Obstetric Fistula is a condition not frequently heard of in industrialized countries, but here in Uganda it affects the lives of many women. Most often a result of prolonged and/or obstructed labor, fistulas develop when the pressure of the baby cuts off blood supply to the tissues of the vagina, bladder, and/or rectum while the woman struggles to give birth. The tissues die and a hole (a ‘fistula’) forms through which urine and/or feces can leak. It is a condition that is preventable through proper pre-natal care and doctor supervised childbirth, two things that women in poverty often make do without. Despite how common fistulas are here, many women go undiagnosed for years, shunned by their families and communities, and living under the assumption that they are cursed. Even if they manage to get diagnosed, surgical treatment is generally too expensive for most women from the villages.
As awareness of Obstetric Fistula has grown, efforts have been made to provide women with surgery free of charge. At Kamuli Mission Hospital, three fistula camps are held per year, where foreign doctors spend just over a week performing surgeries and doing check-ups. Due to the fact that so many women are unaware that their condition can be cured, Uganda Village Project dedicates substantial time and energy to discovering women suffering from obstetric fistula, and ensuring they get surgery. As a UVP intern this summer, I was extremely lucky to be able to accompany eleven fistula patients located by UVP to the fistula camp in Kamuli, and witness the beginning of their transformation.
While all of my time spent in Uganda this summer has been a tremendous learning experience, the 13 days I spent at the fistula camp will stand out in my memory as 13 of the most powerful days in my life. After my first two days of interviewing patients and hearing their stories, I had never felt more frustrated and saddened by the world we live in. However, after the subsequent days watching surgeries and tending to the recovering women, I am now full of hope and admiration for them, and in awe of the talented and compassionate doctors who come from so far away to help these women reclaim their lives.
All of the women had truly painful and inspiring stories, but a few were particularly moving in their illustration of the power of fistula surgery. Nabirye Efulansi was 19 years old when she first suffered from the condition, and it took 12 years thereafter before she was diagnosed. She is now 40 years old, and returning to the fistula camp for a third time, hoping to further alleviate her discomfort and improve her mobility. What makes her truly heroic is that, despite suffering from obstetric fistula, she manages to support herself and 9 other people. Through subsistence farming alone she manages to provide for 2 elderly people and 7 orphaned grandchildren, the eldest of which is only 13 years old. Her success would be remarkable for a healthy person, but for a woman with her condition, it is nearly unfathomable.
Atim Caroline is 19 years old, and has suffered from obstetric fistula for one year. She was attending boarding school when she got pregnant. Her baby died during labor, the father of her child left her – and she was left with fistulas. Although fluent in English, obstetric fistula forced Atim to drop out of school. She has been struggling to support herself through odd jobs and random acts of kindness from others. At such a young age, she has her whole life in front of her, and she confided that after surgery she hopes to go back to school to eventually become a doctor. One year younger than I, she withstood the 3 hour long surgery with the maturity of one resigned to her fate, hardly daring to believe it was actually happening. It is dangerous for fistula patients to invest energy in hope, as surgeries often need to be repeated multiple times. Yet, it is a truly beautiful thing to watch someone regain that hope. Checking up on her every day until I left, I began to see a delicate spark of optimism begin to develop, tentatively at first, and then with a growing sense of confidence. There is nothing greater for a woman who has lived with obstetric fistula, and I am so thankful that UVP helps to bring them that gift.
By Claire Lauer