My husband divorced me for being operated of fistula for 3 times -Achol
Women from Aweil fix each other’s hair as they prepare to go home after fistula operation [Photo by UNFPA]
By Kidega Livingstone
Early this month, the National Ministry of Health in collaboration with the United Nation Fund for Population Assistance (UNFPA) announced that more than 60, 000 women were suffering from fistula.
Early this month, a total of 46 fistula patients were flown to Bentiu, and 25 of them have been admitted for surgery with support from UNFPA and UNMISS.
Fistula is an abnormal opening between two areas of the female body; an obstetric fistula is a hole between the birth canal and either the urinary canal or bowel causing uncontrollable leakage of urine or feaces or both. Fistula is caused by prolonged birth labor that usually happened to young girls who were not matured to produce.
A 15 year old Josephine Achol grew up in Tonj. She got married in 2014 and conceived in the same year. Six months into her pregnancy she started experiencing labor pain, after three days of continuous pain; she was transferred to Wau Hospital.
“I started labor pain from evening upto morning for three days, my husband decided to take me to Wau because in Tonj there was no health facility, women just deliver traditionally. After the doctor had examined me, they told me that the baby was alive but it could not come out without operation,”Achol narrated.
She said after she was operated within three days she started feeling the flowing of urine from her body (development of obstetric fistula). “The Doctor told me that they could not solve my problem but only Doctors from outside can. He told me to go back to Tonj and come back in July 2015 for fistula operation. This was what the doctor told me,” said Achol.
She added that after the first operation was done in July in 2015 she started feeling another leakage and another operation was done in Wau in 2016. However, the second operation did not heal the leakage; she had to go for the third operation. “It was very painful; I refused to go back to Wau for the third operation when I felt another leakage. My contacts were given to doctors in Juba and they (Doctors in Juba) called me on phone to come for the third operation in Juba in June 2018,”she said.
Achol said the third operation has been done in her stomach which was the case she was suppose to be operated in the affected area.
“When I got the third operation this year in June 2018 in my stomach, I am now okay not feeling any leakage,”
The fistula complication cost Achol her marriage. She has separated with her husband after telling her husband that she was experiencing another leakage and wants to go for the third operation in Juba “Right now, I am staying at our home with my brothers in Gudele (Residential area in Juba) after my husband divorced me when I was going for the third operation,” said Achol.
Speaking to UNFPA expert on fistula Mr. Okpwoku Raphael Ballu Sukere added that 50% of women with fistula are abandoned by their husbands. “In most cases, if a woman gets obstructed fistula, they are divorce by their husbands. The love will not be there,” said Raphael.
In another development, Atong Algmbany a 16 year old resident of Tongping residential area in Juba said she started having fistula problem during her first child when she was in Awiel. Algmbany was treated this year and she was thankful. “This year in June, 2018 after my operation, the urine stopped leaking from my private part, I thank the surgeons who operated me because right now, I can stay with people without fear,” said Atong.
She appealed to other women with similar cases to register with the National Ministry of Health and partners in order to be treated.
The Director for the Department of Obstetrics and Maternal Health in Juba Teaching Hospital, Dr. Anthony Lopai said after the last operation in June this year, there are no fistula patients who have registered.
“What we normally do is we advertise for the operation so that those women who are affected can be registered for operation since the surgeons were being hired,” said Lopai.
The UNFPA expert in fistula, Mr. Okpwoku Raphael Ballu Sukere said not all women who delivered at home can develop fistula but any woman who starts delivery at home and transferred to the hospital has a high risk of developing complication that may result into obstructed labor.
“If you look at maternal death, the major cause is bleeding which leads to obstructed labor and if a woman develops labor complication, there is no local home remedy people can provide in order to get the child out. The only thing is to refer the mother to the health facilities where she can get emergency care,” said Raphael.
He said the distance from the village to the referral hospital normally causes the obstruction that could develop into obstetric fistula. Raphael appealed to women that once they get pregnant, they should start attending to antenatal care where their body system would be examined to see if they can have a normal deliver or complication.
“We are advising them (women) to deliver in the heath facility to get help from skilled Doctors and Midwives. They can get all this from the Primary Heath Care, County hospital and Juba Teaching hospital,” said Raphael.
He added that the number of fistula affected women keeps on increasing because the call for women to deliver in health centers has not reached some parts of the Country. However, he warned that women who are operated and healed should follow the rules and advise given to them by the doctor.
“After the operation, a woman should resume sexual intercourse after six months. If she resumes sex before the six months end, there is a high chance of her redeveloping fistula because the wound has not healed very well,” he advised.
He added that women who had fistula should get pregnant after one year of the operation. “If a fistula repaired woman gets pregnant, she can only deliver through censorial section because if she delivers normally she will again develop fistula,” he said.
Speaking during the launching Vice President, Dr. James Wani Igga called for the abolishing of the dowry citing it perpetuated child marriage.
A UNFPA Goodwill Ambassador, Ms. Ashley Judd pointed out that people do not want to consider family planning because some of them want to produce children to replace those who have died during the war.
“Some women do not know about the family planning, they think their role is to produce children as much as they can without knowing producing many children leads to death. Some said they want to produce to replace those who died during the war,” said Ms. Ashley.
UNFPA is supporting fistula patients and the campaign against fistula in South Sudan. The organization hires surgeons from other countries like Uganda, Nigeria and other neighboring countries. UNFPA also trains South Sudanese nationals who shall continue to treat fistula patients.
UNFPA had been doing surgical repair for fistula patients since 2006 up to now 2018 in collaboration with the National Ministry of health and other partners.
According to Raphael, UNFPA spends more than 65,000 USD required to complete a single campaign and it varies depending on the logistics and other factors.
The government has discouraged early girl child marriage. Recently, the National Ministry of Gender, Child and Social Welfare launched a national strategic action plan to end early child marriage by 2030.