An estimated two million women worldwide suffer from obstetric fistula, a hole between the bladder and the vagina through which urine constantly pours.
It is an entirely preventable condition, and the injustice is that it exists at all in the 21st century. Fistulas used to be common across the world, but they are now virtually unheard of in developed countries, thanks to improvements in social and economic conditions and the accessibility of high quality maternity services.
The medical causes of obstetric fistula are easy to identify – prolonged obstructed labour, either because the pelvis is too small, or the baby too big, or the baby is lying in an abnormal position and unable to be delivered normally. The social causes underlying these bare medical facts are much more complex: early marriage – before the girl’s pelvis is mature enough to deliver a baby safely – and poverty resulting in chronic malnutrition, leaving women stunted in their growth.
Roshida married when she was about 12 years old, and her first pregnancy followed fairly quickly. The baby was lying across her womb rather than head down, and when she went into labour the baby’s arm came out first, and the baby died. When her second baby also died in childbirth, the prolonged labour caused an obstetric fistula – she became constantly wet and smelly and people could not bear to be close to her. She was also regarded as spiritually unclean, so was unable to pray or participate in worship.
When her husband divorced her Roshida returned to live with her parents, but they could not cope with the constant smell. She had to move into a separate hut, similar to a cow shed, and was unable to work in any job that required proximity to other people.
After suffering for about eight years, she came to our organisation for help. Her fistula was easily repaired, and 14 days later she was dry. Her condition had brought deep shame to her, so before she left the hospital, our chaplains prayed with her, for Jesus to cover her shame and make her whole again.
Three months later she returned to the clinic a different woman. She was now earning money and playing an active role in her family and community. When we asked her if she’d be willing to speak at the opening ceremony for the hospital fistula unit, her response was, “Why not? People need to know!” And so the woman who had been too embarrassed to show her face on the ward told her story in front of 100 people, including local dignitaries and journalists. Not only had she regained her physical health but her self-esteem had blossomed – she was healed in the full sense of the word. ♦
A Partner with Interserve England & Wales (but with a strong Kiwi connection), the author is a doctor who spent 16 years serving in South Asia with a Health and Development NGO.
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