal and Infant Mortality. We feel much honored for their organization to partner with ours in reducing the deplorable Mortality rate of the Mothers and Infants under 5 in Sierra Leone. We are encouraged this is just a start of many good things to happen for the healthcare of the Sierra Leonean people.
We have come into contact with many other organizations in Sierra Leone and have pushed for all of us to collaborate so we will avoid so much duplication of services and be more productive and efficient and do not care who gets credit for it as long as it is done.

Our most recent trip included many successful VVF (vesico-vaginal) surgeries, RVF (recto- vaginal surgeries, along with many other gynecological surgeries needed by the women of Sierra Leone. Unfortunately we continue to see a tremendous number of women with advanced cancers where appropriate and early screening would be a deterrent to the majority of these we see.

One of the most exciting times of the trip included the probable acquisition of land for the New Medical Center that we are planning in the near future for all the people of West Africa. As stated previously we want this Medical Center to be a referral and teaching hospital for all of West Africa and due to its demographic and geographic location this is the perfect time to embark on this project.
We continue to appreciate each and every one of you that have continued to follow us and work with us during these last several years. We obviously appreciate your continued support morally and financially and will continue to give you updates and be good stewards of a program that you can be part of no matter where you live in this world.
Be sure to go to the website for more updates and other news as it is occurring each and every day.

Darius R. Maggi M.D.

3621 Pottsboro Road #150 Denison, TX 75020 903-463-9400 Office 903-819-7250 Cell

2008 – October

Dear Friends and Supporters,

We are very pleased to report on our last trip to Sierra Leone the addition of more medical services to the people of Sierra Leone. In addition to the Fistula project we feel the need to address the deplorable situation of Maternal Mortality and Infant Mortality in Sierra Leone. Earlier this year we have moved our program up country and more inland to be closer to the problems we encounter. Our efficiency will be improved by this move and have embarked on a long term plan to help not only the medical needs of Sierra Leone but become a referral center for all of West Africa. We are extremely fortunate to have heading up the Medical Arm of the new project Dr. Philip A. Koroma the ONLY Ob-Gyn in the entire Provinces of Sierra Leone. We have collaborated with the Bo Government Hospital. Our ultimate goal is to establish a Medical Center that will provide comprehensive medical care in all medical specialties and provide a teaching environment for Sierra Leonean medical students, resident physicians, nursing students, lab technicians and other medical services. With this process we are hopeful that the final result will have provided Capacity Building and Sustainability.
West Africa Fistula Foundation will continue to focus on the Obstetrical Fistula patients and have embarked on a project to provide a Full Time facility for these patients that have been shunned and have no place to live. We will not turn any patient away and will provide Skills training along with Educational opportunities in order to help these women get back on their feet and hopefully be reintegrated back into society. Our most recent trip this last month we performed several VVF, RVF and Gynecological surgeries.

The Maternal and Infant Mortality in Sierra Leone is the highest in the World and we have plans to provide free care to any lady that requires Cesarean Sections and other services. By providing these services we will be serving a two fold purpose in that the Prevention of the Obstetrical Fistula will be accomplished and hopefully the Obstetrical Fistula will be a thing of the Past in Sierra Leone. We have Family Physicians and Obstetricians from the States that are collaborating with us at this time to facilitate this project and will be on the ground in the near future.
We asked that each and every one of you try to get involved in this worthy cause. Our goal is to get as many people as possible donating 10-20 dollars a month for these unfortunate people. If we could get you to send this email to at least 5 other people this would get us down the road in accomplishing our goals. As I have told you many times in the past all of the volunteers pay their own expenses including their airfare and accommodations. We have absolutely NO ADMINISTRATIVE COSTS taken from the donations you send. We very much appreciate your continued support and encouragement.

Be sure and look at our Website www.westafricafistulafoundation.org which is being updated on a regular basis.
If you have any questions feel free to email, write or call us.

Darius R. Maggi M.D.

3621 Pottsboro Road #150 Denison, Texas 75020 903-463-9400 office 903-819-7250 cell

2008 – March

UPDATE – March 25, 2008

Dear Friends,

I have just returned from Sierra Leone and would like to give you an update. This is my first trip to Sierra Leone after Mariama’s death and since the newly elected officials have taken office. I found Sierra Leone to be as beautiful and friendly as ever but obviously still in tremendous need for the most basic medical care. Our organization is still very committed to helping the people of Sierra Leone and we will continue to do what ever we can to see this through.

We took a trip 5 hours upcountry to have a rally in the City of Bo for the VVF patients. We saw over 120 patients many that we had successfully operated on, many that needed more advanced surgeries and many new first time patients seen with VVF and RVF. It was extremely gratifying to see many of the urinary diversions that we had operated on doing quite well and very happy to finally be dry. Unfortunately we saw 4 patients that had very advanced cervical cancer as bad if not worse than Mariama’s and one with the worst rectal cancer I have ever seen. We had to tell them to go back to their village to die as we do not have any form of treatment for them.
I was fortunate to have meetings with newly elected and appointed local officials. I met the President’s wife Her Excellency, Sia Nyama Koroma I thought for the first time but after introducing myself to her she looked at me and said Dr. Darius you don’t remember me? We sat together on the same plane from Sierra Leone to London in 2005 when I attended my father’s funeral. You told me all about Obstetrical Fistula the entire flight to London. What a coincidence. By the way she is very willing to get involved helping us in any way she can. I also met Dr. Kabia the newly appointed Minister of Health that had practiced Nephrology in Atlanta Georgia many years but left a thriving practice to go back to his homeland to help his people. I also had a great visit with Ambassado June Carter Perry from Texarkana Texas the newly appointed U.S. Ambassador to Sierra Leon along with Lt. Colonel Leslie Bryant with the U.S. Embassy (Oklahoma born but from Fort Worth Texas). Both of these outstanding women have a desire to get involved.

We have included a few pictures from this last visit and would again want to thank you for your continued support.

I    would    encourage    each    one    of    you    to    visit    our    NEW    website www.westafricafistulafoundation.org and go the What is fistula? Scroll down to fistula video and view the most touching video on these women I have seen up to date. Be sure and turn on the volume as the back ground music starts about 1/3 of the way through the video. Amanda Counce a young lady that took care of Mariama during her last several weeks of her life was so touched by Mariama’s story that she took a few of my 2500 plus pictures and made this video on her own. What a talent and inspiration she has been to our program.

Darius R. Maggi, M.D. 3621 Pottsboro Road #150 Denison, TX 75020 903-463-9400 Office 903-819-7250 Cell

2008 – January

UPDATE – January 29, 2008
Dear Friends,
Mariama Sesay, the 27 y/o Sierra Leonean lady with terminal cervical cancer passed away Sunday morning January 27, 2008 in Denison, Texas. As many of you know Mariama was first diagnosed with invasive cervical cancer in August of 2006 in Sierra Leone and was brought to the States for treatment where Dr. Mary Hebert and Dr. Larry Barker along with the Texas Oncology Center treated her for free. I took her back to Sierra Leone in December 2006. April 2008 it was determined she had persistence of disease and was in considerable pain. The U.S. Embassy was kind enough to allow us to bring her to the States where she could spend her final days where pain management would be more accessible. Mariama lived with Karen and myself until Mid-December at which time she was moved to a nursing home for more intensive treatment. The entire 10 months the Home Hospice of Grayson County provided free of charge phenomenal care for Mariama. We owe a big thank you to Nurse Anita Anderson and Kendrea for their relentless dedication and support for Mariama.

You may remember that Mariama gave birth to a baby girl at the age of 14. With her child left behind she was captured by the Rebels at the age of 16 and was held hostage for 3 years. When she finally escaped her 5 year old daughter had died from Malaria 2 months earlier. Mariama loved being in the United States and was very active during her intital treatment and loved going to Church. She was baptized and joined the First Christian Church in Denison, Texas. She is survived by her mother and brother and a 6 y/o daughter she had adopted a couple of years ago.

We will never forget Mariama but more importantly the reminder everyday what a privilege it is to have the luxuries of running water, electricity, transportation, comfortable home etc. but most of all the Freedom and the ability to worship God without fear for our lives.

Mariama will have a church service Wednesday 10 am January 30 at the First Christian Church and will buried in our family plot in Wilburton, Oklahoma.
Darius R. Maggi M.D.

3621 Pottsboro Road #150 Denison, TX 75020

903-463-9400 Office

903-819-7250 Cell

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