UNFPA is actively working together with partners with the leadership of the Ministry of Health for the elimination of obstetric fistula from Ethiopia.
Tirumaed Molla is currently a resident of the Desta Mender (Joy Village) – a rehabilitation center for fistula survivors set up by Hamlin Fistula Ethiopia on the outskirts of Addis Ababa. She suffered obstetric fistula when she was just 17 years old trying to give birth to her first and only child.
She was giving birth at home with the help of a traditional birth attendant. Tirumaed says delivering at a health center was unthinkable as the nearest health facility was 3 hours’ drive from where she lived. For that matter, the awareness on the importance of institutional delivery was low in her community at the time. She was in labor at home for a total of 8 days. She says her family took her to a small clinic in the district on the 5th day but they were told that her condition was beyond the clinic’s capacity. They were told to take her to Bahir Dar, the capital of the Amhara Region, for treatment and care. Fearing that she might die along the way, her family brought her back home and on the 8th day the labor ended up in stillbirth. The ordeal left Tirumaed with a condition of obstetric fistula.
But this was just the beginning of Tirumaed’s suffering. Deserted by her partner, she stayed with her condition for 10 months at her parents’ place in a rural locality in the South Gondar Zone of the Amhara Region in Ethiopia isolated from social interactions due to her condition. Moreover, disabled on one of her legs from a very early age, Tirumaed’s other leg was also affected due to her fistula condition. This complicated matters for her and her care givers even more when she stayed at home during that time. She had to be helped by her family members as she could hardly make any movement without support.
Tackling Obstetric Fistula: A Two-Pronged Approach
Prevention of obstetric fistula through increasing the number of deliveries assisted by midwives as well as improving access to emergency obstetric care is the most tenable strategy to tackle this morbidity. Well-trained midwives, obstetricians and Integrated Emergency Obstetric Officers are essential for providing these services.
UNFPA is actively working together with partners with the leadership of the Ministry of Health for the elimination of obstetric fistula from Ethiopia. The Strategic Plan which is currently being implemented aims at maintaining prevention strategies while accelerating treatment of the backlog of obstetric fistula cases.
Since 2010 UNFPA has been partnering with the Ministry of Health and other partners to train integrated Emergency Obstetric Officers and midwives through supporting the Integrated Emergency Surgery and Obstetrics and Accelerated Midwifery Training Programs respectively. Community mobilization and awareness creation efforts through the engagement of community based structures has been very critical in the prevention effort.
The second prong in tackling obstetric fistula is identifying, referring and treating women with obstetric fistula. With funding from the Government of Sweden and the Maternal Health Trust Fund, UNFPA has been supporting the fistula centers at Arsi, Gondar, Jimma Universities since 2010 and partnering with Hamlin Fistula Ethiopia to repair and treat women with obstetric fistula. Moreover, as part of the scale-up of the program funded by the Government of Canada, support has also been provided for the social reintegration of treated fistula patients in Addis Ababa and three regions – Amhara, Oromia and Tigray Regions.
Embarking on a new life
Luckily for Tirumaed, among the acquaintances of her parents’ who came to visit was a fistula survivor who had been treated from her condition at the Fistula Hospital. She told her parents that her condition looked like fistula advising them to take her for treatment.
Tirumaed was brought to the Addis Ababa Fistula Hospital accompanied by her mother and brother 22 years ago. She remembers it was a long journey which took them three days on the road to get to the hospital. She says she was admitted to the hospital immediately and provided with the necessary care and support. Her medical treatment including the physiotherapy for her limbs took one year. She was cured from her fistula completely. But she had to stay at the hospital for three years for follow-up at the end of which she came to live in the Desta Mender.
“Things have changed a lot for the better for me thank God,” says Tirumaed. After she came to Desta Mender, she got the chance to be trained in handicrafts such as knitting, sewing and embroidery. She also started school and reached the 7th grade.
Tirumaed is currently working as a cashier for the café being operated at the Desta Mender.