Like many women in Malawi’s rural areas, who are suffering from obstetric fistula, Sophie Mbewe lived a miserable life when she had the condition.
It is described as a severe birth injury caused by prolonged obstructed labour that has not been relieved on time.
Mbewe, who hails from Senior Chief Mkanda’s area in Mchinji, says the problem started after she was delivered of a stillborn in 2005.
“I am a fistula survivor. I was very young when I go married to my first husband. My pelvis was too small to deliver a baby. After giving birth, urine started leaking uncontrollably,” she says.
The United Nations Population Fund (UNFPA) describes obstetric fistula as one of the most serious and tragic childbirth injuries which can lead to chronic medical conditions.
In some women and girls, fistula results in leaking of both urine and faeces, resulting in depression, social isolation and deepening poverty, according to the UN agency.
“Half a million women and girls in sub-Saharan Africa, Asia, the Arab States region and Latin America and the Caribbean are estimated to be living with fistula, with new cases developing every year,” UNFPA says.
It adds that the condition, which also triggers a constant, throbbing pain that may be worse when you sit down, move around, poo or cough, is a reminder of gross inequalities in access to health and social services.
Mbewe used to experience some of these disorders and often stayed away from community activities.
It took nine years for her to access treatment. She had initially thought she had been damned to live with “the shame” for the rest of her life.
“At first, I thought the leaking was just some body fluids, not urine. In 2014, I realised it was fistula after listening to a radio programme that unpacked the condition,” Mbewe says.
She states that during the struggle with fistula, she was isolated from her family and friends.
“Eventually, even my husband divorced me,” she says, a distant look appearing in her eyes.
Mbewe admits she was lucky to have been cured from the condition which, according to the World Health Organisation, can be avoided by delaying the age of first pregnancy.
“It took me just a month to be repaired and since then, I have been living a happy life,” she says.
Mbewe arrived at Bwaila Fistula Centre on March 5, 2014 and got her condition repaired 13 days later.
She proceeded to stay in hospital until April 4, 2014 for doctors to monitor her condition before she could be released.
“When I returned home, everyone was surprised to see how fresh and healthy I looked. The pungent smell that had stuck on me for years was gone,” she says radiantly.
All those who used to stay away from her due to her condition renewed the friendships and she returned to full participation of community activities.
She even found new love—and remarried.
“I could not hide the relief I had. So, I reached out to more women with fistula to access treatment,” Mbewe says.
Her efforts earned her a job at Bwaila Fistula Centre—a place that had given her a new lease of life turned into her workstation.
From 2015 to date, the centre has managed to repair over 4,000 fistula patients, representing 86 percent of all those who turn up for attention.
The figures could be convincing, but Dr Ember Chipungu, an official from Freedom from Fistula Foundation, is not wholly contented with such progress.
“Many people in rural areas have very limited knowledge about fistula, hence associating it with sexually transmitted infections, witchcraft and many other misconceptions,” Chipungu says.
According to the foundation, two million women and girls in Africa are suffering from obstetric fistula caused by prolonged, obstructed childbirth and lack of access to maternity care.
The not-for-profit organisation treats thousands of women every year in its three project sites in Africa, one of them being the Fistula Care Centre at Bwaila Hospital.
“[This is] a dedicated fistula care centre for women from all over Malawi and beyond to receive fistula reparation surgery, healing, education and holistic healing,” a note on its website reads.
Chipungu states that more awareness campaigns about obstetric fistula would help in bringing down its prevalence and invite those already with it to seek medical help in time.
Coordinator for the Fistula Care Centre, Margaret Moyo, has called for concerted efforts in fighting fistula, which she says is also affecting “many young girls”.
“We are seeing a lot of teenagers coming to the centre with fistula,” Moyo says.
She adds that only 350 cases are able to get medical assistance out of about 600 which are recorded every year.
One of the centre’s “long-time partners” Rotary Club of Lilongwe, which organised a training session for journalists on reporting on fistula, notes through its president, Vincent Sikelo, the need to explore different ways of raising more awareness about the condition.
