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The first time I heard about obstetric fistula, I was shelling green beans outside of a traditional grass-thatched home in a rural Ethiopian village. I was perched outside of the house with a few colleagues waiting for our interviewee to return from working in the nearby fields. To pass the time, we offered to help her neighbors with preparations for dinner. We were in the area to interview women who had undergone female genital cutting. What I didn’t anticipate learning about that day, however, was the devastating and very real effects of obstetric fistula, a condition I had never heard of.

After waiting close to an hour for our interviewee, Samrawit*, to join us, I asked my research partner if we had arrived at the wrong time. He explained that we hadn’t, but that our interviewee was late because she was walking home from the fields. This was normally a short journey, but because of a health condition, she had to walk very slowly. When I probed further, he explained that Samrawit had obstetric fistula.

The simplest way to describe fistula is as a hole. A fistula is a hole between the birth canal and the bladder or rectum, or both. There are two types of fistula; obstetric fistula, caused by prolonged, obstructed labor without treatment and traumatic fistula, caused by sexual violence. Once created, these holes result in permanent incontinence of urine and/or feces. If untreated, this can also lead to chronic medical problems. Women who suffer from fistula experience a host of traumatic long-term, life altering effects in addition to the physical symptoms, including; shame, social isolation and ostracization, depression and deepening poverty.

Although global attention to the issue is lacking, there are some organizations doing fantastic work in the areas of community sensitization and access to healthcare and rehabilitation services.

In honor of International Day to End Fistula, Saturday, May 23, Vital Voices will feature forthcoming stories of two VVLead fellows, Alice Emasu and Lucy Mwangi, working on obstetric fistula in their communities in Uganda and Kenya respectively. 

Unfortunately, Samrawit’s story is not unique. It is estimated that more than 2 million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa alone, and there are at least 50,000 – 100,000 new cases each year. Fistula is preventable and can largely be avoided by:

–        Delaying the age of first pregnancy;

–        Ensuring timely access to obstetric care; and

–        Educating communities about the condition in order to change social and cultural attitudes and behaviors associated with fistula.

Learn more: 10 Facts About Obstetric Fistula 

*Name changed to protect the individual’s privacy.