What is a Fistula?

An obstetric fistula is a devastating medical condition resulting from difficult childbirth. All fistulas involve the creation of extraneous passageways within the body that damage sensitive areas. There are two main types of fistulas that occur during pregnancy. In vesico-vaginal fistulas, an unwanted hole develops between the vagina and the bladder. A recto-vaginal fistula is a hole that develops from the vagina to the rectum. Both types of fistulas alter the basic body functions of affected girls and women, bringing life long problems. Beyond Fistula helps women living with Fistulas in third world countries regain standing in their community.

What Causes a Fistula?

Women who become pregnant at a young age, or are small-statured due to malnutrition are at higher risk for complicated childbirths resulting from smaller pelvic bones that surround the birth canal. Fistulas result from lack of modern medical care during childbirth, specifically cesarean sections. In poorer regions, the scarcity of medical technology makes care too expensive for many women. As a result, women who cannot give birth naturally have no opportunity to get a cesarean section, causing prolonged obstructed labor. Without proper care, babies are not delivered on time, leaving them in the womb for an extended period of time. The constant pressure of the baby’s head against the mother’s pelvic bone causes tissue degradation in the vagina. This can open holes between the vagina and the bladder or the rectum, creating a Fistula.

What are the Effects?

Fistulas have many serious physical effects on women:

  • Babies almost always die as a result of prolonged labor.
  • A fistula prevents the mother from properly disposing of bodily waste, causing them to leak feces and urine uncontrollably from the vagina.
  • Fistulas lead to ulceration, or skin damage, around the genital area
  • Fistulas damage the lower limbs of women, causing a condition called “foot drop” which makes it painful and nearly impossible to walk.

Beyond physical damage, fistulas cause severe social damage to women:

  • Husbands of affected women often divorce and abandon their wife. Women are often left with no way to support themselves.
  • Women with Fistulas are forced to live alone away from their community. They live their life in social isolation and work alone, eat alone, and sleep alone.
  • Life as a social outcast can bring serious mental harm, including depression.

How are Fistulas Repaired?

Many fistulas are cured with surgery. In a proper medical setting with a trained provider and adequate supplies, surgeries can yield success rates of over 90%. The biggest challenge for women is finding a health facility that has a surgeon trained in fistula repair. Most hospitals in areas with high fistula rates have very few medical professionals that know the specifics of fistula repair.

Our organization helps women and girls who recently undergone surgical repair and need help reintegrating into their community. We use two approaches to help solve this problem.

Who is Affected by Fistulas?

Fistulas affect women and girls in poorer regions of the world that do not have access to professional childbirth resources. This is the case primarily in Africa and South Asia. Beyond Fistula has helped girls in Kenya overcome the hardships of a fistula.