USAID gives fistula victims a chance to rebuild their lives

Fistula is a devastating injury for women. It occurs as a result of obstructed labor, usually when emergency care is unavailable, and results in a laceration between the bladder and the uterus or the bladder and the rectum. Most of the victims are girls who were married at an early age and whose bodies are still too small to support the rigors of childbirth. For them Fistula is an injury with devastating consequences.

“For 50 years I have lived with wet clothes and a smell of urine,” said 65-year-old Iye Banya, who has suffered from obstetric fistula since giving birth to her only child at the age of 15. “I was abandoned by my husband and relatives because of the way I smelled. I had no job and no skills to find a job.”

In Sierra Leone her story is quite common. Most villages in Sierra Leone don’t have medical facilities to assist pregnant women. The nearest hospital is generally several hours drive away. Many cannot afford to pay the cost of public transportation. Some pregnant women walk many miles to reach the closest health facility, often putting at risk their health as well as the health of their baby. For women experiencing obstructed labor, the lack of medical care often results in the loss of the child and, in severe cases, of the mother.

To help victims of fistula in Sierra Leone, USAID partnered with Engenderhealth. The $700,000 activity provides surgical services designed to reverse the effects of fistula. Since 2008, the activity has provided surgical interventions for about 700 women. In addition, the program trains surgeons and nurses in caring for women with childbirth injuries. The activity also addresses the cause of fistula by working with local health providers, communities, and NGOs to counter the cultural practice of child marriage, which often leads to early pregnancies and fistula.

The main focus of the activity, however, is on the holistic care for the women. During the recovery time following corrective surgery, women receive instruction in simple literacy and arithmetic and enjoy spending time with each other doing arts and crafts. For many, this is the first time they have come into contact with women who share their own experience and sense of isolation.

For Iye Banya, the USAID initiative has changed her life. “Thanks to the surgery I can now enjoy my family again after spending more than 50 years isolated and ashamed to go out and be with people,” she said.