Articles

BRIDGING THE GAP TO END OBSTETRIC FISTULA

By CAROLINE BOYANI OYARO

Every 23rd of May is dedicated to celebrating International Day to End Obstetric Fistula, to improve awareness of the condition, offer support to the survivors, and employ effective solutions. According to a report by the World Health Organization (WHO), about 90% of women with Fistula end up delivering stillborn babies, which shows the two are closely linked.

Obstetric Fistula is a hole between the birth canal and the bladder or rectum caused by prolonged, obstructed labour without access to timely, quality medical treatment. It often leads to stigma, depression, and increased poverty levels.

Among the high risks for Obstetric Fistula are high levels of poverty, malnutrition, lack of health education, FGM, early childbirth, and ineffective and inaccessible health facilities. The estimated price for surgery to treat Obstetric Fistula is Sh 60,000 in a public hospital.

The support is emotional and financial since surgery costs to treat Fistula are expensive for an average person. Additionally, it helps reintegrate them back into the community where they can feel safe and accepted.

30-year-old Betty is a survivor of Fistula. She developed complications with her first pregnancy and delivery, which took place at home. “By then, there were few initiatives such as Linda Mama that one could benefit from,” she says.

At the time, her husband had not taken health insurance for her, and while he was out earning a living, the baby came. “I was due in a few days, and no one was nearby. It’s only by grace that a friend came visiting and found me lying down, with a stillborn and almost unconscious due to excessive bleeding,” she narrates.

The nearest health facility was a level 3 (health centre) and could not offer effective treatment. “They stopped the bleeding, gave me medicines, and referred me to a Nairobi Women’s hospital where I could get surgery and be fixed,” she says. She did not understand then what a big deal her condition was.

She recalls her distress when her condition worsened, and no matter how much she tried cleaning her genitals, the smell wouldn’t disappear. Then came the uncontrollable soaking of body waste. After delivering her second child successfully, she was so out of shape that she gave up hope of survival.

“My husband was busy arranging fundraisers and looking into organizations that support women with Fistula. Even in those tough times, he was my rock of refuge,” she explains. “We were able to raise the required amount, and after surgery, it took a few months to feel completely okay.”

“The condition was so terrible since it made me feel like a burden to my husband. His family advised him to neglect me and take up a second wife, but he stood by me,” she adds.

This year’s theme, “Breaking the Cycle: Preventing Fistula Worldwide,” is not only about ending but also preventing. Coordination between the government and non-government organizations can track the prevalence of Fistula, bridge the gaps in healthcare, and address the sociocultural contributors of Fistula. Hence, effective implementation of national Fistula strategies is significant.

Through collective efforts, we must ensure no girl or woman is left behind in the fight to protect their reproductive rights and access timely, quality healthcare.

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