In Ethiopia’s busy capital Addis Ababa there is a hospital only for women. Long rows of white and light-blue sheets hang to dry in the afternoon breeze, and only a faint buzzing from the pulsating life of the capital city slips through the fence into the hospital garden. A group of women are sitting on the wide steps into one of the wards. They talk and braid each other’s hair, while an old Nokia cell phone plays music in Amharic. Suddenly one of the women rushes down to the drain groove, where she squats before it is to late and she accidentally will make her hospital dress wet. Some of the other women have a small stain on the back of their dresses, which tells that they didn’t manage to go to the drain in time.
They are all incontinent and mothers to a stillborn baby. They live with a hidden tear in their lower body and have arrived to the hospital in order to get help. Some of them have lost everything, and to them the hospital has become their only sanctuary.
They all suffer from the childbirth injury fistula.
Worldwide more than two million women and young girls live with untreated fistula. Most of them live in Asia or sub-Saharan Africa in poor areas far away from hospitals. Prolonged labour, limited access to midwifery and teenage pregnancies are some of the factors causing the injury. The women and girls are left with a hole between the birth canal and the bladder, which means that they can’t control the leaking of urine or faeces anymore.
The incontinence leaves the women in a vulnerable situation. Many experience being rejected by family members, abandoned by their husband or expelled by their local community. It is also hard for the women to work due to the incontinence, and many are pushed out into further poverty.
In most cases fistula can be cured with surgery. But many women are not aware that they can get help or it can be too difficult for them to reach a hospital performing the surgeries.
Hamlin Fistula Hospital in Ethiopia is one of the only hospitals in Africa, which entirely focuses on fistula treatment. In Ethiopia alone around 39.000 women live with untreated fistula and nearly 3700 develop the injury each year. The hospital focuses both on fistula surgeries, but has also a rehabilitation centre outside Addis Ababa. The centre works as a refuge for the women most affected by social stigmatization or incurable fistula.