Dr. Steven Kleeman and Sister Clarissa, a physician, at St. Joseph's Hospital in Moshi, Tanzania. (Photo courtesy: LOTWC)
Dr. Steven Kleeman: "If you’re female and married and unable to have children, 'You’re not worth the water in the toilet,’ as one nun told me." (Photo courtesy: LOTWC)
CINCINNATI - Dr. Steven Kleeman of Good Samaritan Hospital is on a mission to eradicate deaths from preventable childbirth-related conditions in the East African nation.
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CINCINNATI - For most people, mentioning the Serengeti and Mt. Kilimanjaro conjures up images of exotic safaris and adventurous climbing expeditions. TriHealth physician Steven Kleeman, a Monfort Heights resident, has a very different take on Tanzania: women suffering and even dying due to inadequate medical care.
“There’s a tremendous need, especially in the developing world, for the education of patients, as well as for people in the trenches to prevent medical problems,” Kleeman said.
Kleeman, 45, is a urogynecologist, a surgeon who specializes in the care of women with pelvic floor disorders. One common problem he sees is the fistula, a preventable childbirth injury.
“There are an estimated 2.5 million fistulas in women in Africa, mostly due to complications during labor,” he said.
Kleeman has repaired a number of fistulas--or tears between organs that resulted in incontinence. He said in Tanzania, women are ostracized for female problems, especially in the case of infertility.
“If you’re female and married and unable to have children, 'You’re not worth the water in the toilet,’ as one nun told me,” he said. “Culturally you’re looked upon in a very different light and you may even be abused.”
In October, Light of the World Charities (LOTWC) sponsored a two-week mission trip for Kleeman and other medical professionals to Moshi near the foothills of Mt. Kilimanjaro. The non-profit organization provides medical, surgical and dental services to the sick and impoverished in developing countries.
The first 72 hours
During his first three days in Tanzania, Kleeman witnessed the death of a pregnant mother and her newborn. While he did all he could to save their lives during the complicated delivery, the mother experienced severe hemorrhaging and died later that night. Her baby died during birth after aspirating meconium, infant stool that is fatal when ingested. The next day, another infant died from the same condition. He realized that if essential medical supplies and blood products had been available, all would have survived.
“We just don’t see moms and babies die here in the U.S.,” he said. “We did all we could to save their lives. We used six units of blood-- all the blood we could get a hold of, but when you lose a tremendous amount of blood, you lose clotting ability. We needed other blood products to help with clotting. If we had had even simple things, like better patient education, more blood products, suction equipment and catheters, their lives could have been saved.”
Although medical care in Tanzania remains rudimentary, LOTWC president Theresa Banks said there have been great strides since the organizations first visit, to St. Joseph’s Hospital in 2007.
“In October--and it was my interpretation of a miracle--I was standing there holding a baby who had just been delivered by C-section who in 2007 wouldn’t have made it because mother and child would have died," Banks said. "So it’s just amazing what has happened.”
Since then an empty room has become an operating suite--complete with operating tables, vital sign monitors and oxygen tanks. Even with improvements, she compares the facilities to those in the U.S. 50 to 100 years ago. She explained St. Joseph’s future hinges on continued education for local medical professionals and the infusion of funding for equipment.
No typical patients
Kleeman said things we take for granted in the U.S. are sorely needed at St. Joseph's: Even basics like reliable electricity, sterilization, and a washer and dryer. Everything in the facility is reused--from catheters to sponges. He finds it hard to believe women clean laundry for the entire hospital as they did a century ago, pounding it with rocks on a cement table then hanging it to dry. He said hospital director and surgeon Sister Urbani dreams of the day she’ll have a fully functioning hospital complete with a CT scan.
“They do the best they can with what they have available,” he said. “The nuns provide compassion and they give as much as they can, but when you can’t do anything else, people just die.”
There’s no such thing as the typical patient, Kleeman said. While at the hospital he saw unusual cases in women including severe underdevelopment in an 18-year-old, ovarian cancer in a 17-year-old and a congenital anomaly in a toddler.
“The typical patient there is atypical,” he said.
While a stark contrast exists between Kleeman’s patients in the U.S. and those in Tanzania, his overall commitment to both remains the same, said colleague Catrina Crisp. She described Kleeman as a role model for others, compassionate and caring.
She said with Kleeman’s encouragement, she joined him on a LOTWC mission in Haiti a few years
ago. She said it was there she witnessed Kleeman donate not only his time, but all his clothing, leaving the country with only what he was wearing. She said she plans to go on the next trip to Tanzania.
“Steve sort of has this theory of the four pillars of working as a physician, and one of them giving back or mission work,” she said. “I think it was just so bad in Tanzania and you think of Haiti and how bad it is there, but from my understanding, Tanzania was even worse. I applaud him for the things he does there.”
Hungry for knowledge
In his role as director of the Good Samaritan Hospital urogynecology division, Kleeman managed the fellowship and taught other physicians the specialty. The skill translates perfectly to Tanzania, Banks said, as educating local physicians is crucial. As a registered nurse, she too traveled to Tanzania. She said she watched Kleeman train physicians who were hungry for knowledge.
“They’re training continues every year and the good thing is they want to learn, they want to improve and this particular hospital St. Joseph wants to be the best,” she said. “Steve was such a great asset on this last mission and we’re glad he’s going to join us for more.”
As for Kleeman, he sees Tanzania as a place where he can change lives by donating his time and expertise. He hopes to raise money for medical supplies for future LOTWC trips. Each surgical trip of 10 people costs about $32,000, which pays for transportation, lodging and medical equipment.
Kleeman is planning a fundraiser for St. Joseph’s Hospital in March 2014 at Good Samaritan Hospital, where Sister Urbani will speak. While he hopes people will support him in his efforts to raise money for the cause, he urges people to identify a need and offer support.
“I would encourage people to get involved in anything they can, whatever moves their heart,” he said. “There’s a ton of opportunities in our area. Oh, and if anybody has a million dollars and wants to give to Sister to get some equipment, that would work too.”
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