What is Fistula
A Fistula is a hole between a womans birth passage and one or more of
her internal organs. Fistula normally occurs during childbirth due to
Without treatment, fistula often leads to social, physical, emotional
and economic decline. Although some women with fistula display amazing
courage and resilience, many others succumb to illness and despair.
The misery of fistula is relentless. In spite of one's best efforts
to stay clean, the smell of leaking urine or faeces is hard to eliminate
and difficult to ignore. The dampness causes rashes and infections.
The cleaning up is constant, and pain or discomfort may be continuous
as well. The grief of losing a child and becoming disabled exacerbates
the pain. The courage many women show in the face of these challenges
The injury leaves women with few opportunities to earn a living, and
many have to rely on others to survive, or turn to begging or commercial
sex. In some communities they are not allowed to have anything to do
with food preparation and may be excluded from prayer or other religious
observances. Although many women with fistula have supportive families,
the smell can drive even loving husbands and friends away. For many
women, the profound social isolation is worse than the physical torment.
The pain and loneliness associated with fistula is often compounded
by a sense of shame and humiliation. In some communities, the condition
is seen as a punishment or a curse for an assumed wrongdoing, rather
than as a medical condition.
The stigma associated with the condition
keeps many women hidden away. Some go into deep physical and emotional
decline and may resort to suicide. And because so many women with fistula
remain marginalized and out of sight, many policy makers - and even
some health providers - have failed to recognize the scope and severity
of the tragedy
Can Fistula be cured?
Yes. An obstetric fistula can be closed with intravaginal surgery. If
her surgery is performed by a skilled surgeon, a fistula patient has
a good chance of returning to a normal life with full control of her
How much does it cost to treat obstetric fistula?
While £350 isn't enough for one night's stay in most hospitals
in East Africa, it is enough to provide one woman with restorative surgery
and postoperative care.
The approximate average cost per patient is £350 GBP. This includes
surgery, postoperative care and physical rehabilitation. Costs and hospitalization
can, however, be greater for more complicated surgeries such as treating
dual vaginal and rectal fistulas.
What are the causes of obstetric fistula?
A fistula results from an obstructed labor that is left unrelieved and
untreated. It is estimated that 5% of all pregnant women worldwide will
experience obstructed labor. In many developing countries where there
are few hospitals, few doctors, and poor transportation systems, and
where women are not highly valued, obstructed labor often results in
death of the mother. When she survives, there is a great likelihood
her child will die and she will develop a fistula. According to the
United Nations Population Fund (UNFPA), there are three delays that
contribute to the development of a fistula: delay in seeking medical
attention; delay in reaching a medical facility; and delay in receiving
medical care once arriving at a health care facility.
I heard that fistulas are a result of female genital mutilation. Is
While harmful traditional practices such as female genital mutilation
(FGM) are rightly of concern to the international medical community,
they are not major contributors to the development of an obstetric fistula.
Some patients have been victims of FGM, but their fistulas are almost
always caused by an obstructed labor resulting from a too-small pelvis
or a malpresentation of the baby. FGM does not "cause" a fistula.
How many women does this problem affect?
Because fistula affects women in the most remote regions of the world,
an accurate count is very hard to achieve. The most common estimate
is that 100,000 women worldwide develop fistulas every year, though
some estimates put the number closer to 500,000. Because most fistula
sufferers are young womenmany still in their teensthey are
likely to live with their condition for upwards of 25 years. By any
estimate, there are hundreds of thousands of women currently living
with fistula throughout the developing world. The world capacity to
treat fistula is estimated at fewer than 20,000 fistula repair surgeries
Where is fistula prevalent?
There is a high incidence of fistula in Africa and parts of Asia, but
women are susceptible to developing fistulas wherever there are insufficient
emergency obstetric care systems.
Can obstetric fistula be prevented?
Any woman who can gain access to emergency obstetric care such as a
cesarean section will not develop a fistula.
What can I do to help?
A tax-deductible donation to the Support Girl Child Organisation directly
assists in restoring health and dignity to women suffering from fistulas.