BUJUMBURA November 27th (ABP) – “Even if obstetric fistula is a dishonorable disease in women, bizarre and inexplicable, we must recognize that we are seriously ill because whoever wants to cure an illness declares it,” said underlined, Mrs. Stéphanie Nsavyimana, one of the women who were cured of obstetric fistula, originally from Musigati commune in Bubanza province, during an interview given to ABP.
For his part, the gynecologist-obstetrician at the Kamenge University Hospital Center (CHUK), Dr. Déogratias Ntukamazina pointed out that if we talk about obstetric fistula, it is mainly a disease linked to childbirth. A woman with obstetric fistula is characterized by an uncontrolled or involuntary and permanent loss of her urine and/or more rarely of her feces wherever she is, whether sitting or standing, through an abnormal hole. which is created between the bladder and the external genitalia. That hole is caused by a difficult, long and complicated birth, even if it means that urine no longer passes through the normal route, he explained.
Dr. Nkunzimana pointed out that that disease can also be linked to non-pathological causes which are not common in the country such as surgery gone wrong when the bladder is injured, genital cancer which is already at the stage of metastasis which destroys part of the bladder, and the destroyed part creates, in turn, an abnormal passage of urine to the genital tract of the woman, a cancerous woman who is trying to treat with chemotherapy, which can destroy the bladder. He specified that, more rarely, women who cultivate rice can, at some point, catch bilharziasis which can weaken the wall of the bladder.
” Prevention is better than cure. According to Dr Nkunzimana, as soon as the woman becomes pregnant, she must have prenatal consultations to detect complications that could arise during the course of the pregnancy. That will help health professionals specializing in the matter to decide the route of delivery for that pregnancy,” he explained. Otherwise, he added, the woman can die during childbirth, lose her newborn or become fistulous after childbirth, without forgetting that the mother and child can lose their lives on the site.
The medical director of the Bubanza health province, Dr. Joëlle Bigirimana, revealed to ABP that obstetric fistula is a reality within the community. That disease mainly affects women who give birth at home and who undergo prolonged labor without the assistance of a health professional.
“Health providers and Community Health Workers (CHWs) were trained on the identification and management of obstetric fistulas. If we receive a woman carrying that disease after diagnosis, we inform the National Reproductive Health Program (PNSR) to facilitate the patient’s travel or stay at the Urumuri center in Gitega to be treated,” a- she reported.
Mrs. Bigirimana launched a vibrant appeal to pregnant women to prevent themselves from that disease by having prenatal consultations to find out if they can give birth vaginally or by cesarean section, as well as the post-natal consultations necessary to know their post-natal state of health. She also reaffirmed that obstetric fistula is curable if the advice given to the cured woman after surgical treatment is strictly respected. “For obstetric fistula to be eliminated in the health province of Bubanza, we will continue to raise awareness among all stakeholders, including men, so that we know the signs and dangers of that disease,” he said.
According to the provincial health promotion coordinator in Bubanza province, Athanase Nzeyimana, cases of obstetric fistula are gradually decreasing because the fistulous women already identified were treated at the Urumuri center and were cured, except for a single case of a woman in in which the disease reappeared following non-compliance with the advice given to him after the first treatment at Gitega, such as having sexual intercourse after at least three or four months and more.
“We work closely with the ASCs of all the 461 sub-villages in the province to identify fistula patients and refer them to the Urumuri center for treatment. Those ASCs communicate regularly with communal health promotion technicians or community health focal points, any health information that arises in the community,” he said, while calling on those ASCs to fully play their role in the community, given that they are considered eye and hearing witnesses of the ministry in charge of public health.
Under the guide of the ASC of the Musigati sub-village in Musigati commune of the Bubanza province, Mrs. Espérance Girukwishaka, the ABP visited a fistulous and mentally ill mother. That widow was at the foot of the mountain on the banks of the river called Nyesiha, preparing her meal. D.M. is no longer able to express himself except for the transmission of outrages.
“We tried to transport her, by force, to the disease treatment center but we failed. When she finishes eating and her clothes become dry, she returns home, to an uncomfortable shelter, opposite the Musigati commune market,” revealed Ms. Girukwishaka. She pointed out that in that locality, that disease mainly affects elderly mothers living in remote areas because, she explained, young women have already understood the merits of visiting health facilities in the event of pregnancy or any illness.
On the other hand, Mrs. Stéphanie Nsavyimana, confirmed that fistula is treatable and curable. “I suffered from obstetric fistula at the age of 47 in 2021. From then on, my husband abandoned me and left me with our four children. I tried to do everything to build a house on my own plot, without finishing it, and to provide for my children. Then, I went to Cibitoke province and to Mudubugu in Gihanga commune (Bubanza province) where I underwent very expensive treatments, without success. It was only at the Urumuri center in Gitega, where, from September 5 to October 20, 2023, I underwent effective surgical treatment, free of charge, to be cured and I was given the return ticket,” a- she testified.
She advised other spouses to remember the promise made during the nuptial blessing and accompany their wives in their suffering.
Note that the all-round elimination of obstetric fistula in Burundi is one of the concerns that are close to the heart of the first lady of the Republic of Burundi, Ms. Angeline Ndayishimiye, the Ministry of Public Health and the fight against AIDS through the PNSR as well as Burundi’s partners in the health sector including the United Nations Population Fund (UNFPA).