Dr. Ennert Banda Chipungu: Bwaila Fistula Care Centre medical director

Dr. Ennert Banda Chipungu, a fistula surgeon, obstetrician and gynaecologist is Bwaila Fistula Care Centre medical director.

Her path in medicine was ignited by her compassion for others, sparking interest in medicine.

From a tender age, Ennert knew she was destined to help others.

This empathy, coupled with a pivotal moment during her childhood, set her on the path to becoming a doctor.

As a child, she vividly remembers watching television reports of the 1994 Rwanda Genocide where a cholera outbreak swept through refugee camps.

Seeing the desperate need for volunteer doctors, young Ennert was moved to act.

“I told my late father that one day I will be a medical doctor to volunteer in situations such as these,” she says.

Her father, a chemist, encouraged her dreams, believing in her potential even when she was just an average student.

Ennert’s educational journey was far from smooth. She attended Chichiri Primary School in Blantyre where her first attempt at the Standard Eight exams ended in disappointment after failing to be selected to secondary school.

Undeterred, she repeated at Katete Girls Primary School in Mzimba and her perseverance paid off when she was selected to Kamuzu Academy in 1991.

This was the turning point as it paved the way for her selection into the College of Medicine in 1998 where she began her studies in general medicine.

“I am a product of God’s grace. From a class of 17 with three girls, I was the only girl who graduated,” she says.

Her medical career began at Queen Elizabeth Central Hospital (QECH) in Blantyre where she first encountered fistula patients.

The mother of two says the affected women were often hidden away as their condition was considered too shameful to be discussed openly. They were treated as outcasts.

“There were final beds where people with cancer and those with fistula were kept for treatment,” she explains.

Ennert says while cancer patients were often told there was nothing more the hospital could do, the fistula patients had a glimmer of hope, thanks to the efforts of Dr. Ryken, the only fistula surgeon at QECH that time.

“Out of compassion, since he had a lot of patients to attend to, I used to assist him, but I didn’t fully understand what I was doing since it was not my area of expertise,” she recalls.

It was during these early years at QECH that Ennert’s interest in fistula surgery was truly ignited.

Seeing the suffering of the women and the gap in care, she knew she had to do more.

“This sparked my interest to specialise in fistula surgery, so I enrolled at the University of Cape Town in 2011,” she says.

However, upon completing her studies, Ennert faced the harsh reality of lacking the hands-on experience she needed as there were no fistula cases during her training.

“I came back without knowing how to do a fistula surgery,” she admits.

Undeterred, she returned to QECH where the plight of fistula patients persisted.

Ennert was determined to gain the necessary skills through further training.

“A stroke of fortune came when a fistula centre was opened in Lilongwe. My then head of department late Professor Makanani delegated me to attend the official opening,” she says.

But luck had its way of locating the doctor as her husband secured a job in Lilongwe, prompting their move from Blantyre.

“I realised that it was a God-given opportunity to go through the training. Without hesitation, l asked my then head of department to allow me to perform fistula surgeries twice a week and to get mentorship from an American surgeon,” she says.

Ennert finally gained the expertise she needed. Over time, she transitioned into a full-time fistula surgeon when her mentor left, dedicating her career to helping women recover from this devastating condition.

She says the road to specialisation was not easy as she met numerous personal and professional challenges along the way.

“I had to leave my two-year-old baby for four years. I was just receiving reports that she was sick

“The financial strain was also significant as the stipend l received barely covered my living expenses in a foreign country. I lost my brother during this time, but I couldn’t return,” she recalls.

Despite these hardships, Ennert found solace in her work, knowing she was making a difference.

“Today, I find comfort in seeing the women I operate on dry again, no longer leaking urine,” she reflects.

Ennert’s work extends beyond her own surgical practice.

Upon recognising the critical shortage of fistula specialists in Malawi, she and her team organised fistula training programmes with UNFPA’s support.

“We have trained 30 clinicians in fistula surgery. The training run for one month.

“We also ensure that all specialists in obstetrics and gynaecology spend at least one month at the fistula centre before graduating,” she adds.

Ennert says the sad thing about fistula is that nobody really pays attention by noting the significant gap in care.

Despite the challenges, she continues to push forward, collaborating with her mentor from Baylor College of Medicine to learn new techniques of treating fistula.

“We work closely with the college, bringing in plastic surgeons to not only treat fistulas, but also lengthen the vagina, allowing women to reintegrate into relationships after surgery,” she explains.

However, Ennert emphasises that more needs to be done in terms of prevention.

“Even though we are treating the cases, we are not doing enough to prevent fistula. Imagine, we have 300 new cases every year,” she says.

The surgeon is passionate about advocating for fistula prevention, recognising that many cases are preventable with the right interventions.

“l believe that fighting fistula should not only be up to the Ministry of Health, but different ministries should join hands.

“For instance, the Ministry of Education should encourage girls to pursue their education and emphasise the dangers of early pregnancy. It’s important for young girls to understand how early pregnancy can negatively affect their health and future opportunities,” she says.

Ennert notes that financial empowerment is also critical as economic vulnerability often leads girls to early pregnancies, which in turn increases the risk of fistula

“Beyond surgery, our centre focuses on social integration, ensuring that women who undergo surgery are empowered to become financially independent.

“We train former patients to return to their communities, identify other women suffering from fistula and bring them to the centre for treatment,” she says.

Ennert shares a touching story of one such patient who, after surgery, returned to school and is now working at the centre while awaiting her nursing exams.

“She treats patients with so much care and compassion because she understands their plight,” the doctor adds.

She observes that women are naturally sensitive to childbirth experiences and empathy makes them excellent doctors.

Ennert believes in making a lasting impact, which is why she travels to rural areas to educate communities about fistula, striving to create a fistula-free Malawi.

“We need to dispel the myths surrounding fistula such as the belief that it is caused by witchcraft. Fistula is a complication that can happen to any woman during childbirth

“Unfortunately, some elders still cling to the misconception that fistula is beyond medical intervention, believing that those who suffer from it have been bewitched,” she says.

Ennert says there is also a dangerous belief among some women who have given birth before that they can deliver on their own without going to the hospital.

T h i s o f t e n l e a d s t o complications, resulting inoistula.

“We must continue to sensitise these women about the importance delivering in hospital.

“Another challenge we face as a community is the reluctance to allow young girls to use contraceptives, out of fear that it will encourage promiscuity,” she says.

She says balancing her role as mother and as surgeon is paramount as family comes first.

She advises people to be ambitious and pursue their goals relentlessly’.

“Don’t be afraid to try. Keep pushing forward, and with time, you’ll achieve the excellence you’re striving for,” she adds.