“Lam alegn be semay, wetetuanim alay.”
I have a cow in the sky, but cannot drink her milk.
That’s what Dr. Rahel Nardos ’97 would have said when she was a little girl growing up in Ethiopia if someone asked if she ever imagined being a commencement speaker for a college in a distant land. But here she is, more than 7,000 miles from her native Addis Ababa, standing before a crowd of thousands on Franklin & Marshall’s Hartman Green on a beautiful spring day. She gives members of the Class of 2019 a glimpse into her remarkable story of passion, resilience and hope.
“My big ask of you is that you use your privilege as a force for greater good,” Nardos told the graduating class. “Do something bigger than yourself. Our world needs this now more than ever.”
It’s a lesson Nardos has lived for more than two decades. Fortified with her F&M degree in biology and psychology, Nardos went to medical school and discovered her passion as a surgeon. She returned to her home in Ethiopia and realized her calling, helping women in poor countries achieve optimal health care.
“Those early experiences were critical in shaping who I became,” said Nardos, director of global health for Oregon Health & Science University’s Department of Obstetrics and Gynecology. “The big- picture message for me is that your professional life evolves and changes all the time.”
Nardos was born and raised in Ethiopia, a communist country at the time, and attended an international high school run by Americans. There, her chemistry teacher directed her to F&M, where she believed Nardos would thrive.
“Certain critical people like mentors come into your life, change your trajectory, and then they go away,” Nardos said. “It’s pretty amazing. It kind of shapes where you go next. Seeking those opportunities and those people is key to being open to ideas.”
One mentor was F&M Professor of Psychology Michael Penn, who invited the undergraduate to write a health-issue book with him. They co-authored “Overcoming Violence Against Women and Girls: The International Campaign to Eradicate a Worldwide Problem,” published in 2003.
“It just opened my eyes about women’s issues in general, but specifically women’s health issues,” Nardos said. “I wanted to make a difference in this particular area, and I didn’t know which way was the best way to go about it.”
Between F&M and Yale University’s School of Medicine, she spent a couple of years deciding how to make a difference in women’s issues. Her thinking eventually evolved from neuroscience researcher to medicine.
“I like the one-on-one interactions with people and making a difference right away instead of further down the line,” Nardos said. At Yale, she decided on obstetrics and gynecology, and found a passion for surgery: “I like working with my hands.”
During residency, her mentor, L. Lewis Wall, a medical doctor and social anthropology scholar, encouraged her to consider urogynecology, a surgical subspecialty that addresses problems associated with the dysfunction of a woman’s pelvic floor and bladder. In countries like Ethiopia, the availability of such procedures was rare, if it exists at all. “He encouraged me to go and spend time there, to learn about the system and what the needs are, and to build relationships,” Nardos said.
She spent a year at Hamlin Fistula Ethiopia, a large hospital system in Addis Ababa, dedicated to the care of women with obstetric fistula, a trauma to bladder and bowels, the result of obstructed labor from lack of access to health-care providers for labor and delivery. This causes women to leak urine continuously, leading to social isolation.
“It’s a very devastating condition,” Nardos said. “I think for me spending a year there, working at the hospital, learning about the sociocultural factors that lead to health disparities in women, started my whole professional career in global health.”
She returned to the U.S. and received fellowship training in Pelvic Medicine and Reconstructive Pelvic Surgery at OHSU. There, she learned to care for women with disorders caused by childbirth and aging such as incontinence, prolapse and other pelvic floor and bladder disorders. Nardos’ dedication impressed Wall, her mentor and founder of the Worldwide Fistula Fund. He invited her to join the organization, and in 2017, she was elected WFF’s secretary.
At OHSU, she founded Footsteps to Healing, a global women’s health initiative that provides surgical services to rural Ethiopian women with pelvic organ prolapse and incontinence. Her organization partners with WFF, Hamlin Fistula Hospital and Mekelle University in Ethiopia to provide pelvic floor surgical care. The partners also created a Pelvic Floor Training program for local clinicians, nurses and physical therapists so that they can provide continued care of women.
“We’re focusing more on sustainability and care,” Nardos said of her organization. WFF provides support for Fistula and Pelvic Floor Health projects in Burkina Faso, Niger, Uganda and Kenya. The care extends to rehabilitation, reintegration and economic empowerment of women.
Under her leadership, Footsteps joined with WFF to increase access and capacity for care in sub-Saharan Africa by training local obstetrician-gynecologists. Their partnership supports the first urogynecology fellowship training program in Ethiopia in collaboration with Mekelle University and Hamlin Fistula Hospital. It also supports capacity building in critical care and hospital quality improvement.
“It’s one of those things that brings great fulfillment to me,” Nardos said. “It’s funny, with global health people think of it as a humanitarian thing. I actually get a lot more back.”
And as she looks at the faces of graduates on Hartman Green, she sees the power of global communities bridging divides for a greater good.
“When I talk to my patients who have lived with terrible childbirth injuries in Ethiopia and my patients in the U.S. who can’t leave their homes because they can’t control their bladder, what I hear is the same suffering, the same vulnerability, and the same hope for a cure,” Nardos says. “When I operate on them, I can’t tell them apart on the inside. Most of all, what gives me hope is you.”