Ethiopia – While in her early teens, Negesse Mesfin was set up in an arranged marriage by her parents. She moved in with her husband and when just 16 years old, gave birth to her first child. In the process she suffered an obstetric fistula.
“My husband didn’t leave me all those years because he believed that it was a curse. But I was isolated from any social life and even at home it was my husband who was helping me in doing the household chores like fetching water,” says Negesse.
In Northern Ethiopia, the region where Negesse hails from, child marriage is treasured in the community – a harmful practice that has impacted negatively on the wellbeing of women and contributed substantially to traumatic morbidities suffered by them, such as obstetric fistula. Obstetric fistula, caused by prolonged and obstructed labour, is the most devastating and serious of all childbirth injuries.
Five year ago, after living with the condition for 28 years, Negesse was treated for both vesico-vaginal fistula and recto-vaginal fistula.
People were trying traditional and spiritual medicines to cure fistula, under the misconception that it was caused by an evil spirit. - Genet Abera, community mobilization worker
It is thanks to the relentless efforts of community mobilization workers like Genet Abera that fistula patients such as Negesse get a second chance in life. The social isolation that obstetric fistula brings for sufferers caught the attention of Genet many years ago, and she has been contributing actively for the reversal of their devastating situation.
“People were trying traditional and spiritual medicines to cure fistula, under the misconception that it was caused by an evil spirit. After the Prime Minster of Ethiopia called for a national meeting on fistula in 2007, we then started advocating for clinical procedures to be used to repair the fistula,” says Genet.
She recalls one case that made the headlines, where a woman suffering from fistula was about to be burnt alive by her community. She managed to convince the woman’s family and community to desist and take her instead to the Hamlin Fistula Centre in Bahirdar, then later to the fistula centre at Gondar University Hospital for treatment. The outcome was positive.
“More than 50 women have been treatment since and each of them in turn convinced fistula patients in their communities to seek treatment,” Genet says proudly.
The fistula centre at Gondar University Hospital is among three such centres that UNFPA, the United Nations Population Fund, is supporting in the country to treat obstetric fistula patients. The support takes the form of provision of medical equipment used for the treatment. The Fund contributes US$100 for the treatment of each fistula patient. To date, more than 2000 fistula patients and around 400 women suffering from uterine prolapse have been repaired over the past few years.
Once women like Negesse are healed completely from obstetric fistula, they become involved in small-scale income-generating activities, including operating food stores, growing and selling vegetables, and fattening animals to sell on the market. Negesse is among the 62 women supported by UNFPA as such. With the startup money that she received she is now fattening animals, which she sells on the market to support her family.
Ambitious national campaign on fistula
The Ministry of Health in Ethiopia is spearheading an ambitious national campaign to eliminate obstetric fistula from Ethiopia by 2020. It is believed that an estimated 39,000 women are living with obstetric fistula and that close to 4000 new obstetric fistula cases occur every year in the country.
Negesse is happy to play a part in such an effort. “Now I am working with the Women’s Affairs Office in my locality, advocating for clinical treatment of obstetric fistula and prevention of harmful tradition practices. I have convinced 11 fistula patients and 13 women suffering from pelvic organ prolapse to get treatment at the hospital,” she says.