DORIS KASOTE, Solwezi
SHE lived an undignified life and was shunned by her community. Her life was full of nothing but misery, yet there was a solution to her problem.
Like Elizabeth Nswana, this is the story of several other fistula patients. Most are ignorant that there is help to end this medical complication.
What is fistula?
Fistula is a hole in the birth canal that occurs due to obstructed and prolonged labour. The condition causes shame and loss of dignity at individual and household level. It also puts social and economic strain on the woman or young girl and their family.
Ms Nswana is grateful to medical staff who carried out the repairs. “I feel as though I never suffered from fistula,” she says.
Another fistula survivor, Sophia Musonda, narrated that she had the problem in 2012 but was repaired in 2016.
Ms Musonda’s word of encouragement to women who suffer from fistula is to seek medical attention. It is estimated that over 500 women are living with fistula in Zambia.
According to the Zambia demographic health survey 2014 report, 398 women per 100,000 live births die from complications of pregnancy and delivery.
Zambia’s fertility rate has dropped from 6.2 percent in 2007 to 5.3 percent in 2014 while contraception use has increased from 33 percent in 2007 to 45 percent in 2014.
Infant mortality rate reduced from 70 births per 1,000 live births in 2007 to 45 per 1,000 live births in 2014. Access to antenatal care has also increased from 94 percent in 2007 to 96 percent in 2014.
“This therefore means that we should not be complacent and allow our mothers to lose their lives as a result of pregnancy and childbirth,” Vice-President Inonge Wina said recently.
She was speaking in a speech read for her by Minister in the Office of the Vice-President Sylvia Chalikosa during the commemoration of national safe motherhood week and international day to end fistula.
The commemoration was under the theme “Universal access to sexual and reproductive health services: Antenatal care within the first three months of pregnancy saves lives”.
According to United Nations Population Fund (UNFPA) country representative, Dr Mary Otieno, the UN agency and other partners have supported more than 1, 900 fistula repair surgeries since 2005 and trained fistula surgeons and nurses.
“However, much more needs to be done, as one in every 200 women aged 15-49 has experienced fistula,” she said.
“We know that pregnancy is a life-changing experience for women, pleasant for many mothers, however for some, pregnancy not only ends in a devastating injury (fistula) but also can result in the death of the mother and/or baby,” she said.
North-Western Province Minister Richard Kapita said he did not realise how many women suffer from fistula and urged them to seek medical attention.
Mr Kapita said Government appreciates the efforts by UNFPA and other cooperating partners in ensuring safe motherhood.
To end preventable deaths and illnesses, there is need to act collectively to address all primary causes, including eliminating poverty, addressing inequalities and disparities that leave women and girls behind, such as child marriage and early childbearing as well as promoting education at all levels.
Recent research has shown that despite widespread global attention to safe motherhood, insufficient progress has been made in reducing the number of maternal deaths.
The World Health Organisation (WHO) and the United Nations International Children’s Emergency Fund (UNICEF) estimate that nearly 600,000 such deaths still occur globally annually.
“This is an alarming high figure for the world. This, therefore, led to the declaration of global commitment to reducing the number of maternal deaths by half by the year 2015 under the Millennium Development Goals (MDGs) and we continue pursuing this agenda under the Sustainable Development Goals,” said Mrs Wina said.
Mrs Wina is concerned that there are still too many women dying from complications of pregnancy and delivery despite the strides made to curb such deaths in Zambia.
She said when women delay accessing antenatal care during pregnancy, preventive services such as prevention of mother-to-child transmission of HIV, prevention of malaria in pregnancy, and other complications are also delayed.
Ending fistula is of high priority to UNFPA, and it is key to achieving the global Sustainable Development Goals by 2030.
Fistula has been eliminated in wealthier countries, so it can also be eliminated in developing countries, Zambia inclusive.