Demystifying Obstetric Fistula in SADC

Zimbabwean women who were at Fistula camp in 2016 (Picture: UNFPA, Zimbabwe-Victoria Walshe)

Sharon Kavhu

Last month the Southern Africa region joined the rest of the world in commemorating ‘International Day to end Obstetric Fistula’ on the 23rd.

This year’s commemorations were held under the theme; “Hope, healing, and dignity for all” which saw several Fistula victims across Southern Africa being healed through surgical operations.

According to the United Nations Population Fund (UNFPA), Zimbabwe, the theme was a call to everyone to realise the fundamental human rights of all women and girls in Zimbabwe, Southern Africa and the rest of the world; with a special focus on those who are mostly left behind, excluded and shunned by society.

“Their isolation means they often go unnoticed by policy makers, and as a result, little action is taken to address or prevent their condition. Political leadership, investment and action can help end the fistula scourge in Zimbabwe,” highlighted part of the UNFPA statement.

According to UNFPA, Zimbabwe, it is estimated that more than 2 million women in Sub- Saharan Africa, Asia, the Arab region and Latin America and the Caribbean are living with this injury, and some 50,000 to 100,000 new cases develop each year. Yet fistula is almost entirely preventable.

But what is obstetric Fistula?

An obstetric fistula is defined by the Fistula foundation as the hole between the vagina and rectum or bladder that is caused by prolonged obstructed labor, leaving a woman incontinent of urine or faeces or both.

Zimbabwean General Health practitioner, Dr Nyasha Sigauke said fistula occurs where there is inadequate blood flow at the pelvic bone.

“Fistula normally occurs when pregnant women get into labour unattended and the labor is prolonged, some to even six to seven days. The obstructed labor produces contractions that push the baby’s head against the mother’s pelvic bone,” said Dr Sigauke.

“When this happens, the soft tissues between the baby’s head and the pelvic bone are compressed and do not receive adequate blood flow. The lack of blood flow causes this delicate tissue to die, and where it dies holes are created between the laboring mother’s bladder and vagina or between the rectum and vagina. This is what produces incontinence in a fistula patient.”

He said obstetric fistula is one of the most serious and tragic injuries that can occur during child birth.

Information from UNFPA Zimbabwe shows that victims of obstetric fistula may develop chronic medical problems.

UNFPA Communications assistance, Victoria Walshe said: “It leaves women leaking urine, faeces or both and over time, it leads to chronic medical problems. Sufferers also endure depression, social isolation and deepening poverty.”

Walshe said the condition occurs more among women and girls who are less privileged.

“Obstetric fistula occurs mostly among women and girls living in extreme poverty, especially those living far from medical services,” she added.

“It is also more likely to afflict girls who become pregnant while still physically immature. Women and girls with fistula are unable to work, and many are abandoned by their husbands and families, and ostracized by their communities driving them further into poverty.”

She said fistula can be repaired through reconstruction surgery.

Sadly, many people suffering from fistula in Southern African region are not aware of the treatment, others cannot afford the treatment and neither do they have access to the facilities where treatment is available.

As such UNFPA in partnership with the countries’ relevant Ministries are working hand in hand to ensure that these people have access to the facilities. So far they have done the reconstruction surgeries in at least 50 countries.

In some African cultures women with fistula are often discriminated and linked with witchcraft and curses, thus they end up having low self-esteem.

Others end up being left by their husbands because it becomes impractical for them to have sexual intercourse in that condition.

As such, there is need for the victims to go through counselling session and other forms of support to the victims.  These include: job training to help these women to reintegrate into their communities after they have been treated

Fistula is preventable if there is skilled attendance at all births especially those with complications.

Although a lot of effort has been made to assist women with fistula in developing countries, the fact that the condition is still persistence is a sign that health systems are failing to meet women’s essential reproductive health needs. Thus more needs to be done.

In Zimbabwe UNFPA together with the Ministry of Health and Child Care have establish a total of 5 fistula repair camps which have seen over 300 women benefiting from the ongoing repair camps.

In 2003, UNFPA and its partners launched the global Campaign to End Fistula which now works in more than 50 countries to prevent, treat fistula, rehabilitate and empower survivors. Over the last 12 years, UNFPA has directly supported more than 57,000 surgical repairs for women and girls, and partner agencies have supported thousands more.

June 2017
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