May 23 is the International Day to End Obstetric Fistula. This year’s theme is “End Fistula Within A Generation.” You can join the conversation and help bring an end to this preventable condition by using the hashtag #FistulaDay.
In many ways, Aissatou Mané is fortunate. At 30 years old, she has a loving husband, a community who supports her—and she was healed from an incapacitating condition: obstetric fistula. “Before, my fistula exhausted me. I couldn’t do anything and no one had the solution.” With Tostan’s help, Aissatou was successfully operated upon and she can now live a life free from fistula.
Obstetric fistula is a hole in the birth canal, caused by prolonged, obstructed labor—often due to lack of adequate medical care—and results in incontinence. However, the fundamental causes of this condition run much deeper. Factors such as extreme poverty, living in remote rural areas, gender and socioeconomic inequality, lack of schooling and basic biological knowledge, as well as child marriage and subsequent early childbearing contribute to more than two million women and girls living with fistula.
Despite the mounting odds against these women and girls, there is hope. While preventing obstetric fistula is imperative to ensuring a woman’s right to health, treatment and social reintegration are also important steps. Surgery is often a viable option for women suffering from fistula, although cost and transport constraints can be huge barriers. Aissatou reflects upon her circumstances: “Thanks to my operation, I was healed quickly. Now, I’m active. I take care of my family and I can walk long distances without any problems.”
Tostan has worked with organizations like UNFPA, Amref, and Handicap International to identify fistula-affected women, facilitate their treatment, and work to raise knowledge and awareness in their communities so that these women can be fully reintegrated.
Aissatou first obtained her fistula when she was 26 years old, during the birth of her seventh child. Although she eventually sought care at a local hospital, the baby died during the prolonged birth and the damage to her birth canal had already been done. She suffered for two years before being operated upon in 2014 in collaboration with Tostan’s fistula project. “I think Tostan’s awareness-raising activities [around fistula] are very interesting—it’s because of this that I discovered what illness I was suffering from and where it came from…Because of Tostan, I learned it was a curable condition…Then I could seek treatment.”
Besides being physically taxing, fistula can weigh heavily on a woman’s psyche. While many women suffer from social isolation, Aissatou did not. The community of Medina Elhadj in southeast Senegal rallied around her. “Before, we didn’t talk about it, just to console me. I wasn’t rejected; they took care of me like any other sick person. The people around me helped me as much as possible.” That said, Aissatou lived with emotional baggage tied to her condition. “Fistula pulls us away from our rights as humans because it makes us useless; you feel guilty for everything. This illness isolates people from others…I no longer had confidence in myself; I didn’t know what to do anymore…After I was healed, I couldn’t believe it. I was blown away by this miracle.”
Fistula has long-term, daily consequences for the affected woman. For Aissatou, “I ate two times as much [and] the fistula would prevent me from sleeping because I couldn’t hold anything in—I had to go back and forth to the toilet. I was always in motion.”
Aissatou doesn’t know others who are living with fistula, but she does discuss her condition openly with the women in her community. As for advice she would give other women affected by the condition: “I advise them all to get treated, to not hide themselves. Fistula is not a shameful illness…It’s a condition that does not hide itself—if you are affected by fistula, everyone will know.”
Although she is healed, Aissatou is not finished with fistula. She and her husband, Lassana Soncko, plan to continue raising awareness about this condition. Lassana explains, “We will continue to discuss [fistula] with others because after what we’ve lived through, we understand that you need to do everything possible to prevent fistula from happening again.”
Now is the time to join Aissatou and Lassana to spread awareness about fistula—the causes, the treatment and the recovery—and help women and girls get the resources they need. By focusing on prevention, treatment and social reintegration, we can “End Fistula Within A Generation.”
By Ashlee Sang, Internal Communications Officer