Agnes was 16 years old when she became pregnant with her first child. Her labor lasted three days. When it was over her child was dead and she was left with holes in her vaginal wall where the baby’s head had pressed so long against the tissue it had cut off the oxygen supply. The holes articulated with both her bladder and rectum and she was leaking urine and feces constantly. She was also temporarily paralyzed below the waist, the prolonged pressure also caused swelling of the sciatic nerve.
When nuns from the Medical Missions of Mary hospital found her she was curled up in a ball in the corner of a hut used for goats, abandoned by her husband and family. In an area where women walk miles every day to carry back jerry cans of water balanced on their heads, she couldn’t keep herself or her clothes clean and the stench of urine and feces was overwhelming. Her family could not tolerate her condition and her husband had no use for a wife who could not bear children. And many in the community were convinced she harbored evil, why else would she not be able to birth her baby like any other woman?
I met Agnes in 2007 in a hospital in Uganda, waiting to receive surgery to repair her fistulas. Her story is all too common in developing countries where it is estimated that over two million women and girls suffer with obstetric fistula. Obstetric fistula is not an unfortunate complication of pregnancy – it is a human rights issue. It is a completely preventable condition caused by social and economic inequities. The worst sequelae of obstetric fistula are not medical issues, they are social ones brought on by the stigma associated with the condition. Again – completely preventable.
When I met Agnes the staff at the hospital were helping her learn to walk again and she proudly demonstrated her progress to us. Her smile of triumph when she tossed her cane aside was perhaps the brightest I’ve ever seen. I knew then I wanted to return and a year later I was back at the hospital. In the back where women waited for surgery in housing built for them I noticed a young woman watching me. At first I didn’t recognize her, her cheeks had filled out and she walked with barely a limp. But then she smiled and I knew immediately it was Agnes. She was scheduled for surgery the next week to reverse the colostomy they had performed the previous year to allow the rectal fistula to heal. The bladder repair they had done then was partially successful, she still leaked small amounts of urine, but she was happy with the results and able to live normally.
Agnes is one of the lucky ones. According to the UN, over the last twelve years only 47,000 women have had surgery to repair their fistula, less than 4,000 a year. With two million women living with obstetric fistula now and 75,000 to 100,000 new cases every year, most women with obstetric fistula will live their lives with the condition and many will do so isolated, impoverished, and stigmatized.
Today is International Day to End Fistula. Please check out the campaigns by UNFPA and EngenderHealth and do what you can to help. No woman should have to endure such great suffering trying to bring a child into this world.