WUNRN
LIBERIA: Living With Fistula
Fistula
from Childbirth (Obstetric Fistula) & from Sexual Assault (Rape)
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Hadjo Garbo, victim of an early marriage in Niger at age
13. She was pregnant by 14 and suffered a fistula after three days in labour
and a still-birth |
MONROVIA,
15 May 2008 (IRIN) - Of 600 rape victims recently interviewed by a Liberian
non-governmental organisation, 90 percent of the women were found to be
suffering from fistulas – a vaginal tear which results in loss of bladder
control and social stigmatisation.
Aid
workers say the statistic, provided by the Women of Liberia Peace Network
(WOLPNET) from surveys conducted in April 2008, shows the horrifying prevalence
of rape and of a phenomenon which Liberian medical officials say they are
ill-equipped to respond to.
“These
women are living with a serious scar and they are not getting access to
treatment,” said Una Thompson, head of WOLPNET.
According
to local health workers two types of fistula cases are prevalent in Liberia.
One is
obstetric fistula, which is a vaginal tear resulting from prolonged obstructed
labour.
A recent
health survey showed that over average 994 women die for every 100,000 who give
birth, a higher rate than was estimated during Liberia’s civil war. Doctors say
the most common cause of death is vaginal haemorrhaging following childbirth.
Some
health workers and officials say the spike is a result of improved data
collecting. However others say fewer births are being attended by trained
medical professionals, who diminished in numbers through the end of the
1990-2003 war, partly because of migration. Read an IRIN report
on maternal mortality in Liberia.
The other
common cause of fistula in Liberia is traumatic gynaecologic fistula that is a
vaginal injury resulting from violent sexual assault or when objects are
forcibly inserted into the vagina.
Violent
crime and rape especially of children are common in Liberia, and police and
justice systems have proven ineffectual at ending impunity for these crimes. Read an IRIN report
on crime in post-conflict Liberia.
Dr. John
Mulbah, head of the maternity centre of Liberia's biggest referral hospital,
the John F. Kennedy Hospital in Monrovia, said resources are limited to repair
the damage.
“We have
only five staff trained to conducted fistula treatment and all of them are
based in Monrovia [the capital]", he told IRIN.
"The
unit only has 30 beds… our facility is overwhelmed with patients and some have
to wait for a long time before being attended to.”
The unit
was created in February 2007 after the UN sponsored a survey which identified
351 women suffering from fistulas in rural Liberia. The unit is 100 percent
funded by international donors, not the government, Mulbah said.
"The
drugs and supplies and the only vehicle conducting outreach in rural parts of
the country were provided by the UN Population Fund (UNFPA). Treatment at the
unit is free," Mulbah said.
Liberia's
health minister, Walter Gwenigale, told IRIN that transporting fistula patients
from rural areas to Monrovia for the treatment is a major constraint on
broading treatment.
"Bringing
those patients to Monrovia requires funds. We are aware that there are lots of
fistula cases upcountry but the national health budget for Liberia is just
US$11 million which is totally inadequate to deal with all health
problems," Gwenigale said.
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