Dr Kirya’s experience as a fistula surgeon

Tell us about yourself
My name is Dr Fred Kirya, I am a senior consultant surgeon and urologist at Soroti Referral Hospital. I am married and I have three children. The eldest is in Primary Seven. My wife is an eye specialist, we got married in 2002.

What inspired you to do medicine?
Initially, I wanted to be an engineer and excelled at maths. I was even offered physics, chemistry and had to choose whether to do maths or biology. I ended up choosing biology and gave up my dream of being an engineer.
I chose biology because I had an uncle who was considered the brightest in our family and he did physics, chemistry and biology. I wanted to follow in his footsteps.

Where did you go to school?
I did my A-Level at Tororo College and later on went to Makerere for my medicine degree. I came from a poor background so my parents couldn’t afford luxury but I enjoyed by undergraduate training. I completed my degree in 1993 and went to train at Lacor Hospital where I got my first salary of Shs300,000. I worked there for two years before I went back to medical school in 1996 for further training. This was in India, where I specialised in urology.

Why urology?
I loved urology. When I completed my studies, there were few urologists. I wanted to offer my services, get better education and definitely a better salary. So I did urology.

How did you end up in Soroti as a surgeon?
When I finished my studies at Makerere, I thought I would teach there but at the time, the policy was not yet clear. I was then posted to Arua for an administrative post as a medical superintendent.
I did not want to go because I wanted to continue practicing my profession. I then exchanged the position with my best friend who had been posted to Soroti.
You deal a lot with fistula repairs, how did you become an expert in this field?
Fistula affects the urinary system of an individual. A fistula is an abnormal opening that is usually created between the bladder and the vagina or the rectum and vagina causing a person to leak urine or faeces uncontrollably.
Because it involves the bladder, which is part of the urinary system, it definitely falls under urology.

Most doctors would rather do something fancier but you chose to specialise in repairing women with fistula. What was your motivation?
There was a certain doctor, Dr Thomas Russen, who used to fly in once a year and carry out fistula surgeries in Kumi. He was the president of International Society of Fistula Surgeons.
I wanted to gain skills so that I could be able to carry out surgeries like he did and change the lives of these women.
After training with him for some time, he felt I could carry out my own surgeries and that is how I became a specialist in that area.

What does your wife think about your job as a surgeon especially for women?
I think being a doctor herself, she is more understanding. This is something I thank God for.
She is grateful about the job but she is not happy that I have little time for my children.

What do you consider as your greatest impact so far?
For the past 12 years, I have carried out more than 1,500 surgeries. We have been able to give back hope to those who had lost it.
Additionally, we have been able to train at least 10 surgeons to continue helping those we have not been able to reach. That for me is a milestone.

What do you think needs to be done to tackle the problem?
There is need to improve maternal health, girl child education, the economy, family planning, antenatal care and emergency response because all these contribute to the development of fistula.
If you do not go to school, you are prone to getting pregnant as early as 13 years of age. You and your parents want to reduce the burden of a big family while at the same time helping you get a better life.
When you get pregnant, because of the poor state of maternal health services in the country, the services are not good enough to prevent you from not getting the condition.
All these revolve around each other and if we are to beat fistula, we have to tackle all of them.

With the knowledge you have, if you were given a chance to change, would you choose the same career path?
I would still love to be a urologist although I would not want to practise from such a country where there is poor equipment and little pay.
I would have gone to a better country with good equipment where I would pass on my skills as I learn with good facilities and general health care.

Tell us about your most challenging surgery
In the line of fistula, my recent yet most memorable surgery was in 2013. It was a 20-year-old girl who was born without a bladder and her uterus had prolapsed or was hanging out of her stomach.
She had had previous surgeries but all did not help with the leaking problem. So, we had to divert her urine to the intestines so that she could urinate while having a long call.
Her case was complicated not only was her uterus hanging out of her body, but her kidneys were damaged, she was leaking urine and her other systems were failing.
It was a very long surgery. I got tired because we spent close to four hours in the theatre. All she wanted was to be accepted in society. I was glad, I helped her.

That is quite a tale. What else stands out?
I vividly remember this like it happened yesterday. One morning, about five years ago, a woman came to the hospital with a knife sticking out of her back.
Her husband had stabbed her at night. We (the medical team)were all worried about how to carry out the surgery.
Finally, we agreed to open her (operate) to see what was in store for us then debate on how to best proceed. We managed to remove the knife, which had just scratched the kidney but injured her intestines. She recovered and I promised that if she needed to report her husband, I would testify in her favour. It was the most brutal thing I had ever seen a husband do to his wife.
To date, I still have that knife as a reminder of that experience.

What motivates you to continue working?
Every morning I wake up and run to work apart from Sunday when I run to church first then to work. I feel the urge to help. I have some skills that many people do not have, so I use them to help others. Although the pay is little, it has enabled me to look after my family and made me what I am now.

Many young doctors love money and status more than helping others. What would be your aice to them?
My job has taught me to look beyond self. There must be someone to sacrifice for others it has taught me that life is not simple. I used to think I would have a good life as a doctor but I have learnt to make do with what God has given.

If you were offered an opportunity to leave Soroti and do something more paying, would you consider it?
I have had offers to go away and work elsewhere but I have not yet accepted any. I do not think I am yet to accept any. I would consider myself a bread winner in our family I think my mother has survived her diabetes because of my close supervision. My father, too, has diabetes and hypertension.
I think if I ever leave, it would crash them. I spare every Saturday to visit and care for them.

Anything we didn’t ask and you would like to share?
My job as a surgeon has helped me become one of the proprietors of Joint Clinic in Soroti and Mt Elgon Hospital in Mbale where I go every Saturday to carry out surgeries. I also think the environment is important and I have planted 20 acres of trees, I love trees.

Kirya at a glance
Born in a family of six, Dr Kirya went to Bukedi College for his O-Level and St Peter’s College Tororo for A-Level. He went on to do medicine at Makerere University and trained at Lacho hospital for a year before he was retained at the hospital as a medical officer. He then headed to India to further specialise in urology.


SOURCE: Daily Monitor


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