August 7, 2023

With the first phase of Texas Children’s Pavilion for Women’s $245 million expansion complete, outpatient OB/GYN practices recently moved to their new home across the street at Pavilion Tower II. The former Baylor Clinic building (located at 6620 Main Street) will transform into Texas Children’s newest medical tower upon completion – adding 190,000 square feet to the hospital’s footprint, improving patient access and creating space for more adult inpatient and neonatal intensive care beds within the Pavilion for Women.

“This investment in our Pavilion for Women will allow us to increase delivery volumes significantly, but additionally the added space will allow us to continue to grow these specialized clinics that cater to women at every stage of life,” said Michele Birsinger, assistant vice president of Women’s Services.

First to migrate was the Women’s Specialists of Houston (WSH) team on June 12, followed by Partners in OB/GYN Care (POGC) on July 18. Both groups halted clinic operations for moving day, gathering bright and early to ceremoniously turn the lights out in their old space and walk together to the new tower. Clinic leaders shared inspiring remarks upon arrival, and a workforce chaplain was present to facilitate a Blessing of the Hands and gratefulness prayer before lights were turned on with excitement and cheer.

We want to emphasize the importance of the people, read the moving day pamphlet. The Pavilion Tower II is a state-of-the-art facility, but without the people, processes and programs in place, it’s just a facility…the dedicated, intelligent and passionate faces that light up our clinics will remain the same for our patients and families.

To mark the special occasion, team members participated in a scavenger hunt to get familiar with their new floors and were treated to gift bags and mini Zen gardens for their desks. Workforce Well-being was also on hand to provide resources and gather insights on how to best equip and decorate respite rooms.

Before the OB/GYN clinics relocated, our Women’s Physical Therapy team were some of the first occupants of the new medical tower.

“Although we’ve offered physical therapy services since 2012, this is the first time we’ve had our own designated space,” said Sarah Ammons, specialty therapy coordinator. “We now have eight treatment rooms and a gym area, including cardiovascular and strength training equipment…care will improve greatly now that we have the space and resources to treat our patients more completely and return them to their prior level of function.”

These clinics are now open for patient activity – you can find WSH on Level 13 and POGC on Level 11 of the new medical tower, just follow the signs on the sky bridge on Level 3 of the Pavilion for Women. Baylor OB/GYN will relocate by the end of 2023, and the full Pavilion for Women expansion will complete in 2024.

Click here to read more on this exciting development.

June 8, 2021
Photo credit: Smiley N. Pool

Editor’s note: This article was prepared by Dr. Jeffrey Wilkinson, director of the Global Women’s Health Program at Texas Children’s. Based full-time in Malawi, he is also vice-chairman for Global Women’s Health and professor, Obstetrics & Gynecology, at Baylor College of Medicine.

With generous philanthropic support, Texas Children’s has partnered with the International Federation of Gynecology and Obstetrics (FIGO) to help provide life-altering surgery to the millions of women worldwide who suffer with obstetric fistula.

Obstetric fistula occurs when obstructed labor is not relieved by a timely cesarean delivery. The woman is left with a hole between the vagina and bladder or rectum, and leaks urine and/or stool constantly. Most often, the baby also dies during the delivery. Surgery is the only cure, and is often complex and requires extensive training.

The condition rarely occurs in high-income settings, but is commonly encountered as a result of delays and lack of health systems capacity in very low-income settings. One such country is Malawi, where Texas Children’s and Baylor College of Medicine have a vibrant program in child, maternal and neonatal health that includes obstetric fistula.

Texas Children’s Global Women’s Health doctors and FIGO have been working together for many years, but in the last two years Texas Children’s has been providing support for the ground-breaking FIGO Fistula Surgery Training Initiative or “Fistula Fellowship.” The initiative has trained 66 fistula surgeons in 22 countries, mostly in sub-Saharan Africa. More than 13,000 fistula repairs have been performed by FIGO-trained fellows, and Texas Children’s doctors are amongst the trainers in this initiative.

It is a great privilege to be involved with such a productive global program that fights for women and girls with obstetric fistula to get the care they need.

“The FIGO Fistula Surgery Training Initiative is just one part of the many ways that Texas Children’s contributes to the lives of women and their babies in low-resource settings,” said Dr. Michael Belfort, Texas Children’s OB/GYN-in-Chief. “We are thrilled to be part of this program.”

Since the COVID-19 pandemic has waned somewhat, our partners in Malawi at the Freedom from Fistula Foundation program have renewed efforts to repair the backlog of women who are suffering with this condition. The team there uses guidelines and training materials from FIGO to teach physicians and mid-level providers how to properly evaluate and surgically repair women with obstetric fistula and work towards better outcomes.

Texas Children’s is committed to helping end this terrible condition by working with partners globally to prevent it in the first place, and treat it once it occurs. Our prevention efforts are concentrated on teaching and providing safe delivery to women in Malawi and other settings. By partnering with FIGO, we have expanded our efforts to reach multiple countries and countless women with obstetric fistula. One day, obstetric fistula will be relegated to the history books and Texas Children’s will have played a significant role.

To learn more about Texas Children’s Global Women’s Health Program and our efforts to end obstetric fistula, click here.

We also recently co-hosted a Twitter Chat with FIGO in recognition of the International Day to End Obstetric Fistula. Read what our partners and leading fistula experts had to say here.

March 30, 2021

Claims linking COVID-19 vaccines to infertility have been scientifically disproven. Doctor Mark A. Turrentine explains further in this short video.

Texas Children’s own Dr. Lisa Hollier recently traveled to the Texas State Capitol to testify on behalf of a proposed bill that would extend Medicaid coverage for low-income mothers across the state, providing them with more access to lifesaving care.

Hollier delivered her testimony to lawmakers on March 23 during a House Committee on Human Services hearing on House Bill 133, which was authored and filed by State Rep. Toni Rose.

In addition to her role as Chief Medical Officer and Sr. Vice President of Texas Children’s Health Plan, Hollier is also chairwoman of the Texas Maternal Mortality and Morbidity Review Committee. The committee released a report late last year that noted that most pregnancy-related deaths in Texas are preventable.

To help reduce the incidence of pregnancy-related deaths and maternal morbidity in the state, the committee recommended increasing access to comprehensive health services not only during pregnancy – but also in the year after pregnancy, and throughout the preconception and interpregnancy periods.

Hollier and other advocates of HB 133 agree that lengthening insurance coverage would go a long way toward saving the lives of new mothers who experience pregnancy-related complications within a year of giving birth. Currently, coverage drops off after 60 days.

“By extending Medicaid with a more comprehensive set of services, we would be able to reach more women and address their needs,” Hollier told legislators, as quoted in an article in the San Antonio Express-News.

A board-certified OB-GYN and leading expert in maternal health, Hollier is the immediate past president of the American College of Obstetricians and Gynecologists (ACOG). She was elected to the post in 2018 and immediately pledged to focus on reducing preventable maternal mortality during her term.

Hollier was also selected to receive the 2019 Mark A. Wallace Catalyst Leadership Award.

If you’re a Texas Children’s team member who has been asked by an advocacy group, legislative staff member or other organization/entity to provide public support or testimony on legislation, please contact Government Relations before responding or taking any additional action. You can reach the team by phone at 832-828-1021.

March 23, 2021

Texas Children’s is using artificial intelligence technology to remotely monitor vital health data for expectant mothers in Malawi, giving providers a new tool to help patients avoid the risky situations that can arise during childbirth – and all from literally an ocean away.

In a unique public-private partnership that brought together Texas Children’s, Baylor Foundation Malawi, Ministry of Health Malawi and software solution company PeriGen, PeriWatch Vigilance successfully went live on March 10 at Area 25 Hospital in the capital city of Lilongwe.

An automated early warning system and clinical decision support tool for obstetrics, PeriWatch Vigilance is designed to enhance clinical efficiency, timely intervention and standardization of care. The technology uses artificial intelligence and other analytical techniques to continuously analyze maternal vital signs, fetal heart rate, contractions and labor progression.

Once the data is collected and analyzed, the Periwatch Vigilance platform associates it with predefined bed or room locations within the system. Approved providers can then view and access the data for each patient at Area 25, which is collaboratively run by Baylor Foundation Malawi and the Malawi ministry of health and performs more than 7,000 deliveries each year.

“This initiative represents a paradigm shift in care for Sub-Saharan Africa,” said Dr. Michael Belfort, Texas Children’s OB-GYN-in-Chief. “The use of advanced artificial intelligence programs to address the needs of a low-resource environment is an ideal way to leverage technology to the benefit of all.”

The Periwatch Vigilance project team at Texas Children’s worked closely with partners in Malawi to overcome many of the obstacles they faced when implementing the new technology, including network infrastructure and procuring the necessary workstations. They also had to work within a complex security design to ensure Texas Children’s data and infrastructure remained safe.

“The technical infrastructure present in Malawi provided some unique challenges that required strong partnership with our vendor, Malawi staff and the Texas Children’s Information Services department,” said Ashok Kurian, Director of Data & Analytics, Information Services. “The teams worked together to develop a solution that would allow for secure data transfer, which overcame these challenges.”

Project team members included Melissa Blado, Mark Carey, William Cheong, Jeremy Church, Keith Garcia, Terry Hamidi, Farkhad Kasumov, Justin McMillan, Veena Nagarajan, Tina Oduguwa, Dan Parker, Aaron Rainey and Melissa Witt.

With the lessons they learned to launch PeriWatch Vigilance in Malawi, the IS Department anticipates deploying the same technology to other African countries in the future – particularly Botswana and Uganda, which are also part of Texas Children’s Global Health Network and have already been discussing, planning and constructing their approach.

Created in 1999 by the Baylor International Pediatrics Aids Initiative (BIPAI), the network catalyzes pediatric and family HIV care and treatment, and continues to be the largest provider of pediatric HIV care in the world. Through its partnership with Texas Children’s, the network has also expanded its scope to include tuberculosis, malnutrition, Sickle Cell Disease, oncology, cardiology, emergency medicine, surgery, anesthesiology and maternal health.

January 11, 2021

Watch this video as Dr. Michael Belfort shares some of his team’s outstanding achievements over the last decade at Texas Children’s Pavilion for Women.

January 4, 2021

The story you are about to read is part of an ongoing series about Texas Children’s efforts to care for women and children around the globe. The series highlights Texas Children’s efforts in Malawi, one of the 17 countries we currently serve. Today’s story focuses on women’s health and the services Texas Children’s, in partnership with Baylor College of Medicine, offers to women suffering from obstetric fistula, a life-changing complication of childbirth that is extremely common in sub-Saharan Africa where specialized medical services are hard to find.

Dita Zakiyeli clasped her 2-year-old daughter’s hand as a group of women at the Freedom from Fistula Care Center in Lilongwe, Malawi, circled around them and broke into song. The celebration marked the end of Dita’s month-long stay at the center where she received life-changing surgery to correct a condition that affects tens of thousands of women in sub-Saharan Africa, often leaving them withdrawn from their social lives and ostracized by their loved ones.

Dita arrived at the center after hearing about how the staff there had helped other women suffering from obstetric fistula, a complication of childbirth resulting in damage to pelvic and reproductive organs, causing constant urinary or fecal incontinence. Most fistulas are caused by prolonged labors and lack of access to timely cesarean delivery. Dita developed the condition when she was 19 while trying to give birth to her first child. The child did not survive and Dita’s husband left her because of her fistula and the symptoms it causes.

“Some of our patients have told us their families have kicked them out, and other times the women feel embarrassed or ashamed and move out on their own,” said Dr. Jeffrey Wilkinson, who has been operating on women at the Fistula Center for the past decade. “Obstetric fistula leads to a life of social isolation, no matter which way it happens, and many women feel cursed because they also have lost their babies in the process.”

It is estimated that more than two million women in Africa – 20,000 in Malawi alone – live with obstetric fistula, even though it is preventable with access to the right kind of obstetric and gynecological care. But in a place like Malawi, there are many barriers to even the most basic care. In some cases, a woman might give birth in a medical facility that doesn’t have an operating room much less a surgeon. In other cases, there might be an operating room available, but not the right equipment or the expertise needed to perform the type of surgery that’s required.

An offering of hope

Texas Children’s and Baylor College of Medicine through the team they support at the Freedom from Fistula Care Center in Lilongwe, Malawi, are working together to provide hope to women like Dita. Run by Texas Children’s Global Women’s Health and the Freedom from Fistula Foundation, the center and its staff care for and surgically treat women with obstetric fistula. Since opening its doors in 2011, the team has performed more than 2,500 fistula repair surgeries – about 400 a year – with a 90 percent success rate.

“The difference the work this team has made in the lives of so many women and their families is tremendous,” said Dr. Ennet Chipungu, a Malawian native and the center’s medical director. “The teaching and training they have provided to local medical professionals is equally as impactful.”
Chipungu herself was trained by Wilkinson as part of a one-year individualized fellowship in obstetric fistula care. The Freedom from Fistula Care Center benefits from these individual fellowships as well as the Texas Children’s Obstetrics and Gynecology Global Women’s Health Fellowship.

The goal of the Texas Children’s Obstetrics and Gynecology Global Women’s Health Fellowship is to provide fully-boarded or board-eligible obstetrician/gynecologist with additional clinical training and research experience in a global setting. So far, three fellows have graduated from the program. One still works in sub-Saharan Africa and the other two work with underserved populations in the US. All are from the US.

In addition to these fellowships, the center’s staff is augmented by two residency programs, the first of which began in 2014 with help from Texas Children’s and Baylor College of Medicine. Housed under the Malawi College of Medicine, the program has graduated 14 residents and currently has 14 enrolled.

A new residency program for local Malawians studying women’s health began last year for residents at Baylor. Rachel Kopkin is the program’s first resident. She will spend six months out of four years in Malawi during her residency.

“There are not very many places where you can get fistula surgery in Africa because it takes specialized training,” Wilkinson said. “It’s not something the typical OB-GYN in the US has even seen or can repair. That’s why the Fistula Care Center and its training program is so important. We have expert surgeons, nurses and staff taking care of these women and we have the knowledge and capability to handle both basic and complex cases.”

Spreading the word

In addition to the fellowship and residency programs, Chipungu, Wilkinson and their colleagues have started training surgeons throughout Malawi to do simple fistulas because they don’t take quite as much expertise and specialized postoperative care. The complex cases, however come to the center.

Fainess Pheleni, for example, came to the center with a fistula and a severe amount of scar tissue. With the help of Texas Children’s Surgeon-In-Chief Dr. Larry Hollier, who has helped train some of the fistula surgeons in basic reconstructive plastic surgery techniques, the team repaired Fainess’ fistula and her scar tissue, allowing the 22-year-old to move past the health issues that had plagued her well-being for some time and took the life of her only child.

“Being able to fix a woman’s fistula and reconstruct some of the damage it has caused has made a huge difference in our patient’s outcomes,” Chipungu said. “Unfortunately, there is a disparity here between what’s available for women to do and how they can support themselves. Having a family, not just a husband, but also children, is paramount to their existence. So, fertility is extremely important, and with fertility comes sexual intercourse. So for our patients who aren’t able to have intercourse, it means they’re not able to find a husband and they’re not able to have an economic stable livelihood.”

The team at the Fistula Care Center provides the physical, and many times the emotional and mental, care these women need to get back on their feet again. For Dita and Fainess, the help they received at the center gave them a chance at a new life.

“I was extremely well cared for while I was here,” Dita said. “They gave me everything I needed, to start over again.”

For more information about The Freedom from Fistula Care Center, click here. To make a donation to Texas Children’s global health efforts, click here.