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Ostracised, outcast and shunned

Wednesday, 5th May 2010    

Ostracised, outcast and shunned

Over two million women in Africa suffer from incontinence caused by obstetric fistula: New publication on International Day of the Midwife highlights the terrible human toll of obstetric fistula
A new publication from the Royal College of Midwives (RCM) published on International Day of the Midwife (IDM) on Wednesday, 5th May lays out the facts about the terrible effects on millions of women across the developing world of obstetric fistula. IDM is organised worldwide by the International Confederation of Midwives.

Around two million women in Africa alone are suffer from obstetric fistula and many are ostracised by their families and communities as they smell and are constantly wet from incontinence caused by problems during childbirth.  Ostetric fistula is a gap between the birth canal and bladder or rectum. Fistulas occur as a result of an obstructed labour when there is no access to skilled midwifery care and emergency care and facilities are unavailable

The focus of IDM this year in the UK is on maternal morbidity, particularly the impact of obstetric fistula. The RCM is joining with the Freedom from Fistula Foundation (FfFF) to raise awareness of the issue.  A seminar looking at the issue is taking place on Wednesday, 5th May with speakers including Baroness Tonge, and Frances Day-Stirk, a director at the RCM and Vice President of the ICM. Grace Mukasa of the African Medical and Research Foundation, will also be speaking. The event is at the Royal College of Obstetricians and Gynaecologists, London, 27 Sussex Place, Regent's Park, London, NW1 4RG, from 1-4pm. For full programme details visit: http://bit.ly/ab0GSO.

Frances Day-Stirk, Director of Learning, Research and Practice Development at the RCM and Vice-President of the ICM, said: “morbidity and particularly obstetric fistula is a devastating problem, and one that is affecting millions of women across the world. It is a scandal and there is a real need for urgent action from Governments to tackle the issue.

“International Day of the Midwife is shining a spotlight on this issue and I hope that it will prompt action to help these women.”

The theme of IDM is ‘The world needs midwives more than ever’. The ICM is calling for the provision of an extra 350,000 midwives worldwide and for world leaders to allocate more resources for midwives. Every year 1. 5 million newborns die within the first 24 hours of life and millions of women suffer long lasting disability because they do not have access to basic healthcare during childbirth
For more information, case studies of women suffering from obsteric fistula, or If you wish to attend the event please contact the RCM press office on 020 7312 3456 or pressofficer@rcm.org.uk. The New RCM publication ‘Obstetric Fistula: A Silent Tragedy’ and more information on IDM 2010 can be viewed at: http://www.rcm.org.uk/college/international/international-day-of-the-midwife/idm2010/.

Case Study

Joyce Chepkoech, Sierra Leone

Joyce is single and has two children. Her husband left her after she got pregnant with the third child.  She was two days in labour in Narok Hospital but her third child died, leaving her with fistula which she had for five months before getting treatment at the clinic. 

She has been depressed because of it and her friends have disowned her and her neighbours refuse to help her. Her mother has supported her and brought her on the long journey to get to the clinic after her Pastor told her about FFFF and the clinic. 

She said “My life with fistula was embarrassing and so I always stayed indoors.  I was constantly wet and my mother had to help me constantly by washing my clothes and cleaning up after me. I am so grateful to everyone at the clinic who has helped me.”

After Joyce’s successful operation, her mother said “I can see the joy in my daughter’s eyes that has been missing for months. She looks more relaxed and is now eating and drinking properly again because she is not scared.”

Case Study Courtesy of the Freedom From Fistula Foundation