Obstetric fistula is the most devastating and serious of all childbirth injuries. It happens because most mothers in poor countries give birth without any medical help. So many are young girls. Complications from pregnancy and childbirth are among the leading causes of death and disability for women of reproductive age in these places.
After enduring days of agonizing, obstructed labour a woman's body is literally broken by childbirth. During labour contractions, the baby's head is constantly pushing against the mother’s pelvic bone — causing tissue to die due to lack of blood flow to this area. All of that pushing creates a hole, or in medical terms a "fistula", between the birth passage and an internal organ such as the bladder or rectum. A woman cannot hold her urine, and sometimes bowel content as well.
A woman with fistula is usually rejected by her husband because of her inability to bear more children and her foul smell. She is shunned by her community and forced to live an isolated existence. These women suffer profound psychological trauma resulting from their utter loss of status and dignity, in addition to suffering constantly from their physical internal injury.
Lack of skilled care during pregnancy, delivery and post-natal period, lack of awareness regarding the danger signs of pregnancy and childbirth are the contributing factors of fistula.
There is huge number of fistula patients in Bangladesh. Experts estimate this number to be around 150,000 and it is increasing each year by around 3,000 new cases. Along with the government facilities, some NGOs are running clinics to treat fistula patients. Yet, the treatment facilities are inadequate to help heal all the women.
While mostly the treatment facilities are located in the division and district level, a hospital situated in Ramu of Cox’s Bazar district is providing fistula operations to the women coming from remote areas and even from neighbouring countries. ‘Hope Hospital (Cox's Bazar Hospital for Women and Children)’ is established by Hope Foundation and supported by The Fistula Foundation.
It is really amazing to see the dedicated volunteer physicians and surgeons from abroad work in the hospital and get hands-on training. Dr Iftikher Mahmood, President of Hope Foundation mobilises the volunteer physicians for the poor patients.
As training is a vital component treating fistula cases, The Fistula Foundation sends trainer surgeon to increase the capacity of the centres they support globally.
Country Representative of Engender-Health Dr A J Faisel said, "For a resource poor country like Bangladesh, awareness should be emphasised also to reduce fistula cases, where the rising number of patients are more than that of the total surgery performed each year."
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