Fieldset
Fistula

"Obstetric Fistula is the single most dramatic aftermath of neglected childbirth."
— WHO

"Obstetric Fistula is the single most dramatic aftermath of neglected childbirth."
— WHO

Try and imagine what it would be like to be continuously incontinent of urine or stool. Imagine how uncomfortable and embarrassing it would be, how it would affect your social relations, your livelihood, your self-esteem.

This is the reality for approximately 2 million women in the world who suffer from obstetric fistula; it is most prevalent in Sub-Saharan Africa and Asia.

An obstetric fistula is a hole between the vagina and another pelvic organ, usually the urinary bladder, sometimes the bowel. It develops from an obstructed labor when the baby is too big or poorly positioned to deliver normally and when there is no access to an assisted delivery or Caesarian Section. The baby, usually the head of the baby, presses down against the mother's pelvis, sometimes for days on end, cutting off the blood supply to maternal tissues. The tissues eventually die, leaving the woman with a hole communicating the vagina with the bladder or bowel. Fistula often causes women to become divorced and socially outcast in their communities.

Almost right away I noticed the urine running down the young girl's legs below the hem of her skirt. She noticed that I noticed, and she looked away, embarrassed. I felt badly that I had let my eyes drift down. About six months ago she went into labor with her first child. She had pains for the better part of 5 days; the traditional birth attendant in her village tried to help her but there was nothing she could do. At some point the baby stopped moving, and the pain became constant. Her family finally carried her on a makeshift gurney all the way from her village to the MSF hospital three hours away. There she delivered a stillborn baby boy. The loss of her baby was, and still is, compounded by the loss of her own health, family and community.

"Yes, your name is on the list for the fistula clinic." I hear myself saying, referring to the fistula repair clinic that MSF helps to organize. She nods and smiles, temporarily reassured that she is not forgotten and that there is still hope. Her smile tugs at my heart. She lingers for a while, then finally turns and starts the long walk back to her village.