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Restoring dignity: Recovering from the horror of obstetric fistula

Zainab Baubau a 32-year-old fistula patient, recalls the pain and complications related to the death of her infant son 19 years ago during childbirth. At the age of 12, she developed obstetric fistula and has lived with the condition ever since. She is one of the 6412 women and girls who have benefited from the free fistula repair surgeries provided by UNFPA.  Zainab shares her story through the tears of time lost and hope found.

After having endured 48 hours of labor, her suffering was compounded by the events that followed. “I had prolonged obstructed labor, struggled with eclampsia, was unconscious for two weeks at the hospital and only survived to hear the sad news of my still birth and this illness”. She was left feeling alone with an undignified life that was no longer hers.

Obstetric fistula is a condition that affects millions of women worldwide, but is most prevalent in developing countries. It is a childbirth complication caused by obstructed labor. It occurs when the tissues between the woman’s vagina and her pubic bone are damaged by continuous pressure from the infant’s neck trapped in the birth canal. The damaged tissue later falls off resulting in a hole through which the woman continuously leaks urine or faeces or both.

In Nigeria, it is estimated that up to 800,000 women are currently living with fistula and approximately 20,000 new cases occur each year. As part of the global Campaign to End Fistula, UNFPA in 2005 launched the “Fistula Fortnight” in Nigeria. It was a ground breaking initiative that was aimed at expanding treatment options for the women and girls suffering from the condition. It also supported the implementation of facility and community based interventions to enable prevention of obstetric fistula and mobilize indigent women and girls to access free treatment and rehabilitation services.

UNFPA has achieved remarkable success in the focus areas of its fistula programming in Nigeria. It has supported free surgical repairs for 6,412 women and girls living with fistula, with a current success rate of  97% . A total of 52 doctors and 94 nurses were trained to repair both simple and complex fistulae. In addition, comprehensive surgical equipment including fistula repair kits were procured and supplied to 9 General Hospitals and 3 National Obstetric Fistula Centers to support routine provision of fistula repair surgery. A total of 463 community educators/mobilizers (128 males and 335 females) were trained to provide counseling services to women (and their spouses) living with untreated fistula. In addition, 40 social workers were trained to support women by providing necessary pre-and post-operative psychosocial counseling services to clients in the treatment and rehabilitation centres.         

Hauwal Mohammed, a 35-year-old fistula survivor, is also a beneficiary of the UNFPA vocational skills acquisition and empowerment programme. At age 16, she was forced to drop out of school due to an arranged early marriage. She has lived with the illness for 10 years after several failed attempts at surgical repair. She felt unworthy because everything she touched was considered dirt. “If I touch a plate they will discard it. I cried a lot” she said.  Beyond the repair, Hauwal was empowered to become economically independent and is now a proud tailor running her business. Hauwal is one of many who have been helped to regain their dignity.

UNFPA has supported the economic rehabilitation of 357 patients whose fistulae were successfully repaired. In addition, 418 survivors with fistula deemed inoperable, were the beneficiaries of social reintegration through skills acquisition training sessions and provision of start-up kits.

Obstetric fistula is preventable, and can be avoided by delaying the age of first pregnancy; ensuring skilled birth attendance at all births and providing timely access to obstetric care for all women who develop complications during delivery. Just like in other parts of West and Central Africa, UNFPA will not stop until fistula is history in Nigeria and it ends within a generation.

Ololade Daniel