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| Patients at the fistula centre |
Much to the delight of her husband and family, she became pregnant again almost shortly after her third child. Since she appeared strong she least anticipated any problems with her delivery.
Due to prolonged and obstructed labour, Fulera had to undergo a caesarian delivery. Her baby, however, died.
A month on, she started passing urine and faeces uncontrollably from her vagina. The leakage left her incessantly wet and smelling bad. So embarrassing was her situation that she confined herself in her room. Neither she nor her husband, or the traditional birth attendant in her community understood that her condition was related to the prolonged labour she went through.
No one in Choggo-Yelpelsi would approach her. Fulera’s situation worsened and her husband who could not bear the embarrassing situation divorced her. Dejected and feeling isolated, Fulera listened to the advice of her sister, who consistently appealed to her to seek medical treatment.
Fulera’s fistula is now repaired and she is reintegrated back into her society and now runs a successful “tie and dye” business. Today, she is a good-will ambassador and has encouraged three other women who had obstetric fistula to seek medical care.
Obstetric fistula, a devastating injury caused during childbirth is a medical condition in which a fistula (hole) develops between either the rectum and vagina, or between the bladder and vagina. An obstetric fistula develops when the blood supply to the tissues of the vagina and bladder (and/or rectum) is cut off during prolonged, obstructed labour. The tissues die and a hole forms through which urine and/or faeces pass uncontrollably.
Obstetric fistula is perhaps one of the most tragic examples of unequal access to quality obstetric care in Ghana. A rapid needs assessment conducted in 2003 in Ghana revealed that not only is the magnitude of fistulae cases unknown, but also the number of trained and experience personnel to handle the cases in the country was inadequate.
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| Fistula centre in Tamale, Northern Region |
The 2008 Annual Fistula Report indicates that at least two million women worldwide areisolated by shame and stigma of obstetric fistula. An estimated 50,000 to 100 new cases occur each year, a testimony to the failure of health systems to respond to the most basic reproductive needs of the world’s poorest women.
In 2003, the Campaign to End Fistula began work in 12 countries, with the aim of eliminating fistula by 2015 in line with the Millennium Development Goals (MDGs). Within five years, the campaign has quadrupled in size and is now operating in more than 45 countries in Africa, Asia and the Arab States. With the support of the UNFPA, governments and partners, increasing numbers of women and girls are accessing the care necessary to prevent and treat fistula and to return to full and productive lives.
Fredrica Hanson, Country Midwifery Adviser for UNFPA, says that the UN agency that was collaborating with the Ministry of Health, the Ghana Health Service, the Ministry of Gender, Children and Social Protection to highlight the issue of obstetric fistula to ensure that victims already living with it are treated and reintegrated into society. She noted that victims of obstetric fistula were women and girls, usually poor, often illiterate who have limited access to health services including maternal and reproductive health care.
The consequences of fistula, she added were life shattering and invariably leaves the victims ashamed, ostracized and left alone, thus deepening their poverty and magnifying their suffering. According to her some progress has been made in the country regarding treatment of obstetric fistula with the establishment of a treatment centre in the Northern Region capital, Tamale where with the tireless efforts of dedicated surgeons from the country’s teaching hospital, working to repair fistula. To effectively address the issue of obstetric fistula, there is the need for all stakeholders including the media to spearhead the movement to eliminate all reproductive health issues as envisioned in the MDG 5 which seeks to improve maternal health.
While the challenges are many, so are the women who have benefited. For Fulera, getting her fistula repaired not helped restore her health, but has also brought a renewed sense of purpose. After seeking medical care, she has been relieved of her condition with her dignity restored.
- story by James Amoh Junior (Ghana News Agency), Simon Tie (Ghana Broadcasting Corporation), Kuupuolo Eva (Ghana News Agency) and Sule Dada (TV3)
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