Five women among every 3000 ever married women of Bangladesh suffer from obstetric fistula, according to a survey of EngenderHealth Bangladesh. The EngenderHealth Bangladesh in cooperation with UNFPA conducted the survey that showed grim picture of obstetric fistula affected patients due to inadequate knowledge about the disease. Ramiza, 42, of Bamna Bazar Sheikh Para village under Badarganj upazila of Rangpur district, is an unfortunate, depressed lady bearing the curse of fistula for long 30 years. She was married and prematurely became pregnant. Following prolonged labour, she gave birth to a dead baby at the Dinajpur Haldibari Hospital and developed obstetric fistula. As such she was rejected by her husband. Ramiza again got married but because of bad odor, she was again thrown out of home after two days.
As she always lives with a bad smell so was isolated by her husband, family and society and left alone.
Kulsum Begum (not real name) got married when she was only 14. She is now about 40 years old and mother of three children. Kulsum was affected with fistula while giving birth to her first child.
As a result of different health complications caused by fistula, Kulsum started to get harsh behavior from her husband. Utter negligence of her husband forced Kulsum to be separated from her family life. She is now living an isolated life in the society.
Both Ramiza and Kulsum got married at their early age. Like Ramiza and Kulsum, thousands of adolescents and teenage girls are becoming victims of fistula disease because of their pregnancy at an immature age and inadequate healthcare facilities.
Deputy Country Director of Save the Children Dr Ishtiaq Mannan said unsafe delivery by unskilled birth attendants and prolonged delivery complications causes fistula disease.
In most cases, poor women are the worst sufferers of fistula disease as they hardly get adequate healthcare facilities with unsafe delivery experiences by unskilled birth attendants at their home, he added. “Fistula affected women experience uncontrolled, non-stop passage of urine and feces per vagina. This happen when the birth canal gets connected with urinary system and rectum through abnormal holes,” he added. Prof Dr Abul Kalam Azad, Director General of Directorate General of Health Services (DGHS) said, “There is no accurate figure of fistula disease in the country and roughly the number of fistula patients is between 70,000 and 2,00,000.”
A total of 10 fistula centres have been set up at different public medical colleges, aiming to cure fistula patients through surgery, he said adding more fistula centres would be set up to provide treatment facilities to the fistula patients.
He said, “Obstetric fistula is one of the most serious and tragic childbirth injuries. It is a hole between the birth canal and bladder or rectum caused by prolonged, obstructed labour, without access to timely and high-quality medical treatment. It leaves women leaking urine, feces or both, and often leads to chronic medical problems, depression, social isolation, he added.
In case of obstructed labour, the fetal head gets arrested in the birth canal for 12 hours or long, he said, adding the fetal head adds pressure on the thin soft wall of vagina against pelvic bones and prolonged pressure destroys the vaginal wall and holes get generated. Pregnant women are affected by fistula disease when they suffer delivery complications for 12 hours and more, he added.
Trend of fistula disease has significantly declined with increasing facility delivery across the country, Prof Azad said adding, “It is a curable disease and we will provide all necessary treatment facilities as well as create awareness to prevent fistula disease across the country.
