Fistula Can Be Surgically Repaired

Now it feels like finally, after 12 years of waiting, I am getting the services I need.

—A 28-year-old woman from the Tigrinya tribe in Eritrea

Fistula cases require specialized surgery. Costs vary, but are usually well beyond the means of most women with fistula.

Fistula surgery is essentially the mending of a hole in the bladder or rectum. It can usually take place through the vagina without a major incision. Success rates can be as high as 90 per cent for experienced surgeons working in well-equipped facilities. But the operation is delicate, and specially trained surgeons and support staff are required. Two or more weeks of post-operative care is also essential.

Some women are so debilitated when they arrive for treatment that they need weeks or months of care before they are strong enough to undergo the operation. Sometimes women have also suffered nerve damage and need extensive physical therapy. Counselling to address emotional trauma and social support is often necessary for complete healing.

Many women with fistula also have suffered nerve damage to the legs and require extended physical therapy. In some cases, injury to the internal organs is so extensive that more than one surgery is required. Some women are so badly damaged that they cannot be cured, but need continual care. New surgical techniques are being pioneered to improve results and address more severe tissue damage.

Many of those who live with the condition do not know that treatment is available. Once they find out, many girls and women show remarkable determination in mobilizing scarce resources to get help. Sadly, this often means borrowing or selling land or precious assets.

Ina zauna a gida na ji labari mai kyau.
I sat confined at home until I heard the good news.

Na ce: Wayyo, iya! Sai ki ba ni ku' di.
I said, "My word, mother! Give me the money!"

—From a Hausa anthem used for building group identity among fistula patients

What the Campaign is doing

The Campaign supports all aspects of expanding treatment, from training doctors and nurses to equipping and upgrading fistula centres or wards.

The Campaign is also mobilizing funding to provide free or subsidized fistula repairs. And it has encouraged more networking among providers, which has led to the sharing of new treatment techniques and protocols.