Fistula Center-Addis Ababa_Desta Menda-Happy Village

Many of the villages in Ethiopia have such a poor health care system that women don’t have access to medical attention during child birth. On top of that, extreme poverty renders people malnourished since child birth, which prevents full development. The effect malnourishment has on women can result in smaller bodies, smaller hips, and bones that do not grow to their full capacity.  These factors lead to dangerous child birth, where the mother is at risk of severely damaging her vaginal area. However, when a mother gives birth she has no other option than to have a vaginal birth since the lack of health care doesn’t offer other solutions, such as a c-section. Because of these factors, the mother can be in labor for up to four to five days trying to give birth to her child. During this time women may rip the area between her vagina and bladder, her vagina and rectum, or in some severe cases, both. Because of the damage that takes place in her vaginal area she becomes incontinent, either urinating involuntary or unable to control her bowel movements, leaving her with uncontrollable waste removal. Additionally, because the baby is unable to exit the mother it dies from asphyxiation when it is caught in the vagina canal and the mother gives birth to a still born. This health condition is known as fistula, which changes their lives dramatically. 

Shockingly, the milder cases are the ones when the connection between the women’s vagina and bladder is ripped in a way that can be easily repaired in surgery. But on rare occasions after the rip is made between the vagina and bladder the bladder comes out and the connection between the bladder and kidney is ripped, which can cause the kidneys to get backed up. This in turn can cause kidney failure, which is lethal. The issue with these extreme cases is that the rip can be repaired with a surgical operation but the women wouldn’t have a bladder, and thus would have to wear a bag at all times for the rest of her life. 

Most of these women are around the age of eighteen when they receive the surgery to fix their fistula problem. The tare always occurs with their first child because the women were never fit to have a vaginal birth, but with poor health care this is not detected.  After the damage has been done, the women become handicapped, incapable of performing their daily activities in the village. If the women are fortunate their family members will catch word of a hospital in Addis that performs surgery to correct the tare. Somehow this news of the hospital finds its way out to remote villages.  Most of these villages are 40 miles from any dirt road. Money is then scrambled together or cows are sold in order to pay the transportation fee for the male figure of the family and the woman to travel to Addis. On some occasions the woman travels alone. Reactions to the woman’s condition can vary between acceptance and love to complete disownment and community isolation. The family’s reaction will depend on how she is treated there after.