How many of you reading this article have heard of the condition obstetric fistula? Not too many, I suspect. Until a couple of years ago, I had never heard of it either. I first heard about it from the Australian singer/songwriter Natalie Imbruglia who was talking about it on a UK television news programme as an official spokesperson for the UN-backed Campaign to End Fistula.
Fistula is a horrendous condition that affects poor young women in Africa, the Arab world and the Indian subcontinent. It is caused by a hole in the birth canal brought about by prolonged labour without suitable medical intervention, usually a Cesarean operation. Apart from having to cope with the trauma associated with giving birth to a stillborn baby, left untreated, fistula can lead to a woman getting ulcerations, kidney disease and nerve damage in the legs.
Two million women have the condition, with up to 100,000 new cases emerging each year. In the main, they have little say in who they marry, when they marry and the social pressure to give birth can be intense. It affects women living far from medical services, who may be undernourished, giving birth at a very young age and/or who have births in quick succession.
The condition is characterized by leaking urine and feces. The misery is endless, the smell can be overpowering and the cleaning up constant. Husbands leave, family and neighbours ostracise the women and a life of intense isolation and hardship ensues. Early marriage and poverty cut off many life opportunities for these women, including access to education, meaning that they later have little, if anything, to fall back upon in terms of economic independence.
Until recently, the condition was usually out of sight, out of mind to policy makers. However, the Campaign to End Fistula is in the process of changing that. I recently contacted Natalie Imbruglia and asked her about her involvement in the Campaign to End Fistula.
How did you initially hear about fistula and the Campaign to End Fistula?
I was talking to Richard Branson about wanting to get more involved in a charity and he thought I would be drawn to fistula, and he was right. I became an Ambassador for Virgin Unite and they linked me up with UNFPA (United Nations Population Fund), the agency leading the Campaign to End Fistula. I was horrified that I had never heard about fistula before, so within weeks I was on a plane to Nigeria and Ethiopia to learn more about it.
What was your particular motivation to get involved with a campaign to eradicate fistula?
This issue struck a chord with me. It was so devastating to me that all these women were suffering from a condition that is preventable and treatable. I just didn’t think it should be happening in this day and age. It didn’t seem like fistula was being talked about at all and I was alarmed by the lack of attention it was receiving. I felt that these women needed a voice. That’s what made me so keen to get involved.
How did your trip to Africa affect you and how did it enhance your understanding of fistula?
My experience in Africa was shocking at first, but the women are so inspiring. In Nigeria I visited various hospitals in Kano and Katsina. I met women who were waiting to have fistula surgery, and women who had already had their surgery. I also went to a village and met a woman who was getting on with life in her community after surgery.
I met a girl who lived with fistula for 16 years. It was just horrible-her baby had died, her husband had left her and she had been ostracised by her community. After she’d been treated, she was just so ecstatic and looking forward to having another baby.
It’s amazing to think that for 300 US dollars, a simple surgery can give a woman her life back. These women are so happy that someone is helping them. To see their dignity restored is a wonderful thing.
There are obviously huge social, cultural, economic and health issues at work, but what do you think is the best way forward for eradicating the condition?
The Campaign to End Fistula is working in three main areas: prevention, treatment and rehabilitation. Prevention is really the key to ending fistula. One of the main ways we can prevent fistula is by making sure that women have a professionally trained midwife on hand during the delivery who can recognise complications and refer them to a hospital for emergency care if needed.
Education is also important – educating men, the community and spiritual leaders about this problem, and educating women so that they understand the need for appropriate care during pregnancy and childbirth. Through the Campaign, we also focus on treating women who already have fistula, and teach them skills so that when they go back into their community they are economically independent.
For the past few years, I’ve been trying to raise awareness and funds for the Campaign to End Fistula – it’s important that people know what fistula is, and to know that they can help. You can go to EndFistula.org to learn more about fistula and how to get involved.
That is where my brief interview with Natalie Imbruglia ended. The Campaign to End Fistula is bringing the plight of women affected by the condition to a wide audience. In just a few years, $ 20 million has been mobilised by donors to help the campaign. Some cynics may ask what is the point of rich and famous individuals getting involved in certain issues that affect the lives of people with whom they have very little in common. But that would be missing the point entirely. If it were not for Natalie Imbruglia, I would never have heard about fistula. If it were not for Natalie Imbruglia, I would never have written this article that you see here today. Ms. Imbruglia says that she did not want to be part of the silence. Neither did I. When you think about it, none of us should be.