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The Horror Of Fistula And A Survivor's Tale

I met Zainab Baubau, a 32-year-old fistula patient twenty years after her failed marriage to Mohammed, and 19 years after the death of her son, an infant she lost during childbirth. At the age of 12, she developed obstetrics fistula and has lived with it for many years until today. She is one of the 6412 women and girls who have benefitted from the free fistula repair surgeries by UNFPA . In an interview with Zainab, through the tears of time lost and hope found she tells her story.

She was in labor for 48 hours, and while she waited eagerly to hear the cry of her baby, what she heard instead was her cry for help. “I had prolonged obstructed labor, struggled with eclampsia, was unconscious for two weeks at the hospital and only survived to hear the sad news of my still birth and this illness”. She went on to say she felt alone because the life she knew was no longer hers.

Obstetric fistula is a condition that affects millions of women worldwide, but most prevalent in developing countries. It is a childbirth complication caused by obstructed labor. It occurs when the tissues between the woman’s vagina and her pubic bone are damaged by continuous pressure from the infant’s neck trapped in the birth canal. The damaged tissue later falls off resulting in a hole through which the woman continuously leaks urine or faeces or both.

In Nigeria, an estimated 400,000 to 800,000 women are currently living with fistula and approximately 20,000 new cases occur each year. As part of the global Campaign to End Fistula, UNFPA in 2005 launched the “Fistula Fortnight” in Nigeria. It was a ground breaking initiative that was aimed at expanding treatment options for the women and girls suffering from the condition. The initiative also supported the implementation of facility and community based interventions to facilitate prevention of obstetric fistula and mobilize indigent women and girls to access free treatment and rehabilitation services.

UNFPA has registered remarkable success in the focus areas of its fistula programming in Nigeria. It has supported free surgical repairs for 6,412 women and girls living with fistula, achieving an average of 97% successful repair rates to date. A total of 52 doctors and 94 nurses were trained to repair both simple and complex fistulae. In addition, comprehensive surgical equipment including fistula repair kits 1 & 2 were procured and supplied to 9 General Hospitals and 3 National Obstetric Fistula Centers to support routine provision of fistula repair surgery. A total of 463 community educators/mobilizers (128 males and 335 females) were trained to provide counseling services to women (and their spouses) living with untreated fistula in the communities. In addition, 40 social workers were trained to support women by providing necessary pre-and post-operative psychosocial counselling services to clients in the treatment and rehabilitation centres.

Hauwal Mohammed, a 35-year-old fistula survivor, is also a beneficiary of UNFPA vocational skills acquisition and empowerment programme. At age 16, she was forced to drop out of school to marry a suitor. She’s lived with the illness for 10 years after several failed attempt of surgical repair. She felt unworthy because everything she touched was considered dirt. “If I touch a plate they will discard it. I cried a lot” she said. Beyond the repair, Hauwal was empowered to become economically independent and is now a proud tailor running her business. Hauwal is not the only one.

UNFPA has supported the economic rehabilitation of 357 successfully operated fistula patients in addition to the social reintegration of 418 survivors with fistula deemed inoperable, through skills acquisition training sessions and provision of start-up kits.

Obstetric Fistula is preventable, and can be avoided by delaying the age of first pregnancy; ensuring skilled birth attendance at all births and providing timely access to obstetric care for all women who develop complications during delivery. UNFPA will not stop until fistula is history in Nigeria and it ends within a generation.