Canadian missionary-surgeon Stephen Foster’s devotion to Angola now stretches beyond 45 years — a significant milestone without a doubt.

Arguably, what makes the Brantford, Ont., product’s longevity of service — highlighted by a 26-year streak beginning in 2000 — in the Central African country particularly noteworthy is that he and his colleagues were called to make a bold, brave choice early on in 1975 when civil war broke out.

“There was a certain wonderful sense in which the willingness to stay put in a place would enable us to serve in the name of Jesus and serve in a way that would point people to Christ,” said Foster, who received his surgical training at the University of Toronto. “If we put our tail between our legs and run for cover to protect ourselves, we weren't going to honour anyone at the end of the day.”

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The civil conflict persisted on and off for 27 years until the Feb. 22, 2002, death of National Union for the Total Independence of Angola (UNITA) leader Jonas Savimbi, which set in motion a path to end the war.

Blessings and challenges are constant companions for Foster in his work on behalf of Jesus and the Angolan people. Presently, the maternal health crisis raging in the country, caused by a high prevalence of the devastating childbirth injury Obstetric Fistula, is of grave concern to the bush hospital medical doctor situated in Lubango.

He explained to The Catholic Register that nearly half the Angolan population — 18 of 37 million — dwells in rural areas. The only type of medical professional available for Angolan mothers, an average of whom bear five children, is a “traditional midwife of yesteryear who has been delivering babies since the book of Genesis.”

Because there is such limited access to caesarean sections or other forms of support during difficult births, obstetric fistula can occur — a condition in which a hole forms between the vagina and the bladder when a baby’s head becomes stuck in the mother’s pelvis. Sustained pressure from labour contractions compresses the soft tissues, cutting off the blood supply. The affected tissue can then break down, leading to a fistula. Within days, a woman may begin experiencing incontinence. In over 90 per cent of cases, the baby dies, as this prolonged obstruction deprives them of oxygen.

Foster said his hospital offers surgical support to 170-200 women a year, and knows of another establishment equipped to handle more than 500 fistula procedures. But he’s cognizant that it's just scratching the surface.

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According to the World Health Organization, there is an estimated 20,000 women currently living with the condition. And the distance many of them are required to travel is like asking someone from Thunder Bay to come to Toronto for help, said Foster.

Fortunately, he and other surgeons looking to tangibly better the situation have an ally in the form of the Missionary Aviation Fellowship (MAF) Canada. The MAF, headquartered in Three Hills, Alta., harnesses the talents of pilots to aid Catholic, Christian and humanitarian agencies around the world. They transport lifesaving aid, and in this case, they make a life-giving impact by transporting rural women to hospital facilities so they may undergo safer childbirth or by couriering medical teams into isolated communities.

Robin Grimstead, MAF’s partnership manager in Alberta, said the impact of a procedure stretches well beyond the surgical theatre. She recalled what Foster once told her about a woman he treated.

“It's about restoring dignity, it's about healing and about connection,” said Grimstead. “He said this woman’s whole posture was different. She just held herself with more pride and dignity, and that's just so significant.”

Foster praised MAF for making a game-changing difference.

“When MAF’s willing to fly a planeload of women two, three, four times a month at our disposal, oh my goodness, it just transforms the whole story,” said Foster. "It makes it a beautiful story when they go home and have joy written all over their face as they’re able to share. There's nothing more powerful than the sharing of a woman who goes home dry with her, fellow ladies who didn't want to talk about it, didn't want to admit it. And then the story starts emerging as they get home and talk.”

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Leading up to International Day to End Obstetric Fistula on May 23, MAF Canada is inviting Canadians to support its “Lift Her Up” movement throughout May with prayer and a charitable gift to help fund flight fuel.

To learn more, visit maf.ca/lift.