This article is part of a series by RH Reality Check in collaboration with EngenderHealth, Guttmacher Institute, the International Women's Health Coalition, the Fistula Foundation, the United Nations Population Fund (UNFPA), and the Campaign to End Fistula. All articles in this series can be found at this link.
The series is being published in conjunction with renewed efforts by advocates and the public health community to increase U.S. international support for efforts to address obstetric fistula, a wholly preventable but debilitating and sometimes deadly condition caused most immediately by prolonged labor and too early or too frequent childbearing, but generally rooted in lack of access to health care and discrimination against women. Fistula affects the lives of individual women, their children and families, and also grossly undermines women's economic productivity and participation in society. The global public health community has called for comprehensive strategies both to prevent new cases and treat existing cases of fistula. Congresswoman Carolyn Maloney (D-NY) will soon introduce legislation intended to support a comprehensive U.S. approach to fistula as part of a broader commitment to reducing maternal mortality and morbidity worldwide.
My name is Awatif Altayib Mohamed Hussain. I am from Sudan, from the state of West Darfur, Furburanga. I'm very happy to be here today to speak about the suffering I have been through when I had fistula some time ago.
I was in the 5th grade when my parents took me out of school. I was married when I was 16 years old, and I immediately became pregnant. When I was delivering, I was in labour for 2 days. I had an obstructed labor and there was no doctor in the village. They transferred me to the nearest hospital; a distance of nine hours by car. When I arrived in the hospital the baby was already dead, and I developed a fistula (VVF). I did not know what fistula was. I stayed in the hospital for 2 months.
The doctor told my family what it was and I was referred to a specialist in Nyala for a repair operation. The first attempt at repairing the fistula did not succeed, and I waited 6 months to do a second repair, which also failed. When my husband took me to do a third operation, we were stopped in the road by bandits who took everything we had. So there was no money left to do the third operation. We returned to the village to save money; but it was not easy to go back. Back in the village I became pregnant, but my husband abandoned me because of the fistula.
While thinking about how to get more money, now that my husband had abandoned me, my family tried to make money for me. I approached Save the Children for support to assist me in studying to become a midwife. In the town of Genina I was trained for 1.5 years as a community midwife. At that time I heard about fistula repair operations taking place in a Campaign in Zalingei, so I gathered 5 friends also suffering from fistula and took them to the hospital. All of our operations, thank God, succeeded.
Following my repair, I started to work at the hospital. I wanted to help the women to avoid bleeding .... and also I moved to work in the camps of the Internally Displaced Persons (IDPs). I worked in a camp called Kerinda which has 4,000 IDPs. We are lucky because some of the organizations have organized hospitals in the camps, and I was lucky to work in one of these settings.
And then I talked to UNFPA.... to talk to my sisters to be helped as I was helped. In 2009 there was a campaign in Genina, close to me. There were some Arab doctors who came, so I went to community leaders and convinced them to recruit women with fistula to seek care at the campaign. I identified 3 women who were treated during the campaign. When I took the patients to the hospital, I was helping the surgeons in the preparation of the patients before surgery in counseling and pre-operative procedures (e.g. enema, catheter insertion). Thank God now we have time and I work to sit with Trained Birth Attendants and talk to them, we make sure that every time they do a delivery we sit with them and work on disinfection and every time there is an obstructed labour we take the woman to the hospital. We make sure that the woman does not have complications after delivery. Anemia and other post-pregnancy issues have been minimized. Thank you and thank God for everything.