The nightmare called Obstetric Fistula

A woman in labour shouldn’t see the second sunrise. That is an attention-grabbing quote from Dr Tekle G. Egiziabher, an obstetrician and gynecologist committed to helping women suffering from fistula. Well, let’s break it down. One of the major causes of Obstetric Fistula is prolonged obstructed labour, meaning if a woman stays in labour pains for longer than 24 hours (sees another sunrise), then she risks suffering from the dreaded fistula. If a pregnant woman, therefore, delays to get medical assistance during her labour pains then she is most likely going to end up with Fistula. Obstetric fistula is a severe medical condition in which a hole develops either in the rectum and private parts or between the bladder and the private parts after prolonged labour or poorly-attended delivery, causing uncontrolled passing out of urine or faeces. This is one of the most frightening diseases for any woman to go through because usually the victims are ostracised and stigmatised in society, reasoning being they always have an appalling odor caused by the urine and fecal leakage. The disease mostly affects poor women or those in rural areas because some of them don’t have access emergency care, skilled attendants and others lack proper antenatal care. Other causes of fistula include having a small pelvis, especially for young mothers below the age of 19, whose bodies aren’t yet ready for child birth, gynecological surgical procedures that might go wrong such as a wrongly done caesarean sections, unsafe abortions and cervical cancer according to Dr Egiziabher of Rwanda Military Hospital. He said fistula is a big public health issue in the country and as Maternal care services improve then Fistula cases will also go down. 250 repairs Dr Egiziabher has done fistula repairs on 250 patients since 2007 up to date amidst challenges such as lack of space of equipment which progressively being addressed. When he started fistula repairs in the country, there was only one bed for fistula patients, but now the beds are many and likely to increase to provide improved health care for the patients. One of Dr Egiziabher’s most remarkable moments was when he operated a woman who had lived with the disease for 52 years. Juliana Kubwimana suffered fistula at the age of 18 during her first delivery, which she had at home. When she went for her first operation at a rural hospital, the operation was not successful and she was unable to seek further medical help. Kubwimana gave up hope thinking that she would never heal since she had failed to find another doctor to do the fistula repair. She gave up and even gave birth to six more children until she heard an advertisement on the radio for low cost obstetric fistula repairs. This is one of the 250 fistula patients Dr Egiziabher has operated on all with different touching stories of how they suffered stigma due to having this disease and the joy the repair or operation has brought to their lives hence transforming them. *** HOW TO PREVENT OBSTETRIC FISTULA The safest way to avoid obstetric fistula is for pregnant women to go to a proper health (maternal) facility at the doctor’s prearranged time before labour pains set in order to avoid prolonged obstructed labour according to Dr Egiziabher. Pregnant women should also seek maternal health care from a good health facility instead of delivering from home or with help of birth attendants, who might not detect complications that could lead to fistula, advises the Specialist. Women should also avoid getting pregnant at a tender age especially below 18 since that puts them at a higher risk due to having a small pelvis. Unsafe abortions which usually go wrong should also be shunned as they are one of the causes of fistula.