The fate of fistula patients in Afghanistan

It is no secret that Afghanistan is wrecked by many a crisis. Despite that, healthcare facilities are attempting to make reproductive care more readily available to women who have an obstetric fistula, particularly in the wake of the country's unprecedented catastrophe.

Aisha, a 35-year-old Ghazni mother of three who has had five costly but fruitless fistula surgeries, is the latest victim. For the past 12 years, Aisha's family has detested her because she was born with an open fistula.

An obstetric fistula is a traumatic delivery lesion that results in uncontrollable incontinence or faeces leaking into the mother and/or the baby. Patients with obstetric fistulas endure physical and psychological pain for all of their lives.

The Taliban's conquest of Afghanistan in August 2021 pushed a large portion of the population into poverty. She flew to Kabul for free fistula treatment at Malalai Maternity Hospital because she had no money for another procedure. Aisha expects this to be her final surgery.

The UNFPA funded the obstetric fistula ward at Malalai Maternity Hospital. Then there's Herat and Jalalabad, to round off the list. UNFPA also educated doctors and midwives on how to treat and repair fistulas, both simple and complex. The ward was supplied with medication by the UNFPA.

Malalai Maternity Hospital treated 50-year-old Haadiya for her second fistula operation. In a private clinic, she paid AFN 50,000 ($700) for an initial surgery but the disease resurfaced. “The second time I've had surgery, I'm optimistic about a full recovery,” Haadiya remarked.

More than half of Afghan women who had obstetric fistula symptoms did not seek medical attention. It is painful and humiliating for many women because of the high prices.

As the chief of the fistula section at Malalai Maternity Hospital, Dr. Nazifa Hamrah has explained, the recent uptick in patients is directly related to the current political climate.

"Women are forced to seek fistula treatment at public health institutions due to economic restrictions and a lack of medical resources," she said. On an average month, about twenty-five persons get surgery. " Five midwives and four doctors work on the ward.

The humanitarian crisis in Afghanistan has disrupted health services in many places, making it difficult to treat obstetric fistulas there. One more problem is the early marriage of girls and boys because of their low socioeconomic status.

For Dr. Abdul Malik Faize of UNFPA Afghanistan, the risk of an obstetric fistula increases with poor health, early marriage, and repeated births. The situation is exacerbated by the absence of prenatal and emergency obstetric care and birth spacing contraception.

Access to skilled birth attendants, maternal health care, the development of health professionals' obstetric fistula prevention capability, case detection and training of more surgeons to do fistula operations must be improved for women.

This bundle of fistula care should encourage physical and psychological healing as well as attempts to raise awareness among health care providers and influential members of the community, according to Dr. Faize.