New Found Hope: Treating Obstetric Fistula
When Africare District Facilitator, Rebecca Lusumpa, drives into a project community in her Africare vehicle, people come running up to the car. It is hand shaking and hugs all around, as villagers congratulate her for the support Africare has given to women in their community who have had their dignity restored.
With funding from New Zealand AID and through a partnership with Mercy Flyers (funded by CORDAID), the Zambian Ministry of Health and UNFPA, Africare is supporting women to receive life changing surgery to repair their obstetric fistula. Virtually unknown in the developed world, it is all too common in remote areas of Zambia. Obstetric fistula is caused by prolonged, obstructed labor which damages the bladder and causes a tear which leaks urine, uncontrollably, through the birth passage.
Rebecca is one of four Africare District Facilitators based in remote areas around Zambia identified by the Ministry of Health as areas with high rates of Maternal and Child Mortality. The Integrated Maternal and Child Health program promotes safe motherhood, assists communities to overcome obstacles to health services, develops nutrition programs and livelihood activities, promotes family planning and assists communities to build waiting shelters at health facilities to accommodate women before they go into labour.
Thirty-six year old, Lontia, from a remote village in Eastern Zambia, says: "I was a laughing stock in my village. Wherever I went people did not stay with me for a long time due to urine leakage. I could not even sleep at funeral houses nor participate in church activities or even go to church. I was not myself, I was downcast, lonely but in the midst of people. When I heard about Africare’s support to go to hospital for surgery, I made up my mind to get there at all costs. But when I first went, I was sent home because I was pregnant. This time, with my small baby, I still went ahead and I was repaired and now I am ALL DRY."
Speaking on behalf of her fellow repaired women, Lontia said, "I tell you, we used to sleep in dambos! (swamp) Wet bedding, no matter what you did, it was as if you slept with a baby who wets the bed. Now that time is like a dream!" Checking her Chitenge (wrap) and dress, "I am dry, I can even put on one skirt and look presentable." (She used to put on 2 or more skirts to delay wetness).
"Luckily enough my husband is still with me and so supportive. When I get back home, I will give the baby to my husband, then go to the people and villages where they were laughing at me, and those with fistula who refused to go for repairs, and show them the changed person I am now. I will also display my kit and tell everyone how I and others were well treated and taken care of, I have even gained weight due to the feeding by Africare and the Hospital! "Nilutowa lomba!" (I am now shining). Thank you Africare, Thank you Mercy Flyer’s doctors, Thank you Hospital staff! Please do not go away with this program, there are many in the communities who need your help." At this stage Lontia started singing and dancing.
Africare’s Safe Motherhood Action Group (SMAG) volunteers are recruited and trained in all aspects of Reproductive Health. As part of their activities, they raise awareness about the problems of obstetric fistula which is common in remote areas, where women lack access to midwifery services. The SMAGs find and refer the women, who are assessed by a local doctor. Africare provides transport, a case with new clothing and toiletries, and food supplements for travel and hospital stay. Eighty-seven women from Lundazi were assisted in June, 2010 with over 140 women assisted since September 2009.
Africare is also working with Chiefs, Headmen and local leaders to change cultural practices which increase the risk of obstetric fistula and maternal deaths. Home births, early marriage and poor nutrition are contributing factors as young girls marry and fall pregnant before their bodies are fully developed. Giving birth is always risky business, with 15% of all births experiencing some form of complication. Once informed of the risk, some Chiefs are banning home births and early marriages in their kingdoms. A skilled birth attendant at a health centre will refer at-risk women for caesarian section, eliminating the risk of developing an obstetric fistula.