Gul Bano, Pakistan
Like many young girls in her mountainous rural area of Pakistan, Gul Bano was married at the age of 12 and became pregnant right away. She had no antenatal care in her husband’s village of Kohadast, in Baluchistan Province, but she was healthy and her family expected no difficulties when she went into labour.
Three days of agony followed. Despite the best efforts of a traditional birth attendant, Gul's child was stillborn. Gul had lost a lot of blood and developed a fever, but the birth attendant gave her antibiotics and her fever broke.
Eight days later, Gul realized she was passing urine and feces uncontrollably from her vagina. Neither she nor her family nor the attendant understood that the obstructed labour had damaged so much tissue in her birth canal that she had developed multiple fistulae – openings between her vagina and both her rectum and her bladder.
The leakage left her constantly wet and dirty. She smelled bad. She stopped venturing out of her mud house, as no one in the village would approach her. Despite the support of her husband, a rarity in such cases, she saw no future for her life and thought seriously about committing suicide.
Worldwide, at least two million women live as Gul did, in shame and hiding with obstetric fistulae. Most are unaware that surgery can usually repair the damage. An estimated 50,000 to 100,000 new cases occur each year, testimony to health systems' failure to meet women's needs.
Gul Bano suffered for two years. Then her younger sister Qus Bano married a man who knew about the Fistula Regional Treatment Center at the Koohi Goth Women’s Hospital in Karachi, where such fistulae were being repaired. The family decided to try to get Gul there.
Gul and her husband and sister walked two days through the mountains to reach the nearest highway, the first tarmac road Gul had ever seen. There they took a long bus to the nearest town, and another eight-hour bus trip to Karachi. It was the first time Gul had ever traveled in a motorized vehicle, and her first experience of light bulbs, large buildings, televisions, doctors, nurses. . .
She was so overwhelmed, weak and anemic that she needed two months of treatment before she was healthy enough for surgery. Finally she underwent first a colostomy and then two operations to close her fistulae.
UNFPA's global Campaign to End Fistula, launched in 2003, now works in more than 40 countries to support treatment and rehabilitation of women living with fistula, and to prevent the condition through support for health care systems, awareness-raising, and discouraging child marriage.
Seven months after her arrival, Gul Bano left the hospital. At her discharge party, she insisted on being photographed with the entire hospital team, including cooks and cleaners, who in return gave her new clothes to celebrate her new life.
Since then, Gul has regained her status in her family and community and has become a mobile good-will ambassador and information source for other women suffering obstetric fistula. She has brought several to the Karachi hospital for treatment. Her life, she says, has meaning once more.