A survivor’s encounter with obstetric fistula

BY: Graphic.com.gh
File photo
File photo

Comfort Mamba was a happily married woman living with her husband and three children at Kpandai in the Northern Region. For her, life was normal until she became pregnant with her fourth child.

Comfort had her first child before age 20 at Over Bank, a village near Nkanchina, where she lived with her husband.

The delivery was conducted with the assistance of a Traditional Birth Attendant (TBA) as the village and the nearby communities had no hospital or clinic, hence all births were through TBA assistance and the use of local herbs.

So, when I had my fourth pregnancy, I thought I could deliver successfully by drinking the usual mixture of herbs and the TBA support. I got into labour and the TBA was called upon to help deliver me. After two days of labour during which the TBA kept inserting her hands into my vagina, I became so weak. I finally had a stillbirth.

After delivery, Comfort experienced heavy blood flow and realised that any cloth she put on got wet or stained within a few minutes. She also noticed that community members who visited behaved strangely, with some of them spitting out, but had no idea what was wrong.

The TBA, she said, “then told my late blind uncle to get treatment for me because I had bad odour. I was given powdered herbs to put in a rag and insert it. It did not help much. It got wet within minutes.”

Stigmatisation

Soon, she was neglected and stigmatised in the community. She could  not participate in any social event as she was accused of witchcraft and adultery and community members demanded that she confessed her wayward ways in order to get healed. Comfort had to deal with this trauma alone for three years as she had no support from her husband or any of his family members.

“My uncle, upon realising my ordeal, came for me to live with him at Kpakpa where I was fortunate to meet a female nurse who has just been posted to Nkanchina No2.  She told me I had Obstetric Fistula, explained what it was and gave me the assurance that the condition can be repaired.”

Thereafter she sent me to the Fistula Center at the Tamale Teaching Hospital where my fistula was successfully repaired by a specialist, Comfort said.

After the repairs, Comfort benefitted from a vocational skills training at the Kofi Annan Vocational Training School in Tamale. She had additional training in the production of different varieties of soap and parazone, courtesy the United Nations Population Fund (UNFPA).

Currently, Comfort works with a community development programme which trains school drop-out girls in the project’s communities on some of these trades.

Devastating injury

Obstetric fistula, a devastating childbirth injury to women can be treated with reconstructive surgery, though many women and girls who experience it don’t know about treatment, can’t access it or can’t afford it.  The encouraging news is that it is not only treatable but largely preventable.

Obstetric fistula is a hole in the birth canal caused by protracted, obstructed labour. Left untreated, it can lead to infection, disease, and infertility. Moreover, the women leak urine and faeces, which may cause their husbands and communities to abandon and shun them, resigning them, her to a life of misery and isolation.

An estimated 500,000 women and girls live with the condition robbing them of a life of dignity. Young bodies not ready for pregnancy and childbirth in the case of child marriage or unintended pregnancy are especially vulnerable. And COVID-19 has exacerbated the problem due to disruptions to family planning and sexual and reproductive health services and inequities in health care systems.

The observance of the International Day to End Obstetric Fistula, which, this year, had the theme “Women’s rights are human rights! End fistula now!” is to bring to global attention that the injury can be prevented by reproductive health care, family planning, skilled birth attendants and emergency obstetric care

In a statement to mark this years’s day, the UNFPA Executive Director Dr. Natalia Kanem observed that while fistula has been virtually eliminated in developed nations, hundreds of thousands of women and girls in the developing world still live with this debilitating condition.

Poor women and girls in rural areas are especially at risk. The disproportionate incidence among the poor of this debilitating and sometimes life-threatening condition is a reflection of social and economic inequities and of unequal enjoyment of the right to health, including sexual and reproductive health. Even in the best of times, they are more likely to lack access to skilled health personnel. Child marriage and early childbearing are among other contributing factors,” the UNFPA Executive Director added.

She further noted that the COVID-19, the pandemic had taken a huge global toll on maternal and newborn health.

Already, the crisis is compounding the economic, social and logistical barriers that women and girls face in accessing sexual and reproductive health services. Even where services are available and accessible, fear, misinformation and stigma related to COVID-19 are deterring some pregnant women from seeking obstetric care,” she said.

Dr. Kanem indicated that the absence of timely medical treatment will likely spur a dramatic increase in obstetric fistula, a serious childbirth injury resulting from prolonged, obstructed labour.  

She said as the leader of the global Campaign to End Fistula, UNFPA provides funding and support for fistula prevention, treatment and social reintegration programmes. Which has, since 2003, enabled more than 113,000 women to undergo obstetric fistula repair surgery.

She called for acceleration of efforts in order to achieve theglobal ambition of ending fistula by 2030, the deadline for the Sustainable Development Goals.  

Dr Kanem honoured the memory of the late Dr. Catherine Hamlin, who passed away in March this year, for dedicatingmost of her long life to treating women and girls with fistula, focusing not only on the physical injury itself, but also on the scars created by stigma and discrimination.

Her charitable organisation, Hamlin Fistula Ethiopia, has brought hope and healing to women and girls, raised global awareness of fistula and spurred innovative efforts to end it, she said.”