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Advocacy for women with obstetric fistulas


Sep 15, 2022

BUJUMBURA September 14th (ABP) – The director of the National Reproductive Health Program (PNSR) within the Ministry of Public Health and the Fight against AIDS, Dr Ananie Ndacayisaba, indicated last week that they must not discriminate or stigmatize women suffering from obstetric fistulas, but rather help them to join the health structures to be examined and once the disease is confirmed, the patients must be sent to the Urumuri center in Gitega for treatment. That appeal was launched during the awareness workshop for media professionals on the disease of obstetric fistulas in Burundi, with the aim of putting them in the bath, so that, in turn, they can contribute, through their role of informing and educating, prevention and management of obstetric fistulas.

The director of the PNSR specified that the reception capacity of the Urumuri center in Gitega has increased from 35 to 100 patients thanks to the initiative of the first lady of Burundi, Mrs. Angeline Ndayishimiye, through the “Bonne action Umugiraneza” foundation.

For patients with obstetric fistulas who have difficulty in having means of transport to reach the Urumuri center in Gitega, Dr. Ndacayisaba said that everything is provided for those patients, including the one-way ticket, accommodation, dignity kits, food, medicine and other needs of women in such conditions, not to mention their return ticket home after treatment.

He also rejoiced that the cases of obstetric fistulas tend to gradually decrease in Burundi, testifying that for the year 2020-2021, 97% of women suffering from obstetric fistulas were treated and cured among the 84 patients who were received at the Urumuri center in Gitega.

The Reproductive Health Program Officer at the United Nations Population Fund (UNFPA), Dr. Yolande Magonyagi, defined obstetric fistula as being a perforation of the wall of the female sexual organ which puts it in communication with bladder and/or rectum due to difficult and prolonged labour, sometimes more than two days without timely obstetric intervention.

Regarding the types of obstetric fistulas, she pointed out that they are the uro-genital fistula where there is a communication between the urinary tract and the genital tract, the rectovaginal fistula where there is a communication between the rectum and the sexual organ of the woman involving the permanent losses of the stools by that organ, and of the mixed fistulas which are characterized by the losses at the same time of the stools and the urines.

According to Dr. Magonyagi, the main causes of obstetric fistulas include delay in going to a health facility for treatment, disproportion between the volume of the fetus and the mother’s pelvis or poor presentation of the baby, abnormally resistant: sequelae of local trauma, malformation of the genital tract, sexual trauma especially in young girls as well as technical faults during a caesarean section, a gynecological or obstetrical intervention and an episiotomy, she said.

                               UNFPA Reproductive Health Program Officer Dr Yolande Magonyagi

Dr. Magonyagi pointed out that the main contributing factors are among others, early marriages and pregnancies, short women who are less than 1.50 m, narrowing of the pelvis or deformed pelvis, large fetus compared to the pelvis of the woman, the malformed fetus for example hydrocephalus (big head filled with water), illiteracy, poverty and erroneous beliefs.

According to her, the consequences of the disease of obstetric fistulas are not lacking. Those include chronic urinary and/or faecal incontinence, divorce or abandonment, discrimination, stigma, isolation, shame, loss of hope, rejection and of infection.

In order to ensure the protection of the health of the woman after giving birth and in order to do family planning, Dr. Magonyagi stressed that the couple must abstain for six months without having sex.

Note that the treatment campaign for women suffering from obstetric fistulas, which began on September 5, 2022, continues at the Urumuri center in Gitega until October 5, 2022.