Healthy Woman : Mothers suffering from Fistula living on the brink

Studies have shown that each year, more than half a million women die during pregnancy and childbirth while others face several complications, maternal injuries or at times they suffer long-term health problems such as obstetric fistula.

Wednesday, December 01, 2010
Sifa Uwera (L) and collegue collecting Sanitary Pads meant to benefit women suffering from obsteric fistula.

Studies have shown that each year, more than half a million women die during pregnancy and childbirth while others face several complications, maternal injuries or at times they suffer long-term health problems such as obstetric fistula.

Obstetric fistula is the most devastating aftermath of all complications at childbirth and has affected most Rwandan women.  

Obstetric fistula is a hole or abnormal opening, in the birth canal, that results in chronic leakage of urine or faeces. It is usually caused by several days of obstructed labour, without timely medical intervention or caesarean section.

This arises when the foetus does not fit into the birth canal either because the mother’s pelvis is too small or the infant’s head is too large.

According to the Fistula Care Project Rwanda, which was started in 2006, a total of 723 fistula repair surgeries have been performed between October 2006 and June 2010. Over 45 surgeons and 105 nurses have been trained on fistula surgery and management in most public hospitals such as Ruhengeri Public hospital, The Central University Teaching Hospital of Kigali (CHUK) and Kanombe Military Hospital.

In Africa and other developing countries, remote villages have little or no obstetric care. Pregnant women stay in labour for days without relief hence the foetus’ head becomes tightly wedged into its mother’s pelvis, cutting off blood supply to the soft tissues of her pelvic organs. 

Without medical assistance after a few days, the foetus dies. The post-mortem degeneration of the foetus’ head allows the mother to give birth to a dead foetus thus damaged pelvic tissues create the fistulae.

Women suffering from obstetric fistulae have absolutely no control over their urine. They are always wet leading to an offensive stench. Left with chronic leaking, they are often divorced abandoned or neglected by their husbands and families, yet they are unable to work, and are also detested by their communities. These women not only have to deal with the loss of a baby, but are among the most impoverished and vulnerable members of society.

On a brighter note, the good news is that obstetric fistula can be completely repaired up to 90 percent of the time if fistula survivors have access to a trained surgeon at a hospital providing fistula repairs.

In January, 2011, about 50 women suffering from obstetric fistula will undergo an operation at Kibagabaga Hospital. The medical staff at the hospital said that sanitary pads will be required before and after these fistula repairs in order to ensure that patients recover under hygienic conditions.

Sifa Uwera, Procurement and Programme Management personnel at the Department of International Development- UK Aid (DFID) saw the need for sanitary pads among these women. Uwera, also a member of Christian Life Assembly (CLA) in Nyarutarama, called upon the congregation to put forward the need to help fistula patients by supplying them with sanitary pads.

"When we were told at church to do an assignment that should benefit the community, this is what came to mind. A colleague who supplies food to patients at Kibagababa Hospital once told me about the situation of these women,” Uwera said.

"Therefore my cell members (Gaculiro Section) embraced the idea and aimed at reaching out to such marginalised, neglected and abandoned women with a message of love and hope for the future in Christ. We have partnered with Kibagabaga Hospital to provide the sanitary pads that these women need,” Uwera said.

In order to do this Uwera said that, Gaculiro Section members will fundraise within their church cell groups, get a matching grant from CLA church and encourage the congregation to donate pads or money that will cover the needs of all women suffering from obstetric fistula.

For a period of one month, 400 sanitary pads will be needed for the 50 women who will undergo the operation. The cheapest sanitary pad packet costs Rwf600—an amount already too expensive for the average unemployed Rwandan woman.

"This uncontrollable leaking is a harsh reality that requires patience, understanding and love from families yet, this has proven to be a challenge leading to abandonment in most cases,” Uwera explained.

Through out the month of December, two desks at Christian Life Assembly have been made available for the collection of sanitary pads or cash to buy the over 400 packets that are needed to restore the dignity of women suffering from obstetric fistula.

Dorau20@yahoo.co.uk