A petition has been launched to pause the use of surgical mesh to treat a common birth injury as women continue to be harmed by the device despite Government intervention.
This week the Herald revealed 30 Health and Disability Commission (HDC) complaints from women living on morphine and becoming suicidal from "razor blade" pain caused by mesh. Many women claimed the medical device was implanted without their informed consent, as they weren't given enough information about the risks and alternative options.
The complaints were collected by Sally Walker, who told her story to the Herald in June, describing her insides being so badly damaged by the medical device that her bladder had to be removed and her vagina sewn closed.
Now, the 73-year-old has also created a public petition to suspend the implantation of mesh for stress urinary incontinence (SUI), a common birth injury that leaves mums peeing without warning.
As of Thursday afternoon, nearly 700 people from across the country had signed the petition listed on Parliament's website.
Walker said she believed many surgeons were implanting the medical device incorrectly and were not properly trained to use the woven plastic for birth injury treatment.
"It's not just one surgeon or one hospital. Mesh harm is happening all over the country and it needs to stop," Walker said.
"The UK paused the use of surgical mesh for SUI and I believe we should follow their example ... the benefit does not outweigh the risk."
A spokesperson for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) said they acknowledged the pain and distress suffered by many women who had experienced complications arising from pelvic mesh implant.
"We remain committed to ensuring women are given evidence-based guidance and are offered an appropriate range of treatment options," they said.
The college supported clinical governance, including regular monitoring of outcomes, a review of early and late complications and a review of complaints, the spokesperson said.
Green MPs Elizabeth Kerekere and Jan Logie have said they back the petition. A spokesperson for the MPs told the Herald they were keen to work with Walker to provide further support.
Associate Minister of Health Ayesha Verrall said she was aware of the petition and surgical mesh was an issue which had affected many people and undeniably caused harm.
"The Government has taken this issue seriously and already undertaken steps to ensure past wrongs are rectified, including an apology by ACC, as well as changes to ACC's processes," Verrall said in a statement.
"Everyone in New Zealand has the right to health services of an appropriate standard.
"Where care isn't to an acceptable standard, they've been treated unfairly or harm has occurred, they have the right to be heard," the minister said.
In June, the Herald revealed documents released under the Official Information Act showing director general of health Dr Ashley Bloomfield had emailed all district health board chief executives, in September 2018, seeking "support of actions to minimise risks [from surgical mesh] to patients".
The director general's email included a letter from the ministry's chief medical officer at the time, Dr Andrew Simpson, advising they were working on requiring surgeons to have an appropriate qualification to use surgical mesh for urogynaecological procedures.
The documents showed that while some DHBs - such as the Bay of Plenty and Lakes - said they would no longer perform these surgeries, other DHBs - such as Auckland - responded saying they already had qualified specialists undertaking surgical mesh procedures.
However, some of the specialists named as having "appropriate qualifications" have also been blamed by affected women for causing them severe harm.
This year, the Ministry of Health rolled out a new framework involving an assessment of practitioners' background, capability, and surgical outcomes - including complication rates, patient-reported experience and outcome measures - by a panel of experts.
However, Walker and other advocates spoken to by the Herald said they remained concerned this framework would not be robust enough to ensure women were protected from mesh harm.
In 2018, a Ministry of Health restorative justice inquiry heard from 600 people, mainly women, injured by surgical mesh.
Many suffered chronic debilitating pain, erosion, and infection and were left unable to walk without aid, have sex or exercise. Some tried to take their own life as a result, the report said.
While other countries, such as Scotland and England, put a pause on the use of pelvic surgical mesh in 2018 - which continues today as surgeons couldn't guarantee its safety - New Zealand did not follow suit.
If 35-year-old "Kate" had lived in Britain, her crippling, life-damaging mesh surgery wouldn't have happened.
British urologist Dr Hashim Hashim says his country suspended mesh surgery to treat SUI four years ago due to public concern - and the ban's yet to be lifted.
He said there were six criteria the Government needed to implement before mesh surgery could be reintroduced.
These included appropriate training for surgeons, a national database, a register of operations to ensure every procedure is notified and the women can be identified as having undergone the surgery, reporting complications, specialist centres for those who experience harm and national guidelines on the use of mesh for SUI.
"Data is lacking when it comes to pain and that is what we need to look into. This is where registries will help."
Hashim said he had removed mesh from more than 200 women based in Britain, Europe and the Middle East.
"Pain is the most common reason we remove mesh, followed by erosion."
He said he was seeing mesh complications arise in women sometimes after eight years following their procedure.
"It's difficult to pinpoint one cause for complications and every case is different. There are three factors that need to be considered: The surgical skill, the patient comorbidities (other illnesses) and the mesh properties. A problem in any of them can cause complications," Hashim said.
"Mesh procedures need to be taught before being practised. Nice [National Institute for Health and Care Excellence] said that at least 20 needed to be performed per year to maintain skills."
The surgeon said informed consent was heavily debated and things are changing in this area.
"Nice guidelines since 2006 have emphasised the need to offer all options. Things have progressed with national leaflets and decision aids now offered to all women having incontinence and prolapse surgery. Clear documentation is key."
READ MORE STORIES FROM OUR IN HER HEAD PROJECT
In Her Head is a Herald campaign for better women's health services. Health reporter Emma Russell investigates what's wrong with our current system, and talks to wāhine who have been made to feel their serious illness is a figment of their imagination or "just part of being a woman".
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