The Women's Dignity Project in Tanzania was established to prevent and manage obstetric fistula, enhance the dignity and rights of those living with fistula, and promote gender and health equity. We mobilize action to address fistula and advocate for the health and rights of the poor, within a human rights framework.




Asha's Story

Asha and her husband lived in a small village and were very poor. Her husband worked as a guard at the village government office and earned a meager salary.
Asha's first pregnancy was not difficult, and she delivered her first baby at home with no problems. When she was ready to deliver her second child, she experienced a very difficult labor and had to be taken to a hospital. Because there was no money to get her to the hospital, her husband took out two loans: one for $6 to pay for a wheelbarrow pulled by a cow to carry her to a main road, and another for $60 for a car to drive them from the main road to the hospital.

Although Asha was able to get a cesarean section, because of the prolonged labor her baby died and she developed fistula. The operation cost $40, a fee that they could not afford, so Asha's husband took a loan from the village government. The loan required him to work without a salary until his debt was repaid. This left the family without a source of income.

Along with the mounting debt, Asha's husband had to pay ten cents a day to someone willing to collect water from the nearest well six hours away. Asha was too weak to make the trip, and she needed extra water to wash herself and her clothes because of the constantly leaking urine.

Keeping up with loan payments was difficult, so the family sold a plot of land for $20 and one of their five cows. Still, this only paid off a small portion of their debts. Along with the financial strains, Asha continued to suffer because of her fistula. Friends collected some money to help the family and pay for Asha's fistula repair. The repair surgery was successful, but the family remains deeply in debt. It is uncertain how this family of three will continue to survive without any income and with outstanding loans to repay.



Pendo's Story

Pendo lived with fistula for over 30 years. As a young girl she attended school until her father forced her to marry at age 12. According to local custom, Pendo lived with her husband's parents until age 14; at which point she had her first menses and moved into her husband's home.

Pendo worked hard during her first pregnancy collecting firewood and water, and doing all other domestic chores. Her labor was difficult, painful and long. After being in labor for three days at home, her family finally took her to a hospital 20 kilometers away. The doctors delivered the baby by forceps.

The baby survived, but Pendo developed fistula as a result of the prolonged labor. She tried several times to have the fistula repaired at the hospital, but each time she arrived, there was no surgeon available to perform the operation.

Pendo's brother said the problem could not be cured and told her she should give up on trying to get treatment. Pendo's husband was advised to abandon her and marry another woman, but he ignored that advice and remained very supportive and loving. After Pendo got fistula she went on to have eleven more children, all of whom treated her with respect and kindness. The sons and daughters helped with the household chores and washed Pendo's urine-soaked clothes.

She continued to work and support her family throughout all those years, but faced significant social challenges. Ashamed of leaking urine uncontrollably, Pendo avoided situations where people might find out about her problem. Whenever she came across someone walking along the road she would cross to the other side so that they could not smell the odor.

When Pendo learned that her fistula could be cured she immediately went for repair. The surgery was successful, and Pendo finally stopped leaking. When she was fully healed and ready to return to her family, providers reminded her that she must wait three months after the surgery to resume sexual relations. Pendo happily told the providers, "Three months of waiting, after 32 years of leaking, is nothing!"



Neema's Story

When Neema was 15 years old a man in her village abducted her, locked her in his sister's house and raped her repeatedly for three days. According to Neema's culture, since she spent the night alone with the man, she had to marry him. Neema's father and brother gave her to the man in exchange for six cows.

The couple moved to the city and worked selling vegetables. When Neema got pregnant she sought antenatal care and worked long into her pregnancy so that she could afford a hospital delivery. The day she went into labor, her husband's family waited for nearly 24 hours before taking her to a hospital. Neema had to try two different hospitals and waited two days before she finally received a cesarean section. Her baby did not survive, and soon after her operation she discovered that she was leaking.

Since neither her husband nor his family visited her, Neema spent two months alone, recovering at the hospital. The relatives of other patients were kind and gave her food and water. When she finally went home, her husband said he no longer needed her; he now had a new wife who was not leaking. Although he treated her badly, Neema did not leave because she had nowhere to go.

Neema's brother eventually helped her obtain a fistula repair. The operation was only partially successful, leaving her unable to pass urine except through a catheter. Neema's husband continued to abuse her physically and emotionally; he refused to give her food and stole the vegetables that she sold for a living. Eventually he threw her out of the house.

Neema found a job as a maid earning 30 cents a day. She used her meager wages to rent a room and purchase her own cleaning supplies. She searched for more work and found a new job that paid her ten more cents a day. She invested half of her daily salary into a women's rotating credit fund and used the balance of her wages, plus the income from the credit fund, to buy a mattress. Neema is now 17 years old.



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