The 23rd May is International Day to End Obstetric Fistula. Calling for an end to this devastating childbirth injury within a generation, UN Secretary-General Ban Ki-moon states, “it pains me deeply that this preventable and treatable condition still exists in our world, mainly affecting the poorest and most marginalised women and girls, causing them even greater suffering and isolation”.
About Fistula
Obstetric fistula is a devastating childbirth injury, caused by obstructed labour. The condition leaves women incontinent, and as a result, the majority of sufferers are shunned by their communities and often abandoned by their husbands. An estimated 2 million women around the world are living with this injury, and some 50,000 to 100,000 new cases develop each year. Yet fistula is almost entirely preventable. According to the United Nations Population Fund (UNFPA), there are three delays that contribute to the development of a fistula: delay in seeking medical attention; delay in reaching a medical facility; and delay in receiving medical care once arriving at a health care facility.
Obstetric fistula still exists in many developing countries because heath care systems fail to provide accessible, quality maternal heath care. Patients with uncomplicated fistulae can undergo a simple surgery to repair the hole in their bladder or rectum. Approximately 80-95% of vaginal fistula can be rectified surgically. Many women live with the condition for years – or even decades – because they are not aware that fistula can be treated through a simple surgical repair procedure.
What Inter Care is doing
Inter Care sends vital medical aid to the Fistula Care Centre (FCC) in Lilongwe, Malawi, which was established in 2012. FCC has 35 beds and an operating theatre with the capacity to treat more than 400 women every year. FCC takes a holistic approach to the care and rehabilitation of patients, which encompasses rehabilitation, education and an empowerment programme. This includes access to micro-finance, a solar project where the women are given and taught to use a portable solar panel unit, vocational training, literacy and numeracy classes, as well as lessons in arts and crafts. FCC has established an Ambassador Programme where former patients visit communities to educate them about fistula and to help identify and refer women for treatment. FCC also run a training programme for surgeons, nurses, medical officers and clinical officers to become specialists in this field.
Violet’s story 
Violet is 51 and married with 3 children. She suffered with fistula for over 20 years, before being successfully treated at FCC. During the years she suffered from the condition, Violet’s husband married again, she lost her business because people refused to buy from her and her family and the community shunned her. She spent many years feeling desperately lonely, depressed and struggling to make ends meet.
Married at just 15, Violet had four children in quick succession, but it was the difficult birth of her fifth child that lead to obstetric fistula. When complications arose, Violet was taken to the local hospital, but by this time she had been in labour for 3 days. Her baby was stillborn and Violet developed a fistula.
20 years later, Violet heard about FCC, supported by Inter Care, from a patient Ambassador who had visited her village. After being treated at FCC, free of charge, Violet’s life has been transformed. She has returned to her community and has re-established relations with her family and community. She now runs a small business providing battery charging facilities from a small portable solar device given to her as part of FCC’s livelihood training programme. She has also become an Ambassador for FCC, speaking to communities about the importance of preventing fistula and the treatment available.