The Facts about Fistula
What is a Fistula?
A fistula is an injury that occurs during a prolonged labour where the pressure of the baby's head causes a hole to form between the woman's bladder and her vagina. If left untreated, the woman becomes incontinent.
Fistulas can cause an unstoppable leakage of urine. Some women suffer a double fistula which means that they also cannot control their flow of faeces. Sadly, the offensive smell that this causes means women with fistulas in Ethiopia become social outcasts.
Fistula sufferers are ostracised by their family and friends, rejected by their husbands and forced to leave their jobs and homes. Very often these women have endured agonising prolonged labours, often resulting in the loss of their child, only to find they also have this distressing condition.
Some believe that by lying down the flow will stop and many who visit the hospital have severe muscle wastage from months, in some cases years, of lying still in the hope of remedy.
Why do Fistulas happen?
An obstructed labour is easily managed in the developed world by assisted delivery or caesarean section, but without this it can have disastrous consequences.
In Ethiopia, pre-natal and maternal healthcare is often unavailable. If a woman experiences complications during childbirth or has an obstructed labour, she is often unable to receive treatment such as an emergency caesarean section. Indeed, only one in every twenty births are attended by a trained medic and often the nearest hospital is days travel away. All too often this means the woman spends days in a fruitless labour, delivering a stillborn child and causing a fistula to develop.
Also, in Ethiopia girls as young as 4 or 5 are betrothed and intercourse often takes place before their teens. Many of these girls are simply not ready to carry children and so complications arise when labour starts.
Can Fistulas be repaired?
Yes. All that is required is simple surgery, the cost of which is only £100.
The operation required usually takes less than an hour - it prevents further leakage of urine and many of the women treated go on to have more babies. Each patient stays at the hospital for three weeks to allow for recovery. For some, this is longer as they require intensive physiotherapy to build up their strength for the operation following long periods of lying down and the inevitable muscle wastage.
When the woman has fully recovered she is given a new dress and the means to get home. They are also instructed in how important it is to get to hospital for their labour if they were to fall pregnant again. Each patient is provided with a card they can present to doctors on their arrival explaining that they may be in need of a caesarean section.