| Fistula Patients Treatment, Recovery and Rehabilitation Project |
Each and every pregnancy is a risk and life threatening condition for a woman. In developing world obstetric fistula is one of the most severe pregnancy related disability, almost always result from prolong obstructed labor. The World Health Obstetric fistula is vivid examples of poor maternal and reproductive health care and the unfortunate ending of motherhood leading to unacceptably high maternal death and disability. The world health organization (WHO) argues that poor socioeconomic development is the basic underlying factors responsible for maternal ill health including prevalence of obstetric fistula. The standards of health in developing countries are very low and that natural hazards such as malnutrition, infections remain largely unchecked. These problems happened to poor, innocent and ignorant, malnourished, young girls, coming from mostly rural areas who get isolated from family, community and continue to suffer from this devastating childbirth injury. Women who survive from this situation, unfortunately continue with a perforation in the uterus and or in the rectum and continuously leaks urine and/or faces, through vagina causes spread bad smell around and became an outcast of civilized society. But this injury can be repaired through reconstructive surgery.Each and every pregnancy is a risk and life threatening condition for a woman. In developing world obstetric fistula is one of the most severe pregnancy related disability, almost always result from prolong obstructed labor. The World Health Organization (WHO) estimates that between 50,000 to 100,000 women worldwide are affected by obstetric fistula annually. About 95% of women can make a safe delivery and only in nearly 5% cases, labor gets prolonged and obstructed and if not relieved by timely caesarean section continue to impact in the pelvis, tissues around gets compressed between maternal bony pelvis and fetal head, blood supply gets cut off leading to extensive damage to surrounding tissues like vagina, urinary bladder, rectum, cervix & uterus. Prolong and unrelieved pressure with crude attempts to deliver the baby causes impaction of the presenting part in the pelvis causes widespread tissue edema, hypoxic necrosis and sloughing of soft tissue of vagina, bladder or rectum or both and urethra. The injured tissue soon rots away, leaving a perforation, or fistula.
Fistula is not only a medical problem but also an acute social problem due to constant leaking of urine or faces and their accompanying foul smell. The stigmatization is isolation, loss of support, divorce & abandoned by their husband. They cannot participate in daily family and community life like rejected to attend social events, practicing religious worship, assisting household task, and so, they are mentally depressed and some take suicidal attempt. They also suffer from hard psychological trauma, resulting from their utter loss of status and dignity; ultimately they become out caste from the society & leave a life full of disgrace and misery.
To address the above-mentioned scenario and situation, the BWHC is implementing ‘Fistula Patients Treatment, Recovery and Rehabilitation Project since 2006 with financial support from United Nations Population Funds (UNFPA) through Director General of Health Services, Ministry of Health and Family Welfare, Government of Bangladesh. The project is being implemented with a view to Empower the obstetric fistula cured patients to reintegrate and rehabilitate in the own society thereby improving their physical & mental health, social and economic well-being.
| Fistula patient’s economical reintegration at community level |
| Working area/s: |
| Dhaka Division: Dhaka at DMCH
Chittagong Division: Cox’s Bazar at CMCH Khulna Division: Bagerhat, Narail at KMCH Rajsahi Division: Sirajgonj at RMCH Sylhet Division: Moulovibazar, Sunamgonj at Sylhet MAG Osmani MCH Barisal Division: Patuakhali, Barguna at BMCH Rangpur Division: Panchagrath, Thakurgaon at RMCH Mymensingh Division: Jamalpur at MMCH |
| Fistula Patient’s Marriage Age |
| Activities & Achievements
Identification & Treatment 427 Awareness and Orientation 15,009 IGA Training 177 Economic reintegration 63 Development of CFA 54 |
| Age Segregation of Fistula Patients (below 18) |
| Objective/s: |
| To identify fistula patients for treatment and taking measures to inhibit new cases of obstetric fistula
To eradicate obstetric fistula through community mobilization and sensitization by developing community fistula advocates (CFA) Ensuring quality of lives of fistula patients through economical reintegration particularly, operating customized skilled based training on income generating activities To assist cured fistula patients in restoring their social acceptance & respect by reintegrating in the community |
| Jhorna is a mother of four (04) children who lives in a remote village of Northern district Panchagarh of Bangladesh. She got married with a landless farmer while she was only 14 years old as her parents had four (04) more children. Being a bicycle mechanic, it was really tough for her father to maintain such a big family for which she was a victim of child marriage. Immediately after her marriage, she got pregnant as neither she nor her husband were aware about any family planning contraceptive methods. Off course, those were not available at their community as well. She gave birth her first child when she was only 15 and again got pregnant for the second immediately after giving birth the first kid. During her first delivery, she somehow escaped any extreme sufferings but at the second birth, her labor pain continued till two and half days (2.5 days) under supervision of a Traditional Birth Attendant (TBA). Failing to manage the situation, the TBA requested her husband to take her to the local hospital but due to her critical situation, the local hospital refused to provide support rather referred her to another private hospital. But unfortunately, due to lack of financial solvency, her husband was unable to admit her in that hospital and brought her back to house where she gave birth of a stillbirth child. After few days, Jhorna noticed that continuous dribbling of urine started through vagina and she lost her pressure/feelings of maturation. Her husband consulted with few local clinicians but they failed to solve the problem. In the meantime, Jhorna experienced ruthless and brutal humiliation from her family (except her husband). Though she gave birth two more children during these periods but failed to get neither treatment nor appropriate information about fistula and it’s treatment. She was totally isolated from the community for near about 15 years.
At last, she managed to visit a local surgeon of government health facility in 2014 who was one of the participants of Fistula Orientation Program organized by BWHC and the doctor suggested her to contact with the local representative of BWHC. Immediately after her communication with BWHC, she was admitted in Rangpur Medical College Hospital and later to Dhaka Medical College Hospital (DMCH) at the National Fistula Center. She was treated for around 03 months of intensive treatment, surgery and care. Finally, she got rid of her long 15 years’ endless sufferings and isolation. During this period, she received 02 month-long training on basic education and tailoring simultaneously at BWHC’s Fistula Center. After successful completion the training, she was provided a sewing machine and ‘seed money’ from the same center of BWHC. After receiving those, she went back to her family and community with new hopes. With the seed money and sewing machine, Jhorna established a small tailoring shop in her community and by utilizing her skills and quality, she manages to earn BDT 1500/ (roughly US $18-20 USD) per month to contribute to her family. She also engaged herself as a CFA at her community to raise awareness among the mothers, adolescent and newly married couples on early marriage and lifelong consequences of fistula.
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| “Fistula treatment offered me my second life”
– Let’s hear story of Jhorna Begum |