The idea arrived, by Dr Sayeba Akhter’s own account, in the aftermath of loss. Two women had died in front of her from postpartum haemorrhage – heavy bleeding after childbirth, still one of the leading causes of maternal death worldwide – and in the hours that followed, a memory surfaced from somewhere unrelated entirely: Village children playing with water balloons. If pressure could stop bleeding from a cut on an arm or a leg, she reasoned, why couldn’t a balloon-like device, inflated inside the uterus, apply the same pressure where surgeons couldn’t otherwise reach?
The next day, at Dhaka Medical College Hospital, doctors had decided a patient’s bleeding could only be stopped by hysterectomy. Dr Akhter intervened and asked to try her idea first. She fitted a condom to a sterile rubber catheter, inserted it into the uterus, and inflated it with saline solution through the catheter’s tube.
The bleeding stopped within 10 minutes. She went on to use the same method – now known worldwide as Sayeba’s Method, or condom uterine tamponade – on 23 more women that year, all of whom recovered. Every component of the device is ordinary and cheap: A catheter, a condom, some thread, a saline set and saline solution, adding up to a total cost of around Tk500.
A formal prospective study was conducted at Dhaka Medical College Hospital between July 2001 and December 2002, examining 152 cases of postpartum haemorrhage. Most were managed with medication or the surgical B-Lynch procedure, but 23 patients with bleeding that resisted those options – either from uterine atonicity or morbid placental adhesion – were treated with the condom catheter instead.
The results, published in the International Journal of Gynecology & Obstetrics, showed the method reliably controlled the bleeding without requiring the hysterectomies that had previously been the fallback, preserving both the patients’ lives and, in many cases, their future ability to have children.
At the time Dr Akhter developed the technique, postpartum haemorrhage accounted for roughly a third to 40 per cent of all maternal deaths in Bangladesh – a share she says has fallen dramatically since. The method’s reach has extended well past the country that produced it: It has since been written into postpartum haemorrhage management guidelines across multiple countries in Asia and Africa, taught directly to doctors and midwives from around the world, and become the subject of numerous FCPS dissertations and MS and PhD theses studying its use.
That global adoption has not always come with the country of origin attached. A BBC News segment several years ago wrongly credited the technique’s discovery to a midwife in Kenya, an error Bangladeshi doctors publicly called “a gross mistake by the media” at the time, noting that a genuinely original medical breakthrough from a Bangladeshi physician had been quietly reassigned to someone else’s account entirely.
Dr Akhter, now affiliated with the Mamms Institute of Fistula and Women’s Health, has continued refining the method she pioneered – leading a registered randomised controlled trial, in collaboration with the International Centre for Diarrhoeal Disease Research, Bangladesh, evaluating a next iteration of the technique.
Alongside it, she has built a career dedicated to treating obstetric fistula, another condition that disproportionately devastates women in low-resource settings. For a discovery built from a childhood memory of water balloons, Sayeba’s Method has done something few Bangladeshi medical innovations have: Quietly become standard practice in delivery rooms its inventor will likely never visit.
