Fistula Mission

Yesterday I started doing translations for obstetric fistula patients at the National Hospital in Niamey. I'll be here for this work for two weeks, so you'll hopefully hear from me much more frequently (daily internet access! holler!).

Obstetric fistula is a condition most often caused by prolonged childbirth. Simply put, fistula is a hole between the bladder and the vagina or the rectum and the vagina, which leads to the leaking of urine and/or feces. Women develop obstetric fistula when, after being in labor for a very long time, their internal tissues begin to die because of lack of oxygen. My understanding is that the weight and pressure of the fetus essentially crushes the woman's organs, which begin to disintegrate. Prolonged labor is more often seen in young girls; their bodies aren't fully developed and are not ready for childbirth. When I say prolonged labor, I mean 2 to 5 days. Other causes of obstetric fistula that I have encountered are genital mutilation and botched hysterectomies.

Women and girls with obstetric fistula are able to function in 'normal' society to varying degrees, depending on the severity of their case. Some women leak urine constantly, while others only leak when standing, working, or walking. Depending on the community in which the woman lives, and the age at which she gave birth/developed fistula, she may or may not be ostracized for her condition. Because perpetual leaking, the women often smell strongly of urine. Those who also leak feces have it harder. In the short time that I've been working with these women, it seems like most of them move out of their husband's house and back to their own family's home. They may remain married, but do not have much contact with their husbands. Many of them are divorced. In the vast majority of cases, the babies do not survive childbirth.

So there are some of the basics about fistula. At the National Hospital in Niamey, there's a wing for women with fistula to live while they await surgery. Currently there are over 80 women waiting here. One of the surgeons on staff knows how to repair a fistula, and groups of American doctors come through 3 times a year for two weeks to do what they can for as many women as possible. The latest group just got in on Sunday night, and I'll be translating for them during their stay.

We just started yesterday, and there's already so much to tell. I think maybe the easiest way for you to know about what's going on here is for me to just give you a play by play-- to tell you about what we're doing, how the women are, the ups and the downs.