HEALTH: Shame Cloaks This Suffering

By Sanjay Suri Reprint | | Print |

Sanjay Suri

LONDON, Mar 9 2005 (IPS) - The suffering of millions of these women, no one is sure even how many million, is cloaked with shame and silence. They suffer from a condition known as obstetric fistula.

”It happens when women go into labour for a long period, it can be as much as seven to ten days,” Gloria Esegbona, a gynaecologist in London told IPS Tuesday. ”The child dies and this also causes great damage.”

Where even minimal medical facilities are available the usual way out is a cesarean. But many women suffer for the rest of their lives as a result of the condition that develops when such surgery is not available.

Nigeria alone is estimated to have close to a million women who suffer from obstetric fistula. A two-week treatment programme that concluded last week sought to lift some of the shame off this condition and offer treatment to the women.

A total of 545 women were operated on during the ‘Fistula Fortnight’, the United Nations population Fund (UNFPA) announced Wednesday.

The ‘Fistula Fortnight’ ran from Feb. 21 through Mar. 6. The event is part of a UNFPA-led global Campaign to End Fistula launched in 2003. The campaign, which is active in more than 35 countries in Africa, South Asia and the Arab States, focuses on preventing fistula from occurring, treating women who are affected, and providing rehabilitation for survivors to ensure that they reintegrate successfully into their communities.

”For 20 years I had been leaking,” 60-year-old Aminatu Liman told doctors in a report released by UNFPA. She suffered fistula after three days of labour while trying to deliver her third child, a stillborn baby boy. She was treated on the second day of the fortnight and was recovering well this week at the Maryam Abacha Women and Children’s Hospital in Sokoto. ”I’m very happy all the inconvenience is gone à I’m so grateful.”

UNFPA took on the project along with federal and state Nigerian governments, Virgin Unite, the Nigerian Red Cross, Volunteer Service Overseas, Nigerian non-governmental organisations and health professionals from Nigeria, Britain and the United States.

”If you see (the patients) when they arrive, they feel like outcasts. There is no hope. When they have their fistulas repaired, naturally they are very happy,” Mustafa Lawal, one of the trainee surgeons based at the Birnin Kebbi VVF Centre in Kebbi state in Nigeria was quoted as saying in the UNFPA report. ”It’s a very good development for UNFPA and its partners to train us as fistula surgeons.”

There is a need to train doctors in such surgery in several other countries, Esegbona said. ”Hopefully the fistula fortnight in Nigeria will be an example to other countries.” The UNFPA and its partners such as the Red Cross plan to expand awareness of the condition and treatment in many other countries too, she said. ”This is a worldwide problem, but there is a high incidence in Africa and South Asia,” she said.

The cost of the treatment is around 300 dollars, prohibitive to many women in poor areas. ”But also this is seen as dirty, unrewarding work, and there are not many doctors around to do it,” said Esegbona, who is involved with the UNFPA project. The Nigerian campaign carried out at four sites that sought to train medical staff besides announcing to women that treatment for the condition is possible.

UNFPA says some studies indicate that as many as 800,000 Nigerian women are living with fistula, with another 20,000 new cases developing each year. The problem is particularly severe in the country’s northern states. About 15 percent of all pregnancies will result in complications that require emergency medical intervention. A Nigerian woman has a 1 in 18 lifetime risk of dying from complications of childbirth. That figure drops to 1 in 2,400 in Europe.

UNFPA says fistula is a relatively hidden problem ”largely because it affects the most marginalised members of society: young, poor, illiterate women in remote areas. Many of these women never seek treatment. Because they often suffer alone, their injuries may be ignored or misunderstood.”