Group of Obstetric Fistula Surgeons at Komfo Anokye Teaching Hospital performing life-changing Fistula repair surgery
At first, it was exciting to welcome a child, but that excitement is cut short after unforeseen complications marred the labor process which rather brings pain and agony.
Victims of obstetric fistula bear a burden of incontinence, making them urinate without control, and even excrete without will from a normal hole created after a long obstructed childbirth.
Such women live in a world jam-packed with social isolation, mental devaluation, everlasting medical complication and child loss.
The buried cost of childbirth
Her troubles began after a traumatic childbirth that even the arrival of a new baby could not provide solace.
The life of 29-year-old businesswoman, Sumaya Abdul Rahim, altered completely after noticing something distressing.
That was a month after her emergency C-section at the Komfo Anokye Teaching Hospital.
“My time was due, and I started bleeding around 5 am. Doctors said my womb had ‘busted’, transferred me to KATH where I had my cesarean section due to the severity.
“But after a month, when I pass stool some flow from my vaginal opening. I was alarmed, reported to the hospital again, and conducted some tests,” Sumaya soberly shares with Clinton Yeboah.
The screening confirmed obstetric fistula; a new situation she would bear alongside the joy of welcoming her newborn.
Vida Opoku, a 33-year-old mother of five, knows this pain all too well.
After delivering her last child, the thriving trader has now been stuck at home.
Her foiled labor also left her incontinent, obliging her to rely on diapers.
“I use diapers and I fear I might stain myself unprovoked anywhere. In fact, I rather not go out at all times,” she said.
The Hidden Epidemic
Obstetric fistula is a hidden epidemic growing in the comfort of limited maternal health care and access.
In Ghana, rural folks, underprivileged pregnant women who lack nourishment and alertness, stand at the highest risk of acquiring this deadly prize.
The hindrance of cost also stares at the poor underprivileged affected women.
Obstetric fistula is an abnormal hole or opening formed between the birth canal and the bladder or rectum, causing affected women to pass urine uncontrollably, and excrete from their virginal opening.
About 90% of these cases are often due to prolonged and obstructed labor.
Data from Ghana’s District Health Management Information System (DHIMS II) indicates 1,300 new cases of obstetric fistula are recorded every year.
There is a heartbreaking twist to this situation: the concern of child marriage and teenage pregnancy.
Reverend Sister Olivia Umoh is the Director of Safe Child Advocacy – a social organization addressing needs of women, girls and vulnerable populations in Kumasi.
She makes a revelation of her experience with the compounded suffering of teenage girls.
Under their undeveloped bodies, they bear pregnancies that subsequently put them in high risk of obstetric fistula.
“I’ve witnessed some very young girls encounter this situation after being compelled to marry and forced to carry pregnancies at a very young age that lead them to suffer under their immature bodies. Our society needs to address this,” she told Clinton Yeboah.
Despite its deadly and undesirable nature, surgical repair rate stands less than 41%, with 1.6 to 1.8 cases occurring per 1,000 births.
Obstetric Fistula Surgeon at Komfo Anokye Teaching Hospital, Dr Baffour Opoku, explains factors compounding the situation which plague rural Ghana.
Preventable and treatable, yet access and lack of resources grip these statistics, influencing deadlock among victims.
“It is troubling that in 2025, modern obstetrics still have women suffering from obstetric fistula, a condition wholly preventable with good obstetric care. Many women who undergo long labors end up not progressing as they should due to inaccessibility to quality obstetric care and they end up developing obstetric fistula. Not all women also deliver in the hospital or have access to the hospital. Such situations open up the vulnerability,” he said.
Programme Specialist, Reproductive Health at the United Nations Population Fund, Dela Bright Gle decries the piling of untreated cases.
“Our study establishment of fistula burden in Ghana 2015 revealed that incidences are around 700 to 1,200 yearly. So if the repairs per year due to lack of resources are just about 60, you can imagine that there are a lot of backlog of cases to deal with and living in the shadows,” she said.
Social isolation and deadly burden
The rest of the story lies in the silent burden of raiding affected women’s dignity and jolly livelihoods.
Since the diagnosis, Sumaya’s confidence has dipped.
She would rather stay home than expose her situation just to escape her constant fear of embarrassment.
“My family was troubled. It beats our imagination how one child birth could have all these complications. I had to be extra cautious but not going out for a year has been a hard time. To go out and experience uncontrolled excrement, I would rather prevent the shame and stay home,” she admits.
Meanwhile, Vida feels this weight of isolation as she abandons her work and social life; the opposite of her bubbly life.
“I’ve been too shy to go out. I can’t even go to church and I feel I need to be isolated from people. I now survive on wearing pampers because I fear I might stain myself unprovoked anywhere, so I rather not go out. I have also not been working. I cannot risk selling outside,” she said.
The lived experiences of Sumaya and Vida rather mirror the social toll of many untold stories.
“It is disheartening that after the pain of child birth, women are subjected to another pain in the form of humiliation and abandonment. And it’s always sad as they are always neglected,” Director of Safe Child Advocacy Reverend Sister Olivia Umoh said.
Many are wallowing in depression and anxiety
In severe instances, wives are made to believe the condition is a curse and a punishment for infidelity.
Obstetric Fistula Surgeon, Dr Baffour Opoku, with enough exposure to treatment of such cases especially from rural Ghana, reveals that the stigma is pervasive, yet the true burdens of fistula on victims are hidden.
He decried the limited research.
“It’s still hard to actually ascertain the burden of disease, including how many women actually are suffering from obstetric fistula. The stigma associated puts them into hiding, so no social support. In some places, they are put in witch camps and specialist and authorities can’t assess them.
“About 90% do not get the babies for which they went through the obstructed labor problem. And if left untreated for long, develop urine dermatitis, contractures and nerve damages. Most of the husbands run away, and they end up being dependent on their immediate relatives,” he said.
The Hope of Treatment
Obstetric fistula is preventable and treatable.
The World Health Organization confirms that surgical repair of an obstetric fistula has a 90% success rate in simple cases, and a 60% success rate in complex situations.
The United Nations Population Fund (UNFPA) campaign to end obstetric fistula by 2030 also promises free obstetric care in Ghana’s major hospitals, on which Vida and Sumaya are banking their hopes to reclaim their lives to normalcy.
The broader challenge now remains: preventing new cases and increasing outreach to the already affected.
With access to skilled surgeons and social interventions for the underprivileged, women can reclaim their lives.
Obstetric Fistula Surgeon, Dr Baffour Opoku, is encouraging early intervention.
He asserts that first surgical repair is critical, as scar tissue from failed surgeries will make subsequent attempts tougher.
“Not every surgeon has the skill to treat fistulas. For complex cases, patients need extremely experienced surgeons to treat them. Early intervention is important. However, the first repair is always the best repair. If the first repair is unsuccessful, subsequent surgeries become more difficult,” he reveals.
Renewed Call to Action
Obstetric fistula is to be more than a medical condition; its intricacies involve human rights, functioning social systems and better health care systems.
Breaking the cycle of stigma and misconception is a step to a sound treatment for the affected.
Sumaya is now an advocate, urging women suffering in silence to seek help.
“Don’t stay home and think it’s not treatable. It’s treatable and with a specialized doctor you will get your normal life back. Women suffering from this condition should remain patient and steadfast. And they should seek help even if they are poor,” she said.
The urge for extensive awareness has become pertinent as society wallows in misunderstanding and lack of alertness for Obstetric Fistula.
Dela Bright Gle of UN Population Fund says heightened education and awareness will dismantle controversies.
She is encouraging partnerships that utilize resources, social support systems and infrastructure provision to prevent, reintegrate, and repair the anomaly in struggling societies.
“When something is shrouded in mystery, it stirs up a lot of controversies, myths, and misconceptions about what it is. When people know what it is, then they would understand that it’s just one of those morbidities that can be treatable and fully eradicated.
“It is not yet covered by the national health insurance package but if partners routinize the repairs and we have more repairs, increasing from 60 a year to 200 to even 2,000 a year we will solve the situation,” she said.
Director of Safe Child Advocacy, Reverend Sister Olivia Umoh believes there should be a national and institutional policies to address the situations.
“These people should be supported by their immediate families. The burden also lies with civil societies, non-profit social organization and the government. Hospitals can set up specific units to tackle women suffering from fistula. This provides a well concentrated approach to tackling the situation head-on. The national health insurance scheme can further its coverage to these vulnerable groups” she said.
The phenomena of obstetric fistula is a national issue, yet neglected at the detriment of victims.
Mothers, wives and young women, want to live happy lives during and after child birth.
The duty falls on all.
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DISCLAIMER: The Views, Comments, Opinions, Contributions and Statements made by Readers and Contributors on this platform do not necessarily represent the views or policy of Multimedia Group Limited.
