This is the experience of millions of women suffering from fistula, a devastating childbirth injury caused when a woman suffers a prolonged, obstructed labour, without the right medical care. The baby usually dies and the woman is usually left without her child and with a hole--or fistula--in her birth canal. And this means a lifetime of chronic incontinence.
As you can imagine, incontinence is not only incredibly unpleasant, but it is also extremely humiliating. And because of this, women and girls living with fistula are often abandoned by their husbands and family, and ostracised by their community. This has a devastating effect on their physical, emotional and economic well-being.
Without treatment for fistula, prospects for work and family life are virtually non-existent. Left untreated, there is increased risk of premature death from infection. While women with fistula show amazing courage, most suffer a lifetime of hardship and isolation.
The World Health Organisation estimates that more than two million women are living with fistula in Africa, Asia and the Arab region, and some 50,000 to 100,000 new cases develop each year. In Nigeria the situation is particularly serious. Roughly 800,000 women and girls are living with the condition and 20,000 new cases are estimated to occur each year. These figures are based on the number of people who actively seek treatment in hospitals and clinics - but some women never seek care so the numbers are likely greater.
Although in most cases preventable and treatable, fistula is a condition that no woman should have to endure.
Our response: Virgin Unite is working with the United Nations Population Fund (UNFPA) to address this life-shattering condition in the northern Nigerian states of Kano and Katsina, which are among the worst-affected areas of the country.
Prevention is a primary focus of the programme, as fistula is almost entirely preventable if women have access to skilled birth attendance, emergency obstetric care when required and reproductive health care, including voluntary family planning.
We’re helping to provide free treatment to those who need it. In most cases, fistula is treatable with a surgical procedure provided by a fistula expert. The surgical repair has a success rate that can be as high as 90 per cent. Surgery, post-operative care and rehabilitation support cost around $300.
We’re also helping to educate the wider community, including men, about the condition to aid prevention, encourage women to come forward for treatment and reduce the stigma surrounding fistula.
Finally, we are working to raise global awareness, to push fistula higher in the health agenda and to mobilise governments to tackle it.
To raise global awareness and funds, we invited actress, model and singer Natalie Imbruglia to be the spokesperson for the Campaign to End Fistula.
She’s captured the attention of the world’s press and raised the profile of this important issue, whether she is visiting fistula treatment facilities in Nigeria or speaking to the UN urging more governments to make sure fistula is properly addressed in their health care systems. With Natalie’s profile, we’re helping to ensure that fistula is no longer something that is hidden, forgotten or not spoken of.
The impact to date: Together with Natalie and UNFPA, we’ve joined efforts to end fistula. Thanks to the money raised so far, our joint programme has contributed to improving the health, economic and social reintegration of thousands of women in northern Nigeria.
In February 2005, we supported Fistula Fortnight - a medical mission to Nigeria during which 564 women living with fistula received treatment for their condition.
But we didn’t stop there. We’re now working with UNFPA to support 30 health facilities in northern Nigeria. The programme is providing free surgery to women at rehabilitation centres such as the Babbar Ruga Hospital in Katsina.
As of July 2011, the programme has provided free fistula treatment and care to over 700 women and has enabled over 2,300 pregnant mothers to receive basic health services to support their pregnancy. Front-line doctors and nurses have also been trained to provide fistula care in overwhelmed clinics working alongside the 123 trained community educators who identify and support women suffering from fistula and pregnant women in their own villages. Much needed medical equipment has also been bought and is now being delivered to remote clinics where poor roads and a shortage of usable equipment have hampered the treatment of fistula.
“Night and day for 12 years, my life was continually put on the verge. With uncontrolled leaking of urine, foul smell, stigma, isolation, pain and rejection, it was like dying every day,” says 33-year-old Sarah, who developed fistula after a prolonged obstructed labour that left her baby dead. Today, two years after successful treatment, she is a strong maternal health advocate in local communities and at international meetings.
Sa’adatu Lawal explains that she spent two days in labour without adequate obstetric care, resulting in Fistula which caused her to develop chronic incontinence. In contrast to most women’s experience, her husband has been very supportive of her, staying by her side. But that did not stop others in the community from shunning her.
Thankfully, Sa’adatu was able to receive a surgical fistula repair and is now fully healed.
“I feel like a human being again,” she says of life after surgery. After receiving training from Virgin Unite and UNFPA, Sa’adatu is helping to educate her community about fistula prevention, and encourages women living with the condition to come forward for treatment.
“Many people still believe that fistula is not preventable or curable,” she says.
“But now, they can learn from my example.”