It’s extremely unfair: obstetric fistulas are as common in certain African and Asian countries as they are rare in developed countries. According to the WHO, they cause 8% of deaths during childbirth throughout the world, in other words approximately 40,000 avoidable deaths each year.
These fistulas occur during abnormally prolonged labour when the tissues of the vagina, bladder and/or rectum are torn, leading to urinary and faecal incontinence. These serious tears often occur when the patient has been unable to have a caesarean.
It is in fact not uncommon for labour to last for two, three or even four days before ending in this way. If the patient does not die, she suffers for a long time, for too many women are not treated. Most of these victims have given birth without the assistance of any qualified health workers. Because of their condition, they are then often abandoned by their spouses and excluded from the family or the community. Seven out of ten women suffering from fistula are in such a situation in India and Pakistan.
Mothers at the age of 10 or 11...
According to the WHO, a large number of these cases could be avoided “by eliminating the traditional dangerous practices and by ensuring access to obstetrical treatment in good time”. And also by delaying the age of the first pregnancy. In some countries, marriages are arranged for young girls - who are then supposed to fulfil their conjugal duties - from the age of 10 or 11. At this age, the pelvis is not sufficiently developed to permit the passage of a baby.
In some countries such as Sudan and Bangladesh, “Fistula Centres” are gradually being established, in particular under the aegis of the United Nations Population Fund (UNFPA). At the Dhaka Centre (Bangladesh) built in 2003, over 500 women have already benefited from surgery, and been given back their dignity.