The Newest Epidemic in Africa: Obstetric Fistula


Obstetric fistula, the most devastating and serious of all childbirth injuries, should be granted a crisis status and global leaders must address the problem that currently affects 3.5 million women globally.

Obstetric fistula was conquered by the west in the early 1900s but it is sad that most mothers in poor countries are still affected by the condition because they give birth without any medical help. So many of these mothers are young girls between 13 and 20 years old.

In an exclusive interview with this author, fistula expert and Africare Zambia Program Manager (for maternal and child health) Meredith Budge explained how fistula patients have to endure days of agonizing, obstructed labour that their bodies end up literally broken by childbirth.

“During labour contractions, the baby’s head is constantly pushing against the mother’s pelvis bone – causing tissue to die due to lack of blood flow to this area,” Budge says. “All of that pushing creates a hole, or in medical term a 'fistula' between the birth passage and an internal organ such as the bladder or rectum. A woman cannot hold urine, and sometimes bowel content as well. The baby is unlikely to survive. Only seven percent of women with fistula end up with a live baby.”

Budge further explains that if she survives, a woman with fistula is likely to be rejected by her husband because of her inability to bear more children and her foul smell.

“These women suffer profound psychological trauma resulting from their utter loss of status and dignity, in addition to suffering constantly from their physical internal injury,” she adds.

This number of the affected keeps growing bigger. According to the Worldwide Fistula Fund (WFF), each year approximately 100,000 women develop fistula or 273 each day.

The number is staggering. Right now, millions of women are suffering from this heartbreaking, treatable childbirth injury because they are too poor to afford surgery that costs about $450.

Fistula can be cured and conquered if global leaders show political will and fund the work of those who are at least trying to do something about the problem.

The WFF reports that the international capacity to treat fistula patients has been estimated at 6,500 each year or 18 patients each day. There is clearly an overwhelming need for treating far more women.

Obstetric fistula can be cured. The world should not ignore the troubled women who are affected by fistula, most of them are suffering in silence.