WUNRN
ETHIOPIA – TACKLING UTERINE
PROLAPSE & ITS CAUSES IN RURAL ETHIOPIA
Santibe
Kurben recuperates after receiving treatment for uterine prolapse, a
condition she suffered for years. © UNFPA
Ethiopia/Abraham Gelaw
18
February 2015 - Author: UNFPA
ASSOSA, Ethiopia – Santibe Kurben,
40, suffered for years from uterine prolapse – a condition in which the pelvic
muscles been weakened, causing the uterus to slip down into, or even out of,
the birth canal. The condition is often painful and debilitating.
Because
risk factors include childbirth injuries, adolescent pregnancies
and heavy physical labour soon after delivery, uterine prolapse often affects
vulnerable and impoverished women with little access to health services.
The
condition, also called fallen or dropped uterus, is widespread in the
Benishangul-Gumuz Region of Ethiopia, where Ms. Santibe lives. The region has
the country’s second highest of child marriage, according to Ethiopia’s 2011 Demographic and Health Survey.
Skilled birth attendance – by a trained professional such as a doctor, nurse or
midwife –
also remains very low, in part because of harmful practices like unattended
childbirth in the bush. Women are also expected to attend to laborious
household chores soon after childbirth.
Fertility
rates are also high in Ethiopia, and multiple pregnancies are a possible risk
factor for the condition.
Ms.
Santibe, like many women in the region, gave birth to all of her five children
out in the bush, unattended.
Several
years ago, she began to pass urine frequently, and suffered from bleeding and
severe back pain, all symptoms of uterine prolapse.
Finding help
When her
condition worsened in the last year, she sought help from a traditional healer,
who provided herbal medicines, but to no avail.
Finally,
she learned from the local NGO Mujejego Loka Women Development Association
(MLWDA), a UNFPA partner, that treatment was available at the Assosa Referral
Hospital, some 200 km away.
Ms.
Santibe, a single mother who had never before set foot in a health facility,
was initially reluctant to go. But she was ultimately persuaded, and the
transportation fare, treatment costs and other expenses were covered by MLWDA.
At the
hospital, she was one of 63 women to receive treatment for the condition, part
of a week-long campaign coordinated by MLWDA, UNFPA, the regional government,
the regional health bureau, and the regional chapter of the National Coalition
of Women against HIV/AIDS.
It was
the third such campaign held
at the hospital.
Looking for long-term
solutions
The
treatments – mostly surgical – were performed by a visiting team of
obstetricians and gynaecologists, mobilized by the Ethiopian Society of
Obstetricians and Gynaecologists, with logistical and financial support from
UNFPA. The team also provided cervical cancer screenings to a total of 128
women.
The
Assosa Referral Hospital is planning to begin regular treatments for uterine
prolapse when it gets a gynaecologist on staff later in the year.
“The
medical professionals of the hospital have gained very good hands-on experience
by working with the visiting medical professionals,” said Dr. Belete Shekuru,
the hospital’s medical director.
The
regional government is also planning to start providing uterine prolapse
treatment at another hospital in the region.
But even
with these added treatment facilities, Dr. Belete says, the condition will
remain a formidable challenge for the region.
Outreach essential
Outreach
efforts are underway to help address the underlying causes leading to this
condition.
Through
grassroots organizations – including MLWDA, with UNFPA support – outreach
workers are meeting with community members to discuss the importance of giving
birth at health facilities, under the care of a skilled birth attendant. They
also discuss the harms caused by child marriage and physical labour immediately
after birth.
Health
extension workers – community health workers who provided door-to-door
information and services – are also speaking with women about healthy practices
for themselves and their families, including birth spacing, which can be
accomplished with family planning.
Recovering
from her surgery in an MLWDA-supported rehabilitation, Ms. Santibe was cheerful
and relieved.
And like
other survivors who received treatment through the programme, she plans to
participate in outreach efforts when she returns home.
“I am
happy that I came all the way here,” she said.