Born: 10 September 1938, Ireland
Died: 9 December 2017
Country most active: Angola, Uganda
Also known as: Mary Lynch
This biography is republished from The Dictionary of Irish Biography and was written by Angela Byrne. Shared by permission in line with Creative Commons ‘Attribution’ (CC BY) licencing.
Lynch, (Mary) Maura (1938–2017), missionary nun and surgeon, was born Mary Lynch on 10 September 1938 in the family home at the post office on North Main Street, Youghal, Co. Cork. She was the fourth of the nine children – three girls and six boys (Aidan, Breda, Brendan, Ciaran, Enda, Finbarr, Kathleen and Kevin) – of postmaster Patrick Lynch and teacher Jane Lynch (née Williams), who raised their children through Irish. Patrick Lynch’s profession caused the family to move frequently. They lived in Bantry before moving to Youghal in 1936 (where Maura attended the Presentation convent school, 1942–5). The family subsequently lived in Carrick-on-Shannon (where Maura attended the Marist convent school, 1945–8), Killarney (where Maura attended the Mercy convent school, 1948–50), Tralee (where Maura attended the Presentation convent school, 1950–54), and, from 1954, Limerick city (where she spent two years in Laurel Hill catholic girls’ secondary school), before finally settling in Dublin.
Lynch decided upon her path in life at nine years of age, when she first learned of the work of the Medical Missionaries of Mary (MMM), a religious congregation established in 1937. In 1956, having just completed her leaving certificate examinations at Laurel Hill, she joined the MMM in Clonmel, Co. Tipperary. It was a time of record professions to religious orders in Ireland; there were 13,360 nuns living in the country in 1950.
Lynch enrolled as a medical student in University College Dublin (UCD) in 1958 with the support of the MMM, and excelled. She came in the top three in her class in 1964, graduating Bachelor of Medicine (MB), Bachelor of Surgery (B.Ch.) and Bachelor of Arts in Obstetrics (BAO), and winning the gold medal for surgery. She was house surgeon, house paediatrician, house physician and house obstetrician at Our Lady of Lourdes International Missionary Training Hospital, Drogheda, Co. Louth (1964–6) before completing a Diploma in Obstetrics and Gynaecology (DRCOG) at the Royal College of Obstetrics and Gynaecology in London in 1966.
Missionary surgery in Angola
Having completed her medical training, in September 1967 Lynch was assigned to Chiulo Mission Hospital in the far south of the then-Portuguese colony of Angola. The MMMs had established their first mission in Angola in 1953 when four Irish sisters, led by Sr M. Dominic Flynn, arrived in Chiulo at the invitation of the Holy Ghost Fathers. They opened a second hospital, 80km to the south in Cuamato, in 1962. There were an estimated 4,000 Irish missionaries across the African continent in the 1960s, but only a handful in Angola, and the MMM was the only Irish order operating in the country. In preparation for her departure, Lynch took a Diploma in Tropical Medicine and Public Health at the School of Tropical Medicine in Lisbon (1967) and studied Portuguese; she became fluent in that language and gained a grasp of some of the indigenous languages of Angola during her long residence there. At Chiulo, Lynch was required to work across the range of medicine, in surgery, obstetrics and orthopaedics, treating patients suffering from infectious diseases like tuberculosis or Hansen’s disease (leprosy), teaching medical students and acting as an examiner in the nurses’ training school. During the twenty years she worked in Angola, Lynch made several return visits to Ireland to work for short periods in nursing and tropical medicine at Our Lady of Lourdes Hospital in Drogheda (which had been established by the MMM), St Vincent’s Hospital, Dublin, and the MMM residence of Rosemount in Booterstown, Dublin.
During the civil war that followed Angola’s independence in 1975, Lynch and her colleagues – who included medical missionaries and local staff – risked their lives travelling through the rough terrain of the south of the country, sheltering in the undergrowth as aerial bombings pummelled the ground around them and travelling by bicycle to see patients at the remote Cuamato health centre. Soldiers armed with rifles could be seen in the operating theatre while Lynch and her colleagues treated combatants on both sides of the conflict. Communications were poor and Lynch’s family and friends in Ireland occasionally had cause for concern; international communication was confined to mail, and Lynch’s letters to Ireland took six weeks to arrive. Staff at Chiulo Mission Hospital could go for weeks without hearing from their colleagues at Cuamato. Friends later recalled Lynch’s calm demeanour in the circumstances, her only complaint being of getting sunburnt.
Prompted by the range of her medical duties in Chiulo, in July 1984 Lynch undertook surgical training at St Vincent’s Hospital in Dublin, where she was senior house officer and casualty officer. She qualified as a fellow of the Royal College of Surgeons in Ireland (FRCSI) in June 1985. A fellow MMM observed at the time that Lynch was apprehensive ‘about her future work, the desperate needs of her mission hospital for equipment and medicines which are no longer easily obtainable in Angola’ (Doran, 12), and so assisted her with securing donations from surgical suppliers. Despite her misgivings Lynch was keen to return to mission life, and did so in November 1985, bringing with her nine tea-chests filled with crutches, walking-aids and prostheses, as well as gifts for her fellow MMMs.
Uganda and specialisation in obstetric fistula repair surgery
In November 1987 Lynch was assigned to Kitovu Mission Hospital in the diocese of Masaka, southern Uganda, as a consultant surgeon, obstetrician and gynaecologist. Kitovu was the MMM’s only foundation in a country emerging from a period of instability following the overthrow of military dictator Idi Amin in 1979, and the Masaka region was badly affected during the Tanzanian-Ugandan war of 1979.
Prior to her arrival in Uganda, Lynch briefly trained in obstetric fistula repair surgery at Anua, Nigeria, under Dr Ann Ward (1929–2016), who had been performing the procedure there since 1959. The MMMs were by then well-established in Nigeria, having opened their first foundation at Anua in 1937, and ran several hospitals and medical centres around the country. Obstetric fistula (or vesicovaginal fistula, VVF) is a debilitating condition that arises as a result of prolonged and obstructed labour. It predominantly affects impoverished girls and women in countries where access to skilled, professional maternity and obstetric care is limited by cost, distance or availability. It is also associated with child marriage, where young girls’ immature (and often malnourished) bodies may struggle with delivery. The physiological effect is a tear or hole between the birth canal and/or rectum, bladder or ureter, leaving sufferers unable to control the passage of urine and/or faeces. The emotional and social effects are great as sufferers are frequently ostracised and isolated from their families and communities and lose their ability to work, often simultaneously grieving the loss of their baby due to prolonged labour. Struck by the plight of girls and women living with obstetric fistula, Lynch dedicated the remainder of her career to performing repair surgeries, training local medical staff and educating the public about the condition.
Lynch is estimated to have performed over 1,000 VVF repair surgeries, often in difficult conditions, with regular power outages and a lack of basic medical supplies. The typical patient was, by the early 2000s, fifteen to twenty years old and living in extreme poverty. By 2002 Lynch was no longer able to perform surgery due to an inoperable detached retina, but continued to play a key role at the hospital. She developed programmes around Masaka to educate husbands and traditional birth attendants about the risks of VVF, and ensured that post-surgical patients remained in the hospital until fully healed. A founding member of the Association of Surgeons in Uganda, Lynch was passionate about passing on her knowledge and pioneered training programmes in VVF repair for Ugandan doctors and nurses through United Nations Population Fund (UNFPA)-funded ‘fistula camps’.
In April 2005 Lynch opened a centre of excellence for the treatment of VVF at Kitovu. By the time of her death, the twenty-eight-bed unit and dedicated operating theatre was performing 250 operations per year; women receive free treatment, antenatal care and, in the event of subsequent pregnancies, caesarean delivery. By December 2008, 1,224 women had received VVF repair, fifteen doctors had been trained in repair surgery and twenty-four nurses had been trained in VVF care management at the hospital. During her thirty years in Uganda, Lynch earned a reputation as a champion of, and restorer of dignity to, vulnerable girls and women living with social isolation, physical pain and emotional distress as a result of VVF.
Legacy
Named by the UNFPA as one of the greatest fistula surgeons in the world, Lynch received international recognition and accolades for her work. In 2009 she was awarded an honorary fellowship of UCD’s school of medicine. In 2012 Lynch, together with her colleagues John Kelly, Brian Hancock and Winnie Nakalema, were presented with recognition plaques from the Fistula Faculty Group UK which held its inaugural meeting at Kitovu. In 2013 she was made an honorary fellow of the London College of Obstetrics and Gynaecology, and in 2015 she was awarded the prestigious Council of Europe’s North–South Prize. On accepting the latter award, she called for better education of girls and of medical staff to help the estimated 192,000 women in Uganda alone affected by VVF and to help reduce perinatal deaths. (The World Health Organisation estimates that as many as 50,000 to 100,000 women globally are affected by VVF each year.) The Ugandan state recognised her three-decade long contribution to the health and welfare of its citizens with a unique certificate of residency for life in 2003. In 2009 Lynch’s work in Kitovu was the subject of a photographic exhibition titled ‘Restoring dignity’ by Irish photographer Laurence Boland. Posthumously, in March 2019, a portrait by artist Enda Griffin was unveiled at the RCSI and, in 2020, the United Nations dedicated the International Day to End Obstetric Fistula to her name.
Lynch died suddenly in Nsambya hospital, Kampala, Uganda, on 9 December 2017 – the same day on which a celebration had been planned for the golden jubilee of her arrival in Africa. Her funeral mass and burial were held in Masaka on 13 December, with a concurrent requiem mass in the MMM convent in Drogheda, Co. Louth.
Lynch was an outgoing, infectiously joyful and exuberant person; after successfully treating an eighty-five-year-old patient who had lived with fistula for forty-five years, she and the patient danced. Boundlessly energetic, in 2013 she participated in a six-mile run to raise €5,000 for an overhead lamp for the Kitovu operating theatre. She was driven above all by a deep dedication to the Ugandan women and babies who were her patients and whose rights she tirelessly championed; they named her Nakimuli (‘flower’). As her sister, Breda Rogers, observed: ‘This was her vocation – looking after these women and babies. She loved Africa. And she always wanted to die there’ (Irish Times, 23 Dec. 2017).