Bangla

Tribune

In 2000, Dr Sayeba Akhter was chair of Dhaka Medical College Hospital’s (DMCH) Gynaecology and Obstetrics Department when she noticed that many new mothers were dying from excessive bleeding after giving birth. Death from blood loss - also known as postpartum haemorrhage - was the primary cause of the high maternal mortality rate in Bangladesh 30-40 years ago. Many women also had to have their uterus taken out to prevent bleeding following childbirth, denying them the opportunity of having more children in future. Bypassing otherwise expensive medical treatment, Dr Sayeba was able to discover a simple and cheap solution to the bleeding which is now known worldwide as ‘condom catheter tamponade’, or simply ‘Sayeba’s method’. [arve url="https://www.youtube.com/watch?v=-NAjgtMwoZ8"/] Speaking to the Bangla Tribune about her discovery on August 6, Dr Sayeba explained how a traumatic experience would change the course of medicine: “One day, two women died right in front of me from bleeding out after giving birth. Then I thought about all the children in the village who played with balloons, and I started wondering if I could stop the bleeding by inserting balloons filled with water inside the uterus. The first step to stop bleeding is to apply pressure on the uterus. But it’s impossible to apply pressure during bleeding. “The very next day, I went to the hospital and saw that doctors were forced to cut out a woman’s uterus to prevent bleeding. I stopped them and told them to not cut the uterus out just yet. I asked for some time, because the primary way to stop bleeding is to apply pressure. If I could somehow apply pressure to the uterus, I could stop the bleeding. That was the first time I used the ‘condom catheter tamponade’, and the bleeding stopped within 10 minutes.” Dr Sayeba then applied the same procedure to 23 other women. They all recovered and were able to return home. Since then, her method has saved the lives of millions of new mothers worldwide. Dr Sayeba explained how her pioneering method works by using a catheter, a condom, a little bit of string, a saline set and a saline solution: “When there are cuts on an arm or a leg, applying pressure stops the bleeding and this method works the same way. The condom is attached to one side of the catheter with the string, and the other side is inserted into the saline solution with the saline set. The condom is then inserted into the uterus and inflated with the saline. The inflated condom then applies pressure on the uterus, stopping the bleeding.” Dr Sayeba said that 31% of all maternal deaths in Bangladesh used to be from postpartum haemorrhage, but that number has reduced dramatically because of her discovery. “The entire apparatus only costs Tk100, so it can be used in any health complex or community clinic. If this method is used, we can save lots of new mothers, and we do not have to take out their uterus,” she said. Dr Saqlain Rasel, a vascular surgeon at the Ibrahim Cardiac Medical College and Hospital (BIRDEM), was interning as an assistant to Dr Sayeba in 2003-2004. He said Dr Sayeba’s method was published in the 2003 Medscape medical journal, as a research paper in the International Gyne and Obs journal, and as an article in the British Medical Journal Review. “It came to be known worldwide as ‘Sayeba’s method,’” he said. “(It) can save the lives of mothers around the world with only 99 cents, or Tk100. The method is being used in Bangladesh, India, Nepal, Sri Lanka and Canada.” Dr Saqlain Rasel also said that Dr Sayeba was jointly awarded for her discovery of this method and the fistula by England’s Royal College. However, the method has recently been wrongly attributed to a midwife in Kenya by a BBC News segment, in what experts have called “a gross mistake by the media”. “A midwife in Kenya learned how to use this method (and) the international media has credited her with the discovery,” Dr Saqlain. “It is sad that such a revolutionary medical discovery by a Bangladeshi doctor is being overshadowed like this.” After the method was published in multiple international journals, doctors from multiple countries learned the method from Dr Sayeba. There are many FCPS dissertations, MS and Ph.D theses on this method. Mosharraf Sultana, who worked with Dr Sayeba in the past, outlined the wealth of research on the method and told the Bangla Tribune: “It is unfortunate that the achievements of our doctors are published in international journals and other countries get the credit for it.” Dr Sayeba Akhter is currently in Indonesia, where she is providing training at an international seminar on the method named after her.