By Beverly Bizeki
For 13 years, Tarisai Madondo (not real name) struggled silently with a condition so stigmatized that she could not discuss openly with anyone and felt she was going through it all alone. Obstetric Fistula left her devastated, ostracizing her from normal life, without a job to fend for herself and her family.
Madondo said she could not do basic things like travelling for long distances or going to work because she felt embarrassed by the incontinence resulting from the birth injury.
“13 years ago, I was injured during childbirth, and to make matters worse, the baby died during delivery. To add salt to injury, my husband left, which relegated me to a life of suffering alone since I could not afford treatment.
“Relatives eventually weaned me off due to the financial burden that came with this condition. I cannot work due to incontinence because I have to make frequent visits to the bathroom to change sanitary wear. Travelling takes a toll on me due to the shame of soiling my seat whenever I do, and I have always suffered in silence due to the stigma,” said Madondo.
The desire to get treatment saw Madondo crossing borders into neighbouring South Africa, which was all in vain as she could not be treated for free because of her status as a foreigner. A whopping R140 000 was then required for surgery, so she had no choice but to return home without any relief.
“The corrective surgery is free for South African citizens but for foreigners they said it was a drain on their doctors. After hearing about the programme here a donation was made to fund my trip to Masvingo to get treatment. I was shocked when I got to the ward and found it full with people seeking treatment for the same condition when I thought I was the only one with this condition,” said Madondo.
Madondo’s experience reflects a crisis affecting thousands of Zimbabwean women facing the brunt of a failing health system resulting in injuries caused by prolonged, obstructed labour without timely care.
Speaking at the International Day to End Fistula commemorations at Mashoko Mission Hospital, in Bikita recently, Ministry of Health and Child Care Deputy Minister Sleiman Kwidini acknowledged the scope of the problem and the need for nationwide intervention with six hospitals capacitated to conduct surgical repairs.
“MoHCC has so far capacitated six hospitals to conduct surgical repairs for obstetric fistula, these are Mashoko Christian, Chinhoyi Provincial, Mutambara Mission, Chidamoyo Mission, and United Bulawayo Hospitals.
“From 2015, over 1 800 women have benefitted from surgical repair of fistula. No woman should suffer in silence. It is our duty to stand together and ensure that our healthcare systems are equipped, our communities are educated and our women feel valued and supported,” said Kwidini.
United Nations Population Fund (UNFPA), a key partner in the campaign’s Country Representative represented by Peter Mukasa said obstetric fistula was more than a health crisis and reflected broader structural inequalities.
“The presence of obstetric fistula reflects broader health inequalities and health care systems constraints as well as wider challenges facing women and girls such as poverty, gender inequality, lack of schooling, child marriage and teenage pregnancies all of which impede the wellbeing of women and girls.
“Ending fistula cannot be viewed in isolation. It demands a comprehensive approach investing in resilient health systems to strengthen maternal health services and safe and dignified childbirth for every woman, ensuring adequate funding for prevention and treatment as well as socioeconomic reintegration of survivors.
“For UNFPA, ending fistula remains one of our highest priorities and we will continue to accelerate efforts, both in our own work and within the United Nations system. I would like to reaffirm UNFPA’s commitment to working with all partners towards zero maternal deaths in Zimbabwe,” said Mukasa.
Fistula Foundation Programs Director representing Atermidis a key partner, Bwalya Chomba stressed the organisation’s mission to stay focused on what matters most, surgical repairs.
“With each surgery we provide we know that it can help change one woman’s world forever and we know that the ripple effect of a restored health on both her family and community is profound. Nothing has been more important to our success than deciding to focus on one critical and measurable outcome which is repair surgeries for women injured in childbirth. We resist the urge to be all things to all people supporting only those activities that directly enable the treatment of women with fistula. Our bottom line is always the number of women we are able to help,” said Chomba.
Since 2009 the Fistula Foundation has supported fistula treatment for over 100 000 surgeries at more than 150 sites in 35 countries in Sub Saharan Africa and South East Asia of which Zimbabwe is one of them. Zimbabwe joined this network in 2015 when MoHCC partnered with UNFPA, Women and Health Alliance International (WAHA) now Artemedis to launch the country’s first fistula camp at Chinhoyi.
Since then the programme has grown with camps now hosted at multiple hospitals with over 800 women having undergone corrective surgeries.
According to the World Health organisation, there are between 50 000 and 100 000 women who develop obstetric fistula each year worldwide. The injury occurs when complications during labour and delivery leading to a hole forming between the birth canal and the bladder or rectum.
The injury often results in uncontrollable leakage of urine or faeces causing physical, emotional and psychological suffering.
