One women’s health issue of critical concern in Ethiopia is that of obstetric fistula. Obstetric fistula is a condition that occurs during childbirth when a rupture or hole in the birth canal obstructs delivery of the infant and forces a pregnant mother to endure hours or days of painful labor. In many cases, the baby is delivered stillborn and the mothers who are fortunate enough to survive the traumatic labor are often left incontinent as they can no longer control the urine and bowels that constantly leak through the ruptured birth canal. Fistula often occurs as the result of pregnancy in highly malnourished women and girls that have been married at extremely young ages. While fistula is relatively easy and inexpensive to prevent and treat, poverty, specific cultural practices and lack of access to medical care make this condition one of the world’s most detrimental threats to maternal and infant health.
The Campaign to End Fistula estimates that 2 million women across the globe are suffering with this condition today and an estimated 100,000 new cases are reported each year.[1] While the painful, prolonged labor and the likely death of a newborn associated with fistula are traumatic enough, most women who suffer this fate face a new nightmare even after the labor has ended. The embarrassment, social stigma and physical discomfort resulting from their total incontinence leaves most fistula victims rejected from their villages and left to fend for themselves. In many traditional communities, the death of a newborn and the fistula in general are viewed as bad fortune and most likely the fault of the fistula victim. This pervasive lack of awareness surrounding fistula, as well as inadequate medical strategies for its prevention and treatment, result in the unnecessary loss of newborn children and the emotional and physical suffering of millions of women around the world.
Artwork painted by patients at the Addis Ababa Fistula Clinic. Top Left: a victim of fistula is portrayed with a cobweb over her womb, Bottom Left: a village scene that portrays separate huts in the distance to keep fistula victims away from the community, Right: a fistula patient forced to leave her community is seated on a bench, crying, with her bags packed and leaked urine on the ground.
In 2007, WCI worked with the National Women’s Caucus of Ethiopia to combat ignorance and social stigma towards fistula. The women Members of Parliament (MPs) chose fistula as part of its caucus platform and attended a WCI workshop to become educated on the topic. The workshop featured local experts from IntraHealth International and the Hamlin Fistula Hospital in Addis Ababa. The women MPs also visited the Fistula Hospital and spoke with patients to learn firsthand about the complexities of the condition and its aftermath.
Having acquired this knowledge, the women MPs organized a session to train all MPs, male and female, about obstetric fistula and what can be done to address the issue on the regional and policy levels. WCI also implemented its gender analysis curriculum with the MPs; calling attention to the fact that fistula is a prime example of a lack of adequate gender-specific considerations in local and national policy and legislation.
These educational sessions were extremely successful, and all MPs reported that they acquired far more Knowledge about the medical and social causes of this taboo condition. Post-training, men and women MPs in Ethiopia formed alliances and drafted region-specific action plans to begin combating fistula in the future.
WCI Ethiopia Field Staff: Program Director Rakeb Abate (left), Program Officer Emebet Bekele Ashagre (right)
WCI Women's Issues Workshop with Parliamentary Committee Members