From September 16-19, 2014 in the Kolda region of Senegal, a week-long ‘Fistula Camp’ was held to provide accessible fistula treatment to communities. Tostan and Amref Health Africa—in partnership with UNFPA—organized the camp as part of the Zero-Fistula Project launched in May of this year. In total, 13 women living with obstetric fistula were successfully operated on at the regional hospital, by Issa Labou, Head of the Neurological Service at the General Hospital of Dakar.
Tostan’s role leading up to the Fistula Camp had been to support fistula awareness-raising sessions in villages throughout the Kolda region, led by social mobilization agents, as well as identify women living with the condition. Therefore the work of social mobilization agents was crucial in making the camp a success in terms of ensuring that all the women booked for operations did in fact turn up.
We caught up with Awa Silla, a social mobilization agent, who gave us the run down on her role in the field.
Tostan: Describe how the awareness raising process unfolds and how you address the topic of fistula in a community that has never heard of the condition before?
Awa Silla: Awareness raising activities happen in steps. The first step is to meet the village chief and talk to him about the condition of fistula which affects many women. The village chief will then summon midwives, religious leaders, and other community leaders to inform them about the social mobilization sessions. We ask that women and girls be present for the sessions. Following this, we present who we are and what are our goals and objectives. We then talk about the project and the donors. This is followed by an explanation of the causes and treatment of fistula; for example, we may start with, “There is a condition called fistula, what does this condition mean?”
T: Through what channels do you share information on fistula during your sessions?
AS: During our sessions we share information through theatre sketches, song, radio diffusion, door-to-door awareness raising, the distribution of brochures, and participatory group discussions. We ask communities what they heard, and what they know. For example, if they hear a woman has gone to the hospital to treat her condition, it can encourage other women to seek treatment.
T: During your sessions, how do you relate harmful traditional practices such as female genital cutting (FGC) and child/forced marriage to fistula?
AS: We first explain that a woman can contract fistula during a difficult and prolonged child birth. We also explain that there are other causes, such as child/forced marriage, where young girls who are physically unable to give birth can contract fistula. In addition, we explain how FGC reduces the elasticity of the birth canal, causing complications during and after child birth.
T: How many men and adolescents participate in the sessions?
AS: Sometimes we have 30 men out of 70 participants. Sometimes there are 40 women and 30 men. Women make up a majority of the participants. Religious leaders, village chiefs, imams, community leaders such as Community Management Committees (CMCs), and other youths from associations also participate in the sessions.
T: Have you noticed differences in your work with communities who are participating or have participated in the Community Empowerment Program (CEP) versus those communities who haven’t?
AS: Yes there is a big difference. In non-Tostan communities, there is not much organization during discussions; it takes time for those communities to listen to what we have to say. Tostan communities however, have taken literacy classes; this enables them to read and understand certain topics and issues better. They thank Tostan for what they already know. The women from these communities are also more knowledgeable and more willing to speak up thanks to these literacy classes.
T: How do religious leaders support your work in the villages?
AS: Religious leaders and village chiefs alike welcome us with open arms; they host us for a period of time. Religious leaders also encourage husbands to support their wives during their pregnancy. It’s not easy for women to go through child birth. We have to continue to raise awareness and encourage women to respect and attend pre-and post natal consultations. We talk about how it is important to prevent child/forced marriage and FGC, both which can lead to contracting fistula.
Story by Valencia Rakotomalala, Communications Volunteer, Tostan