Fighting fistula, bringing hope to Malawian women

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The old adage says many are the sufferings of man, but in this case, many are the afflictions of women.

Women all over the world face many afflictions due to their physiological nature. One of such conditions is the issue of obstetric fistula.

Fistula

Woman suffering from fistula

Obstetric fistula is one of the most distressing medical disabilities troubling women as a result of complications arising from lack of surgical intervention for prolonged labour.

Obstetric fistula is a condition mostly seen in women of reproductive age, particularly in the developing countries including Malawi.

The United Nations Population Fund (UNFPA) estimates that almost one percent of women in the country are living with the devastating effects of the condition which affects almost two million women globally.

The condition, according to UN agency, occurs as a result of prolonged obstructed labour when the head of the baby is not able to pass through the pelvis of the woman.

A hole is created between the bladder and the female genital or the rectum and the female genital. This causes the woman to leak faeces, urine or both through the female genital.

International Day

The United Nations (UN) has observed the International Day to end obstetric fistula since 2003. The day, which is marked on May 23, is commemorated annually to raise awareness of the condition and to garner support around the globe.

The theme for this year’s International Day is “Leaving no one behind: Let us commit to ending fistula now!”

A statement issued by the UNFPA Executive Director Dr Natalia Kanem to mark this year’s occasion said the condition “is silently robbing millions of women and girls of their health, hope and dignity.”

In an interview, Mary Kachingwe, a midwife at Namilango Health Centre blamed the occurrence of the condition in the country on lack of education and some cultural systems that prohibit expectant mothers to seek medical interventions.

She said many women refuses to go for antenatal care and also seek the services of professional birth attendants in health facilities because of their beliefs.

Kachingwe explained that such beliefs systems led to prolonged labour which also causes the women to suffer obstetric fistula as a result.

“We still have people who don’t understand the essence of a hospital,” she said, adding that “although antenatal care to delivery services is free, many women still don’t come”.

She said some people believe that women who give birth at home are not brave hence such mentality encourages some pregnant women to deliver at home instead of health facilities.

Kachingwe said: “In the home delivery, the unprofessional birth attendants don’t even know the position the baby is coming and when they keep asking the woman to push, it leads to prolonged labour, resulting in complications.”

Sensitization campaigns

According to Kachingwe, most of the cases reported are due to home delivery hence the need for more education and sensitization for women of reproductive age on the condition and how to prevent it.

She also encouraged women with the condition to seek medical assistance since the condition is treatable and also free.

Meanwhile, to help raise awareness on the condition and also assist women with the condition to get treatment, Chikondano, a local NGO based in Machinjiri with funding support from the Canadian High Commission, has sensitised 100 communities in Mulanje and Blantyre through the use of participatory theatre and drama to communicate the linkages between child marriage, poor health-seeking behaviour and obstetric fistula.

UNFPA Malawi representative Ratidzai Ndhlovu, said the most effective way to prevent fistula is to increase access to quality maternal health care services, including family planning, skilled birth attendants and emergency obstetric care.

She added that prevention also entails tackling underlying social and economic inequities to empower women and girls.

She explained that through the campaign, many women have been counselled while others have been given a skill training to empower them after their surgery.

“Working with communities is also key because it ensures women are accepted back into society without being stigmatized,” Ratidzai Ndhlovu said.

When asked about the state of care, she explained: “The visiting surgeons work hard with the locals for skills transfer. They are doing a lot to restore smiles on the faces of women, even those abandoned by their husbands. The foreign experts do the procedure and leave, but the locals remain behind to do minor procedures.

Ndhlovu added that Malawi is not there yet in terms of treatment, but it can improve.

“We need to do more to support our surgeons and to take treatment closer to women and girls who spend many years looking for it. We can do something about it.

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