Seek early care for fistula - Women urged

BY: Augustina Tawiah

The Office of the United Nations Population Fund (UNFPA) in Ghana has said that most females suffering from obstetric fistula fail to report to health facilities.

The office observed that in some cases the patients were unaware of the condition, while in some communities the disease was associated with superstition.

The Programme Analyst for Reproductive Health and Humanitarian Assistance of the UNFPA-Ghana, Dr Claudia Donkor, therefore, called for a thorough public discussion about the condition in order to create awareness.

"It shouldn't be shrouded in mystery. It is a medical condition and not a curse,so people should understand what it is,” she said.

What is fistula?

Obstetric fistula occurs when an abnormal hole develops between the vagina, rectum and/or the bladder following prolonged or obstructed labour.

This causes the woman or girl to leak urine or faeces or both.

Dr Donkor said anyone within the reproductive age was at risk of obstetric fistula, and that the risk factors were early pregnancy, child marriage, late pregnancy for older women, traditional practices such as female genital mutilation, and not having access to the services of skilled birth attendants.

Obstetric fistula is a global problem, and the United Nations commemorates the International Day to End Obstetric Fistula on May 23 every year.

This year's commemoration was dubbed: "End Fistula Now: Invest in Quality Health Care, Empower Communities".

In Ghana, fistula has been recorded in all 16 regions, but most of the cases have been found in the northern parts.

Delayed reporting Dr Donkor said delay in seeking treatment for fistula could result in complications, which include infections such as sepsis and urinary tract infections, which occur as a result of the uncontrolled urine and faeces leakage in the affected area; impact on their sexual and reproductive health, including the desire to have sex, and challenging subsequent childbirths and potentially complicated surgical repairs.

She said the good thing, however, was that fistula did not kill, explaining that it was more of a morbidity issue than mortality, which affected the quality of the life of those living with it.

She said some sufferers have had to live with the condition for years, citing one woman who lived with it for 40 years before getting treated.

Fistula, Dr Donkor explained, solely required surgery to repair rather than medication.

She said in Ghana, the cost of surgery for fistula was estimated at approximately $700,adding that this could be more depending on how complex the condition was.

It is estimated that approximately 1,300 new cases occur in Ghana every year, while there are less than 20 surgeons in the country who can perform obstetric fistula surgeries.

Dr Donkor called on communities, including traditional and faith-based leaders, to demystify fistula and appreciate it as a medical condition which could be treated.

GHS action

The Head of Safe Motherhood Programme of the Ghana Health Service (GHS), Dr Chris Opoku Fofie, advised pregnant women and girls against delivery at home.

He encouraged them to rather deliver at health facilities where they would have access to trained health staff to help them to deliver safely.

He said long distances to health facilities and cost of transportation had been identified as the reasons why some people delivered at home, and advised family members to facilitate the travel of pregnant women to heath facilities where they can deliver safely.

Dr Fofie encouraged the public to educate such patients to seek help at medical facilities.


An obstetrician/gynaecologist of the Korle Bu Teaching Hospital and a fistula surgeon, Dr Gabriel Yao-Kumah Ganyaglo, said if one reported to the hospital within three months of getting the condition, it was possible that the person could be cured with other treatment options without going through surgery.

He, however, said when complications set in, surgery was the sole choice, adding that delayed reporting to the hospital was most likely accompanied by infections.

“If you delay, the vagina becomes scarred and repairs become difficult,” he added.

The Paramount Queenmother of Mankessim, Nana Dr Ama Amissah III, told the Daily Graphic that some queenmothers did not have any knowledge about the condition, hence their inability to create awareness of it in their communities.