When, during birth, the child remains in the birth canal for too long, the resulting pressure on the mother's blood vessels leads to an interruption of the blood supply, causing tissue death between the vagina and the bladder or the rectum. In most cases, the child will be stillborn, whilst the mother is left with an unnatural connection between the affected tissues. Girls and young women who still have very narrow pelvises, are most susceptible to this risk. Once the tissue has died, the women suffer chronic incontinence. Many are then repudiated by their husbands, rejected by their families and possibly even expelled from their villages. They live a solitary life, burdened by poverty and shame, left alone with the long-term health effects such as kidney infections, skin ulcers and mental illness.
The WHO estimates that worldwide every year 50,000 to 100,000 women suffer complications during childbirth that lead to fistulas. However, the exact number of affected women is difficult to determine. Frequently they live in remote areas where health statistics are simply not maintained and where knowledge about this condition may be non-existent.
International Day to End Obstetric Fistula May 23rd (www.endfistula.org) will hopefully shed more light on this condition and create possibilities for change. A small operation can reduce the physical suffering and permit the social reintegration of affected women.
IAMANEH Switzerland facilitates fistula operations for women and ensures thorough follow-up care, so that repudiated women can return to their families. Additionally, efforts are being made to raise awareness in village communities to direct attention to this issue and to reduce the taboos associated with it.
