Men Involvement is key to ending Fistula in a generation

By Umar Weswala

Today is the International day to end obstetric fistula with the theme "End Fistula within a generation". In its resolution A/RES/67/147, the UN General Assembly calls on the international community to use this day to significantly raise awareness and intensify actions towards ending obstetric fistula

Many women and girls in Uganda who suffer from fistula are excluded from daily community life and often abandoned by their husbands and families isolating them socially and emotionally. This makes it difficult for them to access medical care.

Fistula is one of the most serious injuries of child bearing which is common among the poorest, most vulnerable and marginalized women and girls. Medical doctors describe it as a hole in the birth canal and bladder caused by prolonged abstracted labour in absence of timely and adequate medical care.

It is a painful and disheartening condition that no woman deserves to experience.

The 2011 Uganda UDHS (UBOS & ICF International, 2012) revealed that 2% of women of reproductive age had experienced leakage of urine or stool from the vagina after childbirth.

Among women who reported leakage, 62% had sought treatment, 12% felt embarrassed and did not seek treatment, 9% did not know where to go for treatment, 7% did not know that fistula can be repaired, and 3% felt that treatment was too expensive.

Arua Referral Hospital is one of the centers where the Ministry of Health in partnership with UNFPA and other partners have joined hands to create an enabling environment for fistula prevention and treatment.

A visit to Arua Hospital Gyn Ward gives an impression that this partnership is working.

All the 24 beds are occupied with women who have just undergone surgical repair. Only three out of the 24 cases are being cared for by their husbands. The rest are either with their mothers, children or on their own after being abandoned by their husbands who accuse them of having evil spirits, being unclean and expensive to live with.

Anzoyo Konsita 35 from Moyo district is lucky to have her husband Owiko Zakary by her side on bed 23 while Angozero Paska 22 from Nebi Ofaka on bed 4 is being attended to by her mother. Her husband abandoned her due to the fistula condition.

In a brief conversation with her, I realize that in addition to the pain inflicted on her by the fistula condition, she is emotionally hurt by the irresponsible attitude of the man trusted.

She however attributes her husband's negative attitude to ignorance and peer pressure.

"At first, he was supportive but he changed suddenly due to pressure from his friends. He is now in Kampala yet he should be here with me because he is partly responsible for my condition".

A conversation with Anzoyo is however encouraging and unlike Paska, she is proud of her husband who is not only cooking for her and washing her clothes; but also rejecting advice from his colleagues to abandon her and marry another wife.

According to Dr. Odar Emmanuel, a Fistula Surgeon at Arua Hospital, women who are abandoned by their husbands and relatives normally stand a risk higher of developing severe fistula which is more expensive and complicated to repair.

On this day, I urge all men to support their partners during pregnancy, delivery and after delivery so that pregnancy and child delivery is a blessing rather than a curse to the family.

We can get inspiration from Zakary's words; "My wife's life is very important to me".

The writer is a media practitioner specializing in health reporting