HASINA MJINGO, 26th February 2010 @ 21:00, Total Comments: 0, Hits: 1181
YOU cannot easily tell that someone is suffering from obstetric fistula unless you get close to them. The smell in her body can tell that she is suffering from the disease.
For Hidaya (50) the journey in battling with Fistula begun in 1983 when she was pregnant with her fourth child.
Hidaya narrates it all started when she went to the wash room for a short call. When she saw blood she knew something was wrong.
She called her husband who took her to Mwembe hospital in Zanzibar. She was put to rest at the hospital for 24 hours before she was shifted to Mnazi Mmoja hospital for further treatment.
The next day the doctor decided to give her Oxytocin to accelerate the labour pains. At 6:00pm the baby was delivered but it had died already.
Hidaya suffered paralysis on the lower part of her body. That is when all the problems started. Without feeling the urge to go to toilet urine was coming out uncontrollably.
“It was very embarrassing and the worst part is when faeces started to come out without feeling the urge,” she says.
She stayed in the hospital for another month because the doctors decided to keep her longer for further observation. After a month, doctors, realising they could not assist her told her to go to Muhimbili National Hospital in Dar es Salaam for further treatment.
But both her husband and her family had no money to take her to the hospital let alone to Dar es Salaam.
When she was sent home from the hospital she went and lived with her parents because her husband was not able to take care of her. Later on her husband married another wife.
She became a prisoner of her life; she had to be indoors for fear of embarrassing other people because of the bad odour.
Her day starts at 5:00am in the morning where she would wake up to pray, get rid of all her dirty clothes that she used at night then she showers. She inserts a whole piece of khanga in between her legs so as not to mess herself.
One day Hidaya decided to make a change, she would never let her condition ruin her life. She decided to go to a nearby market to get coconut and resell them to get at least money to buy her soap for her washings.
It has been 26 years of suffering until late last year when she was seated outside her house when she heard an advertisement on the radio that CCRBT was lending a helping hand to women suffering from Fistula.
Immediately she sent one of her sons to go get all the information about the hospital. Today she is carrying a basin with a pipe connected to her bladder.
She cheerfully carries her basin and seats on her bed. It is a relief for her because her journey of battling with Fistula is about to come to an end.
It's due to poverty and lack of knowledge about maternal health and pregnancy-related emergencies that made Hidaya to suffer half of her life time fight for something she had little knowledge about.
The minute Salma walks in a room, you can tell she avoids eye contact, she carefully sits down.
At the tender age of 19 Ms Salma who resides at Malinyi, in the suburbs of Ulanga, in Morogoro region, suffers from obstetric fistula. On her ninth month of pregnancy, one morning her labour pain started.
Her mother took her to a nearby dispensary and for three days Salma was in critical pain, her mother did not have money to transfer her to a hospital where she could get specialised care.
The man who was responsible for her pregnancy took off the minute he learnt she was pregnant. Her father said he wanted nothing to do with her. The only person available to take care of her was her mother.
Her mother decided to borrow money from relatives and friends so that she would raise 30,000/- out of which 25,000 was for operation and 5,000 were for transportation to and from the hospital. On the fourth day Salma could not feel any pain and her legs could not move either, apparently her child had died.
“The minute the doctor said my baby had died, I was in a shock and it happened because we didn’t get to the hospital fast enough. But how could we? We did not have any money at that time,” she recalls as she fights back her tears.
After the surgery her bladder was leaking so they had to insert a pipe in her bladder. After seven days it was supposed to be healed but for Salma that was not the case.
Urine and stool started coming out uncontrollably, when examined further, it was confirmed she had obstetric fistula. Salma never believed she would ever go back to her normal life again until when she went to CCRBT.
“My life was horrible; I smelled of urine almost all the time, some of my relatives could not even sit near me.
The sad part was when my father refused to show any support to me. In fact he cursed me saying I got what I wanted,” she narrates in anger. Ms Salma had been cautious every time she sat down as she always feared that she would urinate before other people.
The aforementioned are some of the women patients who are admitted at CCBRT hospital in Dar es Salaam. They have few things in common, they suffered fistula at a very tender age, lived with their problems for a long time because of poverty in their families.
They had been abandoned by the men who made them pregnant and finally landed at CCBRT for fistula surgery. In Tanzania, child birth remains a big challenge.
Every year 13,000 women die in childbirth and from pregnancy-related complications. For every woman who dies, 20 others will suffer injuries such as fistula.
Recently the United Nations Population Fund (UNFPA) has awarded a grant of 25m/- to CCBRT, Tanzania’s largest provider of surgical and rehabilitation services for people with disabilities. The funds will go towards CCBRT’s fistula work.
Obstetric fistula occurs disproportionately among poor girls and women, especially those living far from medical services.
Miseries faced by women with fistula are numerous. In spite of one's best efforts to stay clean, the smell of leaking urine or faeces is constant and humiliating.
The condition often drives even loved ones away and isolates women from their communities and diminishes their chances to get out of poverty.
Dr Julitta Onabanjo, UNFPA country representative in Tanzania says, sadly, most women with the condition do not know that treatment is available, or they cannot afford it. “With initiatives such as CCBRT’s fistula ward, these women can be assisted to lead a life full of dignity and respect.”
Dr Vindhya Pathirana, a gynaecologist with the Dar es Salaam-based Comprehensive Community Based Rehabilitation in Tanzania (CCRBT) says the major cause of fistula is child birth trauma caused by lack of care during child birth.
Fistula is a hole that occurs between the bladder, vagina and rectum of a woman during child birth. An estimated 1,200 new cases of preventable obstetric fistula are registered annually in Tanzania.
In 2009 alone, CCBRT carried out 160 fistula surgeries and the organisation also facilitated the treatment of another 30 women in hospitals in northern Tanzania.
The gynaecologist adds that most women suffer because there is no proper obstetric care- this can be due to economic problem as many women cannot afford to go to hospital, thus, they give birth at home.
Another reason is that most health centres in rural areas are where there are no resources. In CCRBT for example, Dr Pathirana says, most patients are in their 20’s and they get mostly infected because their reproductive organs are not matured enough
“Women should be educated that giving birth at home is not safe. Some think it is better than hospitals but actually it is the opposite. And for older women if they know that they are suffering from fistula they should get treated so that they can get their normal life back, the surgery is free,” he says.
Dr Erwin Telemans, CCBRT’s Chief Executive Officer (CEO) said recently: “There are three well known barriers to women with fistula coming forward for treatment- the cost of surgery, lodging and transportation.
He added: “While we are the second largest provider of fistula surgery in Tanzania we still have capacity to do more.
With UNFPA support, we have been able to upgrade a hostel so we can give women free lodging while they await for surgery and we have been able to introduce a new scheme which allows us to pay for transport costs via mobile technology.
These efforts will enable us reach many more women in need of our services.” Despite the enormous impact of fistula, most girls and women living with the condition are either unaware that surgery is available to repair fistula, or they cannot access or afford treatment once they learn it exists.
However towards the end of 2009, CCBRT began a pilot scheme using Vodacom’s M-PESA facility to transfer transport money via mobile phone to women in need of fistula surgery. Already eight women have come to CCBRT for operations through this scheme.
By offering free surgery and follow-ups, free transport and free lodging in Dar es Salaam for women with fistula, CCBRT hopes that many more women will come forward for the treatment.
Total Comments on the above stories (0)
ADVERTISEMENT
Contacts:
TSN Daily News building, Samora Avenue, Plot No. 7, P.O.Box 9033, Dar es Salaam, Tanzania.
