Tuesday 24 July, 2001
Fighting Fistula
Experts from the United Nations and internationally known gynecologists met recently in London to raise awareness and funds for a devastating but curable condition that affects millions of women in developing countries.
Obstetric fistula occurs during complicated and prolonged childbirth and leaves women, particularly young girls, incontinent and extremely prone to infections. BBC Science reports.
Obstetric Fistula
Obstetric fistula occurs when the delivery of a baby goes wrong and the baby gets stuck.
The prolonged pressure of the baby tears the tissue between the bladder and rectum, resulting in women being incontinent and urine and faeces leaking out through the vagina. The baby is usually still born.
About 5% of women worldwide experience obstructed labour, but where medical care is good problems can be avoided by performing a caesarian.
But particularly in rural areas of developing countries where medical can be poor, the obstetric fistula condition does occur.
| ‘The UN estimates about two million women have been affected by obstetric fistula conditions.’ | |
In cultures where girls as young a ten or 11 are married off the problem is greatest, despite being able to fall pregnant they're bodies are still too small to deliver the baby safely. And many teenagers suffer fistulas.
Surgery
Surgery can repair the damage, but there are currently only two centres in Africa where the procedure takes place. Dr John Kelly, a specialist in obstetric fistulas, explains:
‘Each year for the last 32 years I have worked for one to three months in Ethiopia and in more recent years I have worked in other parts of Africa and in Pakistan and I know spend about nine months of each year doing this type of work. Trying to train the local surgeons and gynecologists to treat these women.’
Women with fistulas are often left by their husbands and become social out casts - they are not allowed to prepare food or collect water, and in some areas people believe the condition is caused because of marital infidelity or sexually transmitted disease - casting shame on the woman.
But according to Dr Kelly the problem in developing countries is getting worse:
‘With increasing poverty our impression is that the injuries they suffer are more and more complex and some of the operations can take five hours. There is a certain percentage of women whose injuries are so great that they will never be cured.’
Raising Awareness
A recent meeting of doctors in London has examined how to raise awareness and funds to provide more care.
The UN's ultimate aim is to eliminate obstetric fistulas, something that Kathy Manu, who works for an African women's organisation says is possible if the right messages reach people:
‘We have prevention at three main levels. One, stop early marriage. Secondly stop social cultural practices like female genital mutilation and thirdly to have access to hospitals. Abolish user fees, get infrastructure in place so that people can get to these hospitals.’
Many of the women treated can go back to their villages and live normal lives - even having more children safely after receiving advice about safe labour from the hospital. But even those women who cannot be fully cured can help.
Ruth Kennedy who works at the Addis Ababa Fistula Hospital, says all the women can tell others affected by the condition about where they can be treated:
‘We're going to build a home for these incurable patients so that they can have a small farm and we can train them and eventually they will go out and teach other women how to prevent fistulas and what to do to prevent fistulas.’
|
 |
 |
|
| Obstructed Labour |
 |
|
|
Obstructed labour occurs in 5% of all pregnant women. In the West such births are carried out in hospitals, sometimes by caesarean section.
In countries such as Ethiopia, where medical aid is limited, it is not uncommon for a woman to endure labour for up to five days, with no medical attention.
Whilst fistula figures are unclear, some estimates put the number of sufferers in the developing countries at three million.
In Ethiopia fistula treatment is available, but access to it is limited and women often travel miles to be seen by a doctor.
As a result about 1,500 new patients arrive at The Fistula Hospital in Addis Ababa every year. |
|
 |
|
|
