Let us hope for a Fistula free Society

Rifat Zafreen :
Saleha, 45, suffering from Fistula is rejected and shown sympathy while her husband and only young son has been asked her to stay at the cowshed! Like Saleha all over the country women suffered from Fistula have been passing a severe inhuman life. Some of them are left behind by their husband and family members, while others are dejected, dishonored, humiliated and tortured.
Now question comes- what Fistula is; Fistula, especially female genital Fistula is having one or more hole/s that connects vagina with urinary system or rectum or both causing uncontrolled passage of urine or feces or both through the vagina. Symptoms of Fistula is always leaking urine, stool or both which mainly starts after a delivery or an operation. Obstructed labour, instrumental delivery, operation in the lower abdomen like hysterectomy are the direct causes of Fistula while poverty and early marriage and early pregnancy are the indirect causes of Fistula.
In many of the developing countries of Africa and South Asia including Bangladesh, huge number of women suffer from the obstreric Fistula resulting from complicated and delayed home deliveries. In such depressing condition Fistula related physical problems and above all, negligence and nonchalance by the family member and society make the life of Fistula victims unbearable.
According to a survey carried on by EngenderHealth Bangladesh in cooperation with UNFPA, conducted in 2003, 5 women among every 3000 ever married women of Bangladesh suffer from obstetric Fistula. In our country women try to hide their fistula related problems that make their situation more grave and pathetic.
Fistula is a big problem which could be considered as a global burden even as 2 million women are living with Fistula worldwide while 50-100 thousand new cases are getting added every year. In Bangladesh 70 thousand women are living with Fistula while 2000 new cases are getting added every year . This scenario focuses 1.7 case in every 1000 ever married women which shows a very grim picture in the country.
But this Fistula is preventable. Prevention of early marriage and early pregnancy and so delivery at early age is very much needed to prevent Fistula first of all. Prevention of obstructed labour where it is needed to refer before it is too late can also prevent Fistula. Delivery by skilled person is very important. Quality maternity care highly matters in preventing fistula.
On confirmation of Fistula diagnosis quality counseling like information ‘possibility of treatment, duration of treatment, cost of care, help availability and where and when to go’ is very much needed to cure Fistula. Repair surgery can cure Fistula and let the victimized get back to normal life. Fistula surgery is a high skilled low tech service. It is safe as other common gynecological surgery. Even the malnourished many cases had even successful repair surgery at their eighties.
With the financial support from USAID, Endanger Health began awareness raising for prevention of obstetric Fistula and treatment and rehabilitation of the Fistula patients in July 2005 at 3 private hospitals namely Ad-Din Hospital, Mogbazar, Dhaka and Jessore, Kumidini Hospital, Mirzapur, Tangail and LAMB Hospital, Parbatipur, Dinajpur. Their service, along with Govermnt’s support have increased highly in serving the Fistula affected women. Fistula treatment is completely free countrywide.
In order to have a Fistula free society there needs communication in dessiminating information and needs awareness building initiatives. Our national, local, digital, mobile and traditional media can help to create and build awareness among the people about Fistula. There needs to make a difference and our media, opinion leaders and above all our all out support can do that.
There needs sacrifice in the light of our mentality to support the victimized. A careful communication and a complete one can end Fistula and can present us a Fistula free society. Let us hope to end Fistula within a generation a Fistula free South Asia and so Bangladesh by 2030. Our little support of communication and awareness building initiatives can give back smile to the Fistula affected women and can let them dream and touch the light of life again.
 (PID- Project Feature)