Another Health Crisis Looms: ‘More FISTULA’

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Drs. Pratt (left) and Mulbah are alarmed_web.jpg

The alarm bells are beginning to ring again of another looming health crisis that might arise as a result of the breakdown of the nation’s healthcare system due the Ebola virus disease.

This time it is “more fistula because more pregnant women are giving birth in their communities without the supervision of trained and skilled birth attendants or doctors.”

Dr. John K. Mulbah, Lead Surgeon of the Liberia Fistula Project (LFP), who just returned from the 5th conference of the International Society of Obstetric Fistula Surgeons (ISOFS) in Kampala, Uganda, told journalists yesterday that the gains LFP has made in restoring hope for most fistula survivors might be eroded as more pregnant women could come down with the condition as they are giving birth in the community not in a health facility.

“Just yesterday I met a renowned doctor from ELWA Hospital who said to me, ‘Doc, just get ready for more fistula.’ He had performed more than 10 surgeries and reported that all the women exhibited leakage of urine and feces either because the women are not coming to the available health centers or most of them are being rejected at the health facilities and hospitals due to fear of Ebola by medical staff.

It was evident that the progress made in reducing the backlog of fistula patients would recede as more cases appeared, said Dr. Mulbah, who is a Gynecologist and also a professor at the University of Liberia’s A.M. Dioglotti College of Medicine.

Last February he told this newspaper that the LFP team had been able to fix the fistula problems of more than a thousand girls and women from Liberia, Guinea, Sierra Leone and La Côte d’Ivoire. He had also disclosed that Liberian women and girls comprised at least 92 percent of fistula cases operated on while three percent were Ivorians and the rest Guineans and Sierra Leoneans.

He had cautioned during that interview that it was too early to celebrate the gains that had been made in trying to eradicate fistula from Liberia.

In August and September, there were reports everywhere that pregnant women were being rejected at hospitals and health facilities. Reports also said some died in labor because there was no one to attend to them. A well-known incident was of a woman who delivered her babies in the street with the assistance of a few other women who had to quickly create a lappa fence around her. Thankfully, she successfully gave birth to twin boys. The incident occurred a few yards from a renowned hospital in Paynesville.  

Also speaking yesterday, Dr. Philderald Pratt, UNFPA-Liberia Fistula Focus Person and Assistant Resident Representative, UNFPA-Liberia, stated that most fistula victims are often shy to come out because the condition is demeaning to their person.

Dr. Pratt, who, too, attended the just-ended 5th ISOFS conference in Kampala, said the Ebola epidemic has “arrested all of the progress that has been made in rebuilding our health system, especially for maternal and newborn child health.”

He stated that Liberia, being one of the major players trying to eradicate Obstetric Fistula in the world, would likely see more fistula cases after the Ebola crisis.

Both Drs. Pratt and Mulbah were given international awards by ISOFS for their outstanding roles in trying to “restore health and dignity to women and girls.”

 They said the awards were not only theirs but was also for every nurse and the women whose conditions have been fixed through surgery and other components of the LFP programs.

About Fistula

One of the most serious injuries of childbearing is obstetric fistula, a hole in the vagina or rectum caused by labor that is prolonged – often for days – without treatment. Usually the baby dies.

Because fistula leaves women leaking urine or feces, or both, it typically results in social isolation, depression and deepening poverty. Left untreated, fistula can lead to chronic medical problems. It can be prevented, however.

Fistula can cause involuntary passage of urine and feces by its sufferers.  A woman with fistula can feel the urge to urinate or defecate but cannot control or stop the flow. Both are discharged anywhere at any time, leaving the woman very embarrassed and ashamed.

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