Responding to Obstetric Fistula’s in the Developing World

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Invisible. Rejected. Social outcast. Those are just a few words that can be used to describe one of the most alienating pregnancy complications a woman can face: obstetric fistulas. An obstetric fistula (OF) is a hole in the vagina, rectum or bladder caused by prolonged or obstructed labor without prompt medical intervention in the form of a caesarean section. After what can be nearly a week of labor, the woman is left with chronic incontinence and in most cases, a stillborn baby. Because of their chronic incontinence, these women become exiled from their communities.

The Fistula Foundation’s work in Uganda is making strides in responding to OF’s through a variety of tactics including fundraising to provide preventative training, restorative surgery and advocacy of government systems to better prioritize maternal health issues. However, there is still mistrust in the formality of medical care during labor as child birth is seen as a simple, every day part of life. Government infrastructure is also still weak in parts of this war torn country, and given the nation’s recent and prolonged instability, medical professionals are nervous to enter conflict zones.

The Foundations approach to overcoming OF feeds into UN’s Millennium Development Goal #5  of improving maternal health. Women, one of the world’s most vulnerable demographic, are most susceptible to OF when combined with malnutrition, young childbearing age, poverty and/or poor access to proper health. Of the one to two million women suffering from OF, only 20,000 are treated each year through an operation costing between $300 – $400. OBFIST

A few other organizations also taking an active role in bringing OFs a greater advocacy audience include The Campaign to End FistulaPretty Purposeful, and of course, the United Nations Population Fund, UNFPA. These organizations advocacy work, along with better maternal health practices can bring dignity back to those who are fighting for Hope, Healing, and Restoration.

For more information about OF, click here to watch the 2009 Emmy award-winning video, A Walk to Beautiful or the video below.

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4 Responses to “Responding to Obstetric Fistula’s in the Developing World”

  1. hqas Says:

    Such important work, really glad to see UNFPA Uganda’s progress, here Pakistan udpate at http://saadiahaq.wordpress.com/2014/03/07/pakistan-a-view-from-within-by-wendy-marijnissen-2/

  2. prelan Says:

    Thanks for sharing. This is a cause that is not often publicized, but very prevalent abroad, and easy to fix, relative to other causes. Global surgery is one of my passions, and the issue of fistula repair often comes up in discussions with my mentors and colleagues.

    Last year, Nick Kristof of the NYT wrote a moving piece about OF, the Worldwide Fistula fund, and the Danja Fistula Center in Niger. He has been a strong advocate for this cause. http://www.nytimes.com/2012/05/13/opinion/sunday/kristof-saving-the-lives-of-moms.html?smid=tw-share&_r=0
    http://worldwidefistulafund.org/danjafistulacenter/

    A few weeks ago, he followed up with another moving piece about the heroes that are taking this cause into their own hands:
    http://www.nytimes.com/2014/02/06/opinion/kristof-at-90-this-doctor-is-still-calling.html

    Some of the stories seem unreal, but they are the ones that are sadly “statistically ordinary”:
    Mahabouba Muhammad was sold at age 13 to be the second wife of a 60-year-old man. She became pregnant, delivered by herself in the bush and suffered a severe fistula. Villagers, believing Mahabouba to be cursed, left her for the hyenas. But she fought off the hyenas and — because nerve damage from labor had left her unable to walk — crawled for miles to get help. At Dr. Hamlin’s hospital, she underwent surgery and now is a nurse’s aide at the hospital.

    Thanks for bringing this issue to light on this blog!

  3. karinswihart Says:

    Thanks for the resource! I watched Wendy’s youtube video (http://www.youtube.com/watch?v=jxTv2dZtlAs) quite powerful.

  4. samanthaholcombe Says:

    Hi Karin,

    Thank you for writing about this…it is definitely a condition that needs to be addressed. Aside from the many physical consequences women face in regards to obstetric fistula (chronic leakage, stillborn, extensive vaginal scarring, secondary infertility, footdrop, the list goes on) there are also many social consequences that result as well. Women plagued with obstetric fistula face being abandoned by their husband and family and shunned by the community, psychological trauma, deteriorating health, increasing poverty and social stigmatization.

    The organization I work for does some work in obstetric fistula found that there are many service delivery and programmatic challenges in combating the condition including lack of supplies and especially skilled personnel who can support programs and work on fistula repair. However, we have also found that investing in cesarean sections can be a cost-effective preventative measure.

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