By ANETTE OS

Nine thousand Ethiopian women face fistula complications every year. Few of them know that a free operation can save them from a life as abandoned.

Imagine constant pain and the depression by a growing sense of the humiliating nature of infirmity. At the same time you realise that your very presence is an offence to others. Then imagine that you are able to be restored to full health and able to resume a rightful place in the family. Life has been given a new start, and you once again become a citizen of the world.

Tsehay faced complications during birth when she was only 15 years old. She lived far away from hospitals, and she could not reach any doctor. She stayed in her little hut for days with labour pains. After four days of pain, she still didn’t give birth. The baby eventually died. At the same time, she was left with permanent damages from the baby’s pressure against her pelvis, and she could not hold back her urine. Her husband left her after a while because he could not stand the smell of urine, and Tsehay had to live alone in a small hut. Today she is 45 years old, and is finally getting treatment.

 “I’m happy to have my life back. If I had this operation when I was 15, my life would be different. But I don’t blame anyone because God has always been by my side, she says. After smelling urine for over 30 years, Tsehay got cured. The operation at the fistula hospital in Yirgalem took only twenty minutes and was free of charge. Tsehay shares room with 17-year-old girls at the fistula hospital. They do not have to go through life as she did because they reached treatment early.

“The best thing about being at this hospital is seeing the young girls who get their life back. When they get cured, I feel happy. I don’t want them to end up like me,” Tsehay says.

Even though fistula hospitals have existed in Ethiopia since the 1970s, few people in the rural areas have any knowledge about it. It took 30 years before Tsehay heard about the fistula hospital. Her story does not stand out of the crowd.

So what is fistula? When the prolonged and obstructed pressure of an unborn baby’s head against the mother’s pelvis is unrelieved during labour, it causes lasting damage. Labour proceeds, often resulting in a stillborn baby, and women are left with horrendous constant and uncontrollable leakage of body waste products.

In the developed world a pregnant woman with obstructed labour would quickly be taken into surgery and a caesarean section performed. But in rural Ethiopia this is not an option. Women will instead remain in labour, sometimes up to five days, resulting in the baby’s death, and sometimes the women die as well.

“We can help the women, but the problem is finding the patients. We go from house to house in the rural areas to find them. Sometimes we bring a cured fistula patient who can recount her experiences. We only find the patients by seeking them out, because they won’t get information about the hospital in other ways,” Agegnehu Gebiso says.

He is coordinator for the Female Genital Mutilation Project in a local church in Yirgalem, which cooperates with the fistula hospital. Their main area is the Sidama Zone, which has three million inhabitants. 120,000 babies are born every year, and 350 of these pregnant women end up with fistula during birth.

Gebiso give lectures about fistula in the villages, both at schools, in churches and in mosques. In a period of two years, they have found close to 400 women with fistula. The Yirgalem Fistula Hospital has also cooperated with the regional health ministry. They have informed local clinics and health bureaus about fistula and different treatments. They have also explained what fistula is on the local radio, where they emphasize that the treatment is free.

Einar Lande works at Yirgalem Fistula Hospital as the only doctor. He has operated over 400 patients since January 2007. “My job is not only to close a hole, which is leaking fluid. The damage influences their whole life. Some women with fistula can’t even travel by bus because of the smell. Someone gets abandoned by their husband, while someone gets another child even though they have fistula. Every one of the patients has an emotional story,” he says.

While there was only one fistula hospital in Ethiopia before, they have now three new ones. They can double their capacity and operate 1100 patients a year. The fistula hospitals are located in Addis Ababa, Yirgalem, Bahir Dar, Mekelle, Harrar and Metu.

Rahel, 21, is a previous fistula patient. Today she works as a nurse at the fistula hospital in Yirgalem. Most of the nurses at the fistula hospital have been admitted to the hospital earlier.

“I had fistula, but I’m cured now. I give hope to the fistula patients who come to the hospital. I know what they have been through, and I can relate to them. I can comfort them, and they can see that I got through this, and so would they. Previous patients give the new patients a ray of hope,” Rahel says.


The names of the fistula patients are pseudonyms.