Adiza Mohamadou, a resident of northern Mali, recently underwent surgical repair of her obstetric fistula through the first fistula campaign supported by Fistula Care in collaboration with Medecins sans Frontiers which took place in March 2009 in Gao. “I have lived with obstetric fistula for the past three years,” Madame Mohamadou says. “I heard about the campaign on the radio and I decided to come on my own. I am very satisfied with this initiative. People have been very respectful.”

Obstetric fistula is the result of prolonged, obstructed labor. An abnormal opening between a woman’s vagina and her bladder and/or rectum develops, leading to the uncontrollable flow of urine and/or feces. Obstetric fistula can be surgically repaired in 90% of cases; however the same factors that frequently contribute to fistula—youth, poverty and lack of access to key health care services—can hinder women from receiving this life-altering treatment. Where the causes of fistula are poorly understood, women with the condition are frequently ostracized from their families and communities. Most of the estimated two million cases of untreated fistula worldwide are in sub-Saharan Africa and parts of Asia.

Doua Maiga has been diagnosed with obstetric fistula and was awaiting treatment when she shared her story. “I currently live in Gao château secteur III. I have been suffering from fistula for 15 years as a result of a delivery during which I lost consciousness, my baby died, and I almost became paralyzed.” Madame Maiga adds, “I have learned here that fistula results from complicated birth and that it is not linked to a co-wife or someone else putting a curse on me. God willing, if I am healed when I am released from the hospital, I will relay to the village everything I learned here about fistula and will encourage the women who suffer from it to come to the hospital to be repaired.”   

Working through the Fistula Care Project in Mali, IntraHealth has initiated, implemented and supported events that have brought together leaders and stakeholders from Mali’s policy and medical communities, as well as representatives from local and international NGOs and faith-based organizations, to map out ways to help Malian women with obstetric fistula. These events culminated in the launch of the first fistula campaign at the Gao Regional Hospital. IntraHealth’s contribution to the campaign included an assessment of the hospital’s ability to handle the fistula campaign by a team composed of IntraHealth’s own Dr. Demba Traore and two EngenderHealth staff. Furthermore, the project supported internationally-renowned fistula specialist, Professor Kalilou Ouattara, to train the local surgical team in the diagnosis and repair of obstetrical fistula. During the campaign, Professor Ouattara’s team diagnosed 31 cases of fistula among the 51 women who came in for a consultation, including Adiza Mohamadou and Doua Maiga. Thirteen women were repaired in the course of the campaign while two surgeons and one obstetrical gynecologist were trained by the professor.

 “I would like to thank the hospital and its partners for everything they have done for us,” says Madame Mohamadou. “When I go back to my village, I will tell women facing the same problems to go to the hospital and seek treatment. I will also share the information I have received with my relatives and my community.”

Fistula Care is a five-year cooperative agreement with the United States Agency for International Development managed by EngenderHealth in partnership with IntraHealth. IntraHealth is Fistula Care’s implementing partner in Mali.

^{Photos of people in this article are not indicative of health status.}