Usually when women suffer from fistula, they take little fluids due to fear of leakage so when they don’t drink enough, they end up getting formation of stones in the gall bladder, which is one of the possible complications, according to Dr Egiziabher.

Fistula can also lead to cancer of the rectum or bladder as there have even been some cases at the Military hospital, the doctor said. Other complications may include infertility and chronic renal failure.

Besides the physical health complications, most fistula patients end up traumatised and isolated.

In a recent interview with Dr Anicet Nzabonimpa, the coordinator of Family Planning and HIV Integration Programme in the Ministry of Health, most of the people suffering from the disease are too shy to talk about it, while others assume it cannot be treated.

"Most fistula patients are poor people in rural areas. It’s even hard for them to go for treatment because they can’t easily use public transport because of their condition. If the fistula health site isn’t within their reach, then they ignore the disease,” Dr Nzabonimpa said.

Fistula is not common in developed countries because of quality maternity and healthcare, which is why even in developing countries, most of the cases are in rural areas, Dr Egiziabher said.

Most fistula patients are poor women and 80 per cent lose their husbands when they suffer the disease, while two-thirds of them lose their babies, he adds.

There is an estimated 350-400 new cases of fistula in Rwanda every year, health sources say. 

It takes 45 minutes to an hour to carry out a simple fistula repair, while it takes about four hours for a complicated case.

It is every woman’s desire to have a safe delivery. To achieve this, women should ensure that they go for proper antenatal care during pregnancy, report any complication early, give birth at a reasonable age, avoid unsafe abortions and deliver from a proper health facility.