Women who get fistula treatment live with incontinence and strong odor that accompany the condition and they are likely to face debilitating physical, psychological, social and economic consequences.
Eva Mgara (28) a resident from Rukwa Region is amongst women who have suffered from obstetric fistula for a long time. She hunted for help from various areas including traditional doctors but she got no relief rather a thorny life situation.
“After reaching a point where I realised that I couldn’t control my urine anymore I started isolating myself from my neighbours and society, feeling shame with the smell which was coming from my body all the time,” Mgara revealed her story recently when speaking to The Guardian during when journalists toured CCBRT hospital.
According to her, she used to suffer from social discrimination as the public started isolating her by laughing and mocking her whenever she was passing; which eventually affected her businesses and other daily activities.
“I stayed with my husband for one year with such a situation, but later he didn’t tolerate living with me and decided to send me back to my relatives without anything, as a result I lived miserable life,” Mgara explained bitterly.
However, Comprehensive Community Based Rehabilitation in Tanzania (CCBRT)’s mobile outreach unit was informed about Mgara’s situation when they were visiting the area.
“CCBRT assured me that the leaking could be controlled with surgery. I was so relieved. CCBRT gave me the bus fare from my place to Dar es Salaam so as to attend treatments,’ she revealed.
“From isolation and psychological torture, I am now free from all kinds of difficulties I had for the past five years,” says Mgara.
Mgara got fistula five years ago when she was giving birth to her baby, child, who unfortunately later passed away, something that still haunts her till today.
Mgara now smiles all the time after CCBRT showed her and the whole community that fistula was a treatable disease.
She further noted that women who live with fistula can not be able to assume their ascribed socio-cultural responsibilities. They only become a kind of a burden because they cannot contribute to the family earnings. They can neither satisfy their husbands sexually nor bear children well.
Lack of power decision making, illiteracy, low economic status, gender inequality, malnutrition, and lack of emergency obstetric care contribute greatly to the occurrence of the condition. For example, decisions about mobility of women and expenditure on health care are commonly controlled by men.
“I have gone through a very difficult time. These five years have been like a century to me because there was a time I thought like committing suicide,” she asserted.
The lady is now drawing her happiness life again, thanks CCBRT for making her smile again as she will be able to go back home and join fellow villagers with a new start but lovely.
“I do not believe because the doctor has told me that I have one more surgery left for my situation to become normal, as I have already got one surgery and I’m feeling much better than previously,” she said, adding that CCBRT is a good place, calling for women faced with fistula seek for treatments from CCBRT because its doctors and nurses are kind, and welcoming.”
For his part, a fistula specialist from CCBRT hospital Dr Peter Majinge explained that during Mgara’s labour a hole developed between the bladder and the vagina; a disability called Vesico-Vaginal Fistula (VVF) something that led her fail to control urine.
At CCBRT, Mgara was operated on to repair the fistula, however, the first operation didn’t work well as her affection was worse, thus needed for the second operation to make it normal.
He said that women with this problem, in the eyes of the society are of less value due to their inability perform their social and marital roles.
In Tanzania, over 3,000 women a year develop obstetric fistula after childbirth as a result of obstructed labour and the unavailability of emergency obstetric, thus leaving them in a tough situation socially and economically.
The trend needs more efforts be invested in addressing the challenge. The efforts could be also part of implementation of the Sustainable Development Goal number three which lies in ensuring health lives and promoting the well-being for all at all ages.
Dr Majinge also mentioned that lack of society awareness about fistula has contributed to the negative perception by society about the affected women and in turn women’s experiences of social discrimination.
“Education programmes through various sources to communities will help people understand about fistula including the nature of the condition and its cause so that women living with fistula are welcomed and receive fistula treatment and necessary social support,” he recommended.
Since 2010, the Vodacom Foundation has been working closely with CCBRT to facilitate free travel and treatment for women with fistula. The text-to-treatment project activates doctors and community members (“ambassadors”) across Tanzania to identify patients suffering from the specified condition.
Having identified a potential fistula patient, the ambassador contacts the Vodacom/CCBRT coordinating office, where referrals are screened to ensure that symptoms are compatible with obstetric fistula.