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Last Updated: Friday, 19 October 2007, 11:33 GMT 12:33 UK
'They thought I was cursed'

Each year, 100,000 women who give birth in poor countries develop a devastating condition which leaves them incontinent and ostracised.

Obstetric fistula, a hole linking the vagina with the bladder or rectum, occurs when women - often in their early teens - are in labour for days.

Campaigners at a global conference on maternal health in London this week, entitled Women Deliver, have emphasised that a simple and cheap operation can cure it.

The BBC News website speaks to two survivors about how surgery has transformed their lives.


Halima (image: David Rose/Panos/UNFPA)
Halima's labour lasted four days (image: David Rose/Panos/UNFPA)

I was 13 years old when I was married to my husband and 14 when I developed fistula after a difficult birth.

It was an arranged marriage. I wasn't happy about it but my parents told me that he was a good man and that he would look after me. It's better than nothing.

I got pregnant after my very first period. I didn't understand what was happening with my body. I started to have little illnesses and the traditional medicine wasn't working so my husband told me to go to the clinic.

It was there that they told me that I was pregnant. My reaction was: "Oh God! I'm dead!".

Caused by prolonged labour
Hole develops between vagina and rectum or bladder
Renders women incontinent
Occurs almost entirely in developing world
Two million have the condition
Up to 100,000 cases each year
Operation costs 170 ($350)
Source: UN Population Fund

When I returned home I was still ill all the time but I continued to do everything - I had to collect wood, prepare meals, clean the house and care for my husband as well as work in the fields. I had to do everything.

When the time came for me to give birth, I had two days of labour at home because in my culture it is preferred if you can give birth at home.

But it wasn't working so I went to a clinic. Labour continued and they said I would need a Caesarean section but the doctor sent me home because I couldn't afford the operation.

I had to wait for my family to collect the money to pay for the operation. Then we drove to Niamey which took a day. By that stage I had been in labour for days. I didn't know where I was, I was almost unconscious.

We tried to hide it from everyone, they thought I was cursed. I didn't want anyone in the village to know

At Niamey they carried out the Caesarean. The baby died. He was a boy, I felt so sad.

Three days after the birth I realised that I could not hold in my urine. I was told to be patient but the leaking carried on for six days. They told me to go home and come back in two months.

We didn't tell my husband, we told him that I was ill and I went back to stay with my parents. We tried to hide it from everyone.

They thought I was cursed. I didn't want anyone in the village to know. I felt very isolated.

After two months we returned to Niamey to a non-governmental organisation which helped me.

I had one operation and I was healed. I was delighted. Before, I was always crying but afterwards it was like I was reborn. Only now that I am healed does my husband know what happened to me.


I was raped at the age of 19. The rape left me pregnant and I developed obstetric fistula during the birth.

I was in labour for more than 18 hours. I'm an orphan so I was taken to the health care centre by my aunt. But once there I was left alone, nobody cared. I didn't understand what was happening.

Sarah (image: David Rose/Panos/UNFPA)
Sarah lived with fistula for 12 years (image: David Rose/Panos/UNFPA)

The doctor only came at the very last minute and I was referred to another health facility nearby. They delivered the baby by Caesarean section - it was a stillborn baby boy. He weighed 4.8kg.

After three days, I realised that I was always wet. I was told that I had a fistula problem. I never really understood what this meant.

I was told that I could seek further medical assistance but I'm an orphan, I simply didn't have the financial means. So I just went home.

It was such a difficult time for me, I suffered rejection, isolation, discrimination. I felt I didn't have a place in my society.

My friends didn't understand what had happened. It made me lose hope in life, I saw no reason to live. I couldn't see my friends and go out with other people my own age.

It made me lose hope in life, I saw no reason to live

I lived with fistula for 12 years. In April this year I suffered depression and it was then that the doctor realised that the problem of leaking urine was affecting me psychologically and I was referred to a gynaecological clinic.

The surgery was done in May. It took four and a half hours. I felt confident going into theatre, I knew this could bring about a change in my life.

Now I no longer smell of urine, I can go back to my society, carry out my duties. Now I am just like any other woman.

Three weeks ago I took part in a national event on fistula and it was then that I realised that there are thousands and thousands of women affected by this condition.

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