Q

What is Fistula

A

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 prolonged labour.

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 is extraordinary.

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

Q

Can Fistula be cured?

A
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 bodily functions.

Q

How much does it cost to treat obstetric fistula?

A

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.

Q

What are the causes of obstetric fistula?

A


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.

Q

I heard that fistulas are a result of female genital mutilation. Is this true?

A:

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.

Q:

How many women does this problem affect?

A

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 women—many still in their teens—they 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 per year.

Q

Where is fistula prevalent?

A


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.

Q

Can obstetric fistula be prevented?

A


Any woman who can gain access to emergency obstetric care such as a cesarean section will not develop a fistula.

Q

What can I do to help?

A

A tax-deductible donation to the Support Girl Child Organisation directly assists in restoring health and dignity to women suffering from fistulas.


 

 









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