- UNFPA Says there is need for post-surgery psycho-social support for survivors
MEMORY (50) (real name protected) from Bikita, Masvingo experienced Obstetric Fistula for the first time on October, 27, 1995 when she had her second child. At first, she didn’t even know what was happening to her, she thought it was just a minor tearing which would heal after a few days. Obstetric fistula is described as the “most devastating birth injury” by the World Health Organization (WHO), that results in continuous and uncontrollable leaking of urine or faeces, resulting in social stigmatization and lifelong emotional scars.
By Michael Gwarisa
Even though she was sewn up after the birth experience, she started experiencing challenges controlling her stool from coming out even in public spaces. Because it was not a major tearing, she went on to have her third, fourth, fifth and sixth children and all this while she was not being fixed or sewn up.
Trouble came after the birth of her sixth child on August, 3 2011, when the tearing worsened to the extent of linking her rectum and birth canal. She couldn’t control her bowel movement and neither could she stop urine from coming out owing to the injuries. She approached her husband who turned down her request to get repaired . She became an outcast as no one wanted to associate with her due to her condition.
People would laugh at me and tell me that I smell. Since I couldn’t control my bowel movements, it made it difficult for me to attend meetings or travel long distances. I only attended events which had toilets close by. I couldn’t even participate in other community initiatives.
“When preparing for church, I would make sure the previous night I just eat a small portion of food so as not to feel the urge to use the rest room frequently the following day. Since 2011 up to today, I was now making sure that whenever I wanted to travel, I would limit food Intake,” said Memory.
Memory recently visited Harare following the intervention by Amnesty International Zimbabwe who are facilitating surgery for her and other women who have the same condition. Memory’s story is not an isolated one as majority of women who develop post birth injuries and Obstetric Fistula are forced into a shell due to high-level of stigma and discrimination at the hands of society.
Even though Tariro (42) (real name protected) from Zaka in Masvingo has healed following her successful repair, she recalls the amount of stigma she faced following her Obstetric Fistula diagnosis which led to her using a urine bag for at least two years.
“I face developed Obstetric Fistula in 2017 when I was operated on after my unborn child had died before delivery at Mashoko Hospital. They then transferred me to Masvingo after realizing that I had developed an injury in the birth canal. In Masvingo they told me they had no capacity to deal with my condition. They told me to use a urine bag, which I did.
“When I returned home, people started ostracizing me saying I stink. It was traumatic. I eventually stopped going to church because people would say I make them uncomfortable. I then met a certain gentleman who told me that I could get assistance. On December, 16 2019, I had my surgery and i got healed. I no longer carry a urine bag now,” said Tariro.
According to a Report titled, “I never thought I could get healed from this” that was recently released by Amnesty International, women and girls in Zimbabwe are at a greater risk of life changing childbirth-related injuries, including obstetric fistula, as many shun public healthcare facilities in favor of home-based deliveries due to inadequate health infrastructure, cultural practices and high hospital costs.
The reports also gathered that women and girls face high levels of stigma and discrimination due the Obstetric Fistula condition and in turn and this jeopardizes their economic prospects.
Mandipa Machacha, the Amnesty International regional Researcher Economic, Social and Cultural Rights for Amnesty International Southern Africa Regional Office said Obstetric Fistula related stigma was real and there was need to bridge the information gaps rampart in society.
“There is widespread lack of information about the causes and treatment of Obstetric Fistula in Zimbabwe and this has been found to increase levels of discrimination against women with Obstetric Fistula In Communities. We reported incidences where women suffered discrimination at the hands of family members who wouldn’t even allow them to cook saying they were dirty and girls of a young age being moved from house to house just because family members couldn’t stand the condition.
“We have also learnt of women who were left by their husbands and women who had relatives of their husbands encouraging family members to leave them for a better woman or second wives. Additionally, the stigma results in women not being able to work and women who have Obstetric Fistula end up facing economic challenges. There was a case of women who used to work as a housekeeper earning a decent salary of US$200.00 but her employer fired her the moment she discovered that the women had Obstetric Fistula,” said Machacha.
Meanwhile, the Programs Specialist for Reproductive Health in the United National Population Fund (UNFPA), Dr Edwin Mpeta said there was need for psychosocial support for survivors of Obstetric Fistula post-surgery.
“For the global campaign against Obstetric Fistula, the key main pillars are firstly prevention. This is very important, we need to close the tap, we need to prevent, yes we may not be able to close the tap totally so those women that are affected really need to be treated and repaired so treatment and repair is the second pillar on the global campaign.
“Then we have the third pillar which is support after surgery. You notice that some of the survivors will be victimized and maybe isolated and some may need to be reintegrated back into the society so that is very important. The fourth pillar is around advocacy including resource mobilization this is also key in terms of support and repair and somebody has to take care of the bill,” said Dr Mpeta.
