Over 2 million women worldwide living with untreated fistulas - WHO

Over 2 million girls and women worldwide are estimated to be living with untreated fistulas, this is according to the World Health Organization (WHO).

Obstetric fistula is a serious injury and complication that occurs during childbirth due to prolonged labour.

Dr. Grace Kanyi, an obstetrician and gynaecologist, explains that fistula occurs when a woman withstands prolonged or unskilled childbirth.

She further says this occurs when the baby’s head is constantly pushing against the mother’s pelvic bone during contractions hence preventing blood flow and causing harm to the tissue.

This creates a hole - or a fistula - between a woman’s vagina and her bladder or rectum. Although the child is likely to survive, the mother might get injured and could experience challenges where they’re unable to hold urine and, in some cases, bowel content.

“This complication occurs when a patient does not get timely and skilled delivery. It is caused by neglected labour and the way to prevent it is by using skilled delivery. If the labour is prolonged, emergency cesarean section can be quickly administered when the mother gives birth in a health care facility,” she said.

According to Dr. Kanyi, without emergency intervention, obstructed labour can last for days. Obstetric fistula is associated with devastating lifelong morbidity with severe medical, social, psychological and economic consequences.

According to the WHO, prevention is the key to ending fistula, further that the condition is a clear indication of poor maternal care.

Dr. Kanyi adds that ensuring skilled birth and providing timely and high-quality emergency obstetric care for all women who develop complications during delivery would make this tragic condition rare.

According to the Ministry of Health, over 300 women develop fistula every year, and 90 per cent of the children die in pregnancies in which women develop the complication.

“Although we still have fistula affecting women today, the government and other bodies have slowly managed the occurrence through Linda Mama. When we have removed the element of cost, most mothers are able to access healthcare on time,” she said.

Stigma is heavily attached to fistula because for most women with the condition, it is much more than a physical injury; they’re often treated as outcasts because the leaking of waste and urine results in hygiene issues and odor that is difficult to cope with.

Women with fistula are often unable to work, and many are abandoned by husbands and families and ostracised by their communities.

Fistula has a far-reaching impact on the patient; some will avoid eating and drinking in a bid to reduce their urine and quit their daily activities because of shame and stigma attached to it.

“During labour, women who are at risk of developing obstetric fistula usually present challenges with walking, are very tired, have tensed abdomen, and sometimes the babies’ heads are usually compressed…for this we rush them into surgery for assisted labour,” Dr. Kanyi explained.

Reconstructive surgery can usually repair a fistula. Unfortunately, the women and girls affected by this injury often do not know that treatment is possible, cannot afford it or cannot reach the facilities where it is available.

“Sometimes it can be a challenge to completely achieve 100% dryness after reconstructive surgery. I advise all expectant mothers to visit health facilities on time for child delivery because once you have fistula that goes untreated it will disrupt your life completely,” added the doctor.