When you feel the urge to pee, can you hold it reasonably until you reach a convenient place before you let go? How about when you sneeze: does urine gush out of your body uncontrollably? In a worst case scenario, do you leak urine and poop from your vagina? If you answer ‘yes’ to any of these questions, let’s go a little bit further. When did this problem start: Was it after a major surgery such as hysterectomy, caesarean section during childbirth or after a traumatic incident such as rape or female genital mutilation?
If you experience urine leakage after any of these experiences, you need to see the doctor who will assess your condition to determine whether or not you have fistula.
What is fistula?
For many women and their families, they’ve never heard about the word ‘fistula,’ even though their conditions are symptomatic of this medical condition that currently afflicts between 100,000 and 150,000 Nigerian women, while 12,000 cases are being recorded annually.
Globally, experts say, over two million women live with untreated obstetric fistula, mainly in sub-Saharan Africa and Asia, with about 50,000-100,000 new cases annually.
Sad to say, many women have suffered in silence because of this condition, with many of them attributing their challenge to attack, witchcraft and everything but the real cause.
Speaking at a media workshop organised by the Engender Health, and sponsored by the United States Agency for International Development, gynaecologist/Country Project Manager, Engender Health/USAID Fistula Care Plus, Dr. Habib Sadauki, says broadly speaking, there are two primary types of fistula in women – obstetric fistula and traumatic fistula.
Sadauki describes obstetric fistula as an abnormal opening in the birth canal, between the bladder and/or rectum and the vagina, resulting in chronic inability of the body to control urination or defecation.
“It is an injury that occurs during childbirth, usually when a woman is in labour for too long or when the delivery is obstructed in some way.”
While traumatic fistula is also an abnormal opening in the birth canal, between the bladder and/or rectum and the vagina, resulting in chronic incontinence, Sadauki says it is an injury caused by rape or sexual violence, and is most common in conflict and post-conflict settings.
He laments that when a woman is suffering from fistula, she may experience any of the following life-shattering conditions: incontinence, dribbling, wetting, leaking and stress incontinence.
The sad thing is that many women don’t know the name for this condition, as was the case of mother of three, Madam Olayemi, who narrated her experience to this reporter a day after she underwent surgical procedure to repair the obstetric fistula she had endured for four agonising years.
Olayemi says trouble started following a prolonged labour she experienced as she attempted to deliver her third baby, now four years old. She says she was in labour for three agonising days and had to undergo a caesarean section to have the baby.
In her estimation, the CS went well, and she was discharged after some days. Barely two weeks after her discharge, though, trouble started – she discovered that she could no longer hold herself whenever she was pressed to urinate.
She says, “I discovered that before I reached the bathroom any time I wanted to pee, I would have wet myself. The first time I experienced it, I dismissed it as one of those things and went about my schedule. But I kept experiencing the condition and within a day, I had wet myself more than four times.
“As time went on, my condition worsened and I had to pad up myself with clothes if I wanted to quickly dash out to a nearby place. I could not travel or attend social functions because at a time, I was stinking.”
Olayemi says she first thought it was something she could keep to herself, thinking that the condition would resolve itself. It never did, and she eventually disclosed her experience to her husband.
The husband supported her, she says; and, together, they started seeking solution for a condition Sadauki says “occurs in settings where there is limited access to skilled medical care or caesarean section.”
Olayemi says she moved from one hospital to the other, and eventually landed at a tertiary hospital where, for four years, the doctors didn’t really diagnose her condition but kept giving her appointments.
“Each time I went for my appointment, the doctors were either on strike or the consultant I was billed to see had travelled. In frustration, I stopped visiting the hospital, but my life was hell,” she recalls.
Her situation changed, though, when she heard a radio jingle that not only described her condition but also assured women living with fistula that it is repairable.
“The icing on the cake is that they said the surgery is free of charge,” the now-relieved housewife says.
At Sobi Specialist Hospital in Ilorin, Kwara State, where 30 women who had experienced fistula are currently being surgically repaired under the aegis of Engender Health/USAID Fistula Care Plus, it was moment of rejoicing as hitherto forlorn women got their dignity restored one after the other.
Even though the average fistula repair costs between N80,000 and N100,000, none of these women could pay for it. Indeed, but for the intervention of the Engender Health/USAID Fistula Care Plus, ably supported by the Kwara State Government, these women would have died of grief, as many of them had become social pariahs, abandoned by their husbands and rejected by the society.
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