Fatima, 14 years old narrates her story:
I was in labor for six days, for six days I did not pass stool or urine. When the urine finally came, it came nonstop. That’s when I knew I had a problem; the smell of urine was constant and humiliating.”
Obstetric fistula has disappeared in Europe and North America, a century ago while Nigeria is still facing the obstetric nightmare of fistulas. Nigeria harbors an estimated 40% of all the women affected with obstetric fistula in the world. Obstetric fistula is a devastating childbirth injury, at current rate of treatment and if no new fistulas occur in future, the situation will remain same for next 300 years in Nigeria.
Nigeria has the highest obstetric fistula prevalence rates in Africa and an estimated 400, 000 to 800, 000 women suffer from fistula in Nigeria. It is common in countries with high maternal mortality rate like Nigeria; where lifetime risk of a woman dying during childbirth is 1 in 18.
Sex. Abortion. Parenthood. Power.
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Women in Nigeria are not fortunate enough to give birth in a hospital equipped with medical technology and doctors. Like many developing countries, women in Nigeria are undernourished, married and get pregnant at younger ages and lack access to health care services. The social, economical and cultural norms render mothers to deliver at homes under the supervision of traditional birth attendants and often unsupervised too. The head of the baby gets lodged in the narrow birth canals and cut off the blood supply to the bladder, vagina or rectum, ending in urine or fecal incontinence or both. The story never ends here; they now have to face the demoralizing social consequences of the problem. They are outcast in their own communities; lose their dignity, abandoned by their husbands, and ashamed to socialize.
They are bearing the sheer consequences of being poor, unfortunate and underprivileged. But perhaps being women on this planet is their biggest fault.
When and how and who will help them?
What could be the role of International donor agencies, policy makers, local government, public health professional, gynecologists/obstetricians?
Little drops of water make the mighty ocean.