A 46-year old mother of three, Mariam Tuffuor, after a prolonged labour for the fourth child, developed obstetric fistula, rendering her incontinent and ashamed.
Sharing her ordeal in a trembling voice with the Ghana News Agency in Accra, she said: ‘My husband abandoned me, saw me as filthy, smelly, and useless and society mocked me, pointing hands at me whenever they saw me.
Ordeal
‘So I was forced to live in solitude, hiding my condition. As if the pain, I went through to arrive in this condition wasn’t enough, my children became school dropouts because I couldn’t work to support them again and their dad left us to be spared of my unappealing new condition,’ she said.
Mrs Tuffuor lamented: ‘When you get fistula, you can’t go anywhere and you won’t even feel like going anywhere because people will be running away from you when they smell any unpleasant scent on you. So the effect is still here with me, I struggle to go out even now that I am cured’.
What is obstetric fistula?
An Obstetric Fistula acco
rding to the World Health Organization is a hole in the birth canal caused by obstructed labour, surgical complications, cancer, or radiation therapy.
It leaves women and girls leaking urine, faeces or both and often leads to chronic medical problems, depression, social isolation and deepening poverty, according to the United Nations Population Fund (UNFPA).
Scenarios
The UNFPA estimates that two million women live with Obstetric Fistula globally and 30 to 50 per cent of fistula cases are attributed to gender-based violence, while the WHO states that 50 to 80 per cent of women with fistula experience social isolation.
The 46-year old mother explaining the cause of her condition said: ‘I went to give birth at the Trauma and Specialist Hospital, Winneba and stayed there for five months with no baby. After they massaged my uterus to expel the blood clots, I went off and didn’t see anything again. After some hours, I felt people were hitting me and I came back to life.
‘I went through complications and so th
ey removed my womb. I run short of blood and had to receive nine pints of blood just at the theatre. I just thank God that I am still alive because this experience could have been fatal for someone else.’
Mrs Tuffuor afterwards, started leaking urine and faeces uncontrollably and had to resort to using adult diapers, a situation that made her husband take to his heels, without thinking twice even about the welfare of his children.
The situation according to the survivor, led to emotional trauma within her children, altered parental relations and affected her children’s sense of security, altered the care given to the children due to physical limitations, adding that reduced income or increased medical expenses had an impact on the children’s wellbeing.
The children also suffered malnutrition and their education was compromised as their mother’s condition’s medical expenses diverted family resources.
Mrs Tuffuor said the children, like her, also suffered social isolation and the oldest among them had to ta
ke on caregiving roles including selling in traffic for money, a situation that endangered their lives and affected their childhood and education.
A report by the UNFPA Ghana, on May 2022 on the topic: ‘Maternal Mortality: The End to Obstetric Fistula’, said Obstetric fistula is an illness that not only affects the mother, but also the child, who witnesses the mother’s agony, humiliation, and stigmatization.
The 46-year old survivor said a lot of women had gotten the condition but were sceptical to make it visible or speak to others about it for fear of being stigmatised and disgraced.
Dr Abraham Frimpong Baidoo, Programme Officer, Family Health Division, Ghana Health Service, at the opening of the 2024 ‘Commemoration of the International Day to End Obstetric Fistula ‘ in Accra, said the condition had physical, social and psychological implications for the affected women and their children.
Dr Patrick Kuma Aboagye, the Director-General, Ghana Health service, said people with Obstetric Fistula were often s
tigmatised due to lack of understanding about the problem.
Mrs Tuffuor appealed that the public are sensitised on it to know its causes, and how it could affect anyone, to prevent them from running away and neglecting victims in such conditions, adding: ‘Initially when I had it, I personally thought it was a spiritual attack but I realised it was a medical issue after seeking medical attention.’
‘Our husbands shouldn’t neglect us because it is nobody’s wish to get into such a situation. Some women are fortunate to get men who stay with them during such situations but some of us were not fortunate and our husbands left us in this mess.
‘When we were getting married, we pledged to be with each other for better for worse. We also know they married us because of love and so it would be nice if they stick to us while we go through such double pain,’ she appealed.
The case of Ms Anita Acheampong, a 36-year old caterer, was not very different, although she had a fistula through a surgical procedure.
In sharing
her experience, she said: ‘I delivered my fourth child and had complications and so was taken to the theatre for the first time but the complication wasn’t corrected. They took me back to perform a procedure called Hysterectomy on me (surgery to remove the uterus).
‘So I spent one more week at the hospital thinking I was free. I got home and realised I was leaking. Initially, it didn’t have any odour and Doctors assured me it would stop, but a week afterwards, I realised it smelt like urine.
‘Nobody knew I had fistula with the exception of my mother and husband. My husband ran away from the children and I because he could withstand it and he never cared what I was going to do about it. I don’t even want to remember what he did to me. My own mother also used it against me in front of family members, letting everyone know I was surviving on diapers,’ she said in tears.
According to ‘EngenderHealth’, 75 per cent of women with fistula have had multiple pregnancies likely to increase complications during delive
ry, increasing their risk of developing fistula.
The WHO’s Family Planning/Contraception Fact Sheets and UNFPA’s family planning strategy suggest the promotion of family planning to save lives, spacing births to reduce prolonged labour and fistula risks, and using contraceptives to empower women and prevent complications.
Recommendations
Dr Lahdan Aranki, an Obstetrician-Gynaecologist, University of Utah Medical Centre, advised husbands to support their wives with the condition, as it affects not just the woman but the entire family.
She asked husbands to acknowledge their partners’ suffering and reassure them of their love, while accompanying them to medical appointments and helping them with house chores.
Husbands are also to provide their surviving wives with economic empowerment to reduce financial stress from the complication.
They are also to break stigma and support their wives to partake in community activities.
Husbands can be powerful advocates of health of their wives and wellbeing, and shou
ld not hesitate to when they find their wives in such poor conditions, Ms Minky Worden, Director of Global Initiatives, Human Rights Watch advises.
Source: Ghana News Agency