What is Fistula?
Obstetric fistula is an abnormal opening that forms between a woman’s genital tract and her urinary tract or rectum (UNFPA, 2020; WHO, 2020). This has been linked to prolonged obstructed labor which leads to uncontrollable constant incontinence, shame, social segregation and other myriad health complications. Obstetric fistula accounts for at least 6% of maternal deaths and is a silent condition affecting an approximate thirteen thousand women in Kenya reported annually with at least a million women in Africa and Asia needlessly suffering from this treatable condition (WHO, 2020).
Today at least one million women in Africa and Asia needlessly suffer from untreated fistula.
Statistical facts about Fistula
A condition that has resulted in sufferers treated as outcasts by both family and the community (Fistula, 2020). Although the impact of obstetric fistula is well documented in poor rural African contexts with the UNFPA labelling it the most serious and tragic birth injuries, its prevalence amongst more educated elite women is vaguely understood (See…UNFPA, 2020). This is mostly due to the shame associated with the condition and subsequent high costs of surgery which is largely away from reach for many women in Kenya.Most fistula surgeries are therefore only carried out with funding from non-governmental organizations but even these are quite limited due to the lack of awareness and stigma associated with the condition. Many women therefore continue to suffer in silence. It is considered as a poor women’s disease and as such rarely given the attention it deserves.
HOW FISTULA OCCURS
An obstetric fistula occurs when a mother has a prolonged, obstructed labor, but doesn’t have access to emergency medical care, such as a C-section. She often labors in excruciating pain for days. Tragically, her baby usually dies.
During her prolonged labor, the mother’s contractions continually push the baby’s head against her pelvis. Soft tissues caught between the baby’s head and her pelvic bone become compressed, restricting the normal flow of blood.
Without adequate blood supply, sections of tissue soon die, leaving holes—known as “fistulae” —between the mother’s vagina and her bladder or rectum. It is these holes that cause incontinence. If untreated, the woman will uncontrollably leak urine, stool, or sometimes both, for the rest of her life.
Severe perineal tears are another debilitating injury that can occur when a woman in labor does not have access to adequate care. The effects of this injury—a tearing to the anal sphincter muscle—leaves a woman incontinent of feces. In recent years, as our partners’ outreach workers have found women with fistula, they’ve increasingly encountered women with this similarly debilitating childbirth injury. Perineal tears now account for approximately 20% of the women treated.
Did you Know?
HOW FISTULA IMPACTS A WOMAN’S LIFE
Obstetric fistula most commonly occurs in poor, rural areas of Africa and Asia where the women affected live in dirt-floor dwellings and lack access to running water and incontinence pads.
Under these circumstances, a woman with fistula faces devastating physical and psychological consequences. Unable to control the leaking of her body’s waste, she suffers with chronic infections and pain. Too often, her smell drives away her husband, family and friends. With little community understanding of fistula and its causes, a woman is frequently blamed for her condition. She too often lives in isolation, unaware that others share her injury and that it is treatable. Because fistula usually occurs during a woman’s first pregnancy—when she is in her teens or early twenties—she will likely suffer for decades, if it is not repaired.
