Obstetric fistula: Living with incontinence, shame

SIR: I am 30- year- old Hauwa Muhammad Aminu, based in Bauchi. I have been a survivor of Vesicovaginal fistula ( VVF) for four years. It happened when I was involved in an accident 26 years ago, which led to an injury in my bladder , which was repaired at that time.

Fast forward to 2019 when I gave birth to my second child, I started experiencing severe pain in my stomach, difficulty in sleeping and breathing. Several in vestigations were conducted, which showe d bladder diverticulum, mild right side obstructive uropathy, stenosis, and many more.

I underwent a successful surgery, and a two- day post- operation while I was eating, I felt a sudden pain in the abdomen. Before the end of the day, I had started leaking urine pericatheter . I was taken back to the operating room for urethrocystoscopy, which stenosis and others were noticed.

Some 12 days’ post- operation,

I started leaking urine again. Thereafter, an assessment of VVF was made, and I was placed under observation for six weeks. I cannot tell y ou the level of devastation I had, but I only hoped for healing or a miracle to happen.

I was later referred to the National Obstetric Fistula Centre ( NOFIC), Ningi, Bauchi State, where I met other women with similar cases. Being diagnosed with fistula was quite scary and depressing at the beginning, because I had to take pills to be able to sleep. That was despite all the support from my family , especially my husband, who has been very supportive and tolerant.

While it has affected my social relationships in terms of visitations or social gatherings, despite ha ving to sur - vive providing myself diapers, perfumes, clothing and d e tergents that will take away the foul smell, the development got me think ing about all the other women that are shunned or divorced by their husbands or community, and how they survive mentally, emotionally and financially, as one may undergo multiple surgeries and still come out unsuccessful. How do they cope, and who do they go to for help as 80 per cent of them are divorced? All we want is to feel among and be treated with kindness.

According to the W orld Health Organisation ( WHO), over two million women worldwide live with obstetric fistula, with the majority of such cases occurring in resource- poor countries like Nigeria. The afflicted tend to be both old and young primiparous mothers, who are too impoverished to interact with society as a result of our foul smell and inability to bear more children. This results in us being ostracised and shunned by our community.