Rupa, a live-in housemaid, suffers from a disease that she never knew existed. She is unable to hold a job for more than a week, because wherever she goes she emits a foul odour, causing her employers to fire her.
The 25-year-old has had this problem for five years. She was upset and desperate and thought it was something she would never be cured of.
Rupa is one of the thousands of low-income women with
obstetric fistula, known in medical science as “the disease of poverty”. The disease is caused by a difficult or failed childbirth resulting from obstructed labour.
These women hardly know anything about their condition or even that there exists a cure for it. But treatment for fistula is currently available in 10 public medical college hospitals and five private hospitals in the country.
According to ‘Situation Analysis of Obstetric Fistula in Bangladesh’, a 2003 survey, over 71,000 women in Bangladesh suffer from fistula. The survey was carried out by the NGO, Engender Health in cooperation with the UNFPA.
There has been no known
attempt to conduct another survey since then. Health experts say the number of fistula patients would be much higher now.
Fistula usually occurs when a woman goes through obstructed labour for days on end, without medical help, and cannot get a Caesarean section. The blood supply to the soft tissues surrounding the mother’s bladder, rectum and vagina is cut off due to the prolonged pressure of the baby’s head against her pelvis.
The injured tissue soon rots away, leaving a fistula (hole). If the hole is between the woman’s vagina and bladder, she loses control over her urination, and if it is between her vagina and rectum, she loses control of her bowel movements. This can be repaired with reconstructive surgery.
Recently, the UN declared May 23 as the International Day to End
Obstetric Fistula. To observe the day, the UNFPA arranged a discussion meeting at the Rupashi Bangla Hotel yesterday. The current fistula situation in Bangladesh was discussed at the meeting.
Professor Dr Khondokar Md. Sifaetullah, director general of health services (DGHS), presided over the event which was also attended by MM Niaz Ahmed, secretary of health and family welfare.
In his speech, MM Niaz, the chief guest, said the ministry of health and family welfare would open fistula treatment spots in 64 district hospitals from July 1. He said as far as the project was concerned, money would not be an issue for the ministry.
“Anyone interested in working with fistula patients will be provided with financial as well as logistic support by the ministry. A national survey on the patients will be conducted this year with the assistance of the UNFPA,” he said.
He, however, did not say exactly when the survey would begin.
A.K.M Amir Hossain, the director general of the family planning directorate, said they were distributing free contraceptives to women throughout the country. He urged everyone to join the effort, in whatever capacity, to prevent this disease.
ArtherErken, UNFPA representative in Bangladesh, urged fistula patients to come to the health centres where they could receive proper medical attention and treatment. “There’s nothing to be embarrassed about. Don’t keep yourself isolated. Get yourself cured,” he said.
Professor Sayeba Akter, the former president of the Obstetric and Gyne Society of Bangladesh, said a survey would be crucial to the mapping out of a plan to fight the disease.