By: Madeline Taskier, Partnership Coordinator at Women Deliver
Obstetric fistula, like maternal mortality, is an almost entirely preventable condition experienced by at least 2 million women in Africa, Asia, and the Middle East every year. When a woman has prolonged or obstructed labor delaying delivery of her baby, a hole can form in the tissue between her bladder, vagina, and rectum causing uncontrollable leakage of feces or urine and often resulting in a stillborn birth. Performing surgery to repair the fistula is successful 90 percent of the time, but many women in these regions often do not have access to trained surgeons and have little knowledge of the existing treatments.
In 1998, Edna Adan Ismail, former first lady of Somalia and trained nurse-midwife, recognized the need of women in her country for maternal health services, specifically fistula operations due to female genital mutilation (FGM). She founded the Edna Adan Maternity Hospital in Somaliland, an autonomous region of Somalia bordered by Djibouti and Ethiopia, which has some of the highest maternal mortality rates in the world. Her goal was to train qualified health professionals, educate the community about the dangers of FGM and fistula and provide comprehensive health services for the women in her war-torn country.
Since 2002, the hospital has added 25 maternity beds and 13 surgery rooms. The program has trained over 100 Somali health professionals in this small territory: 30 nurses, 23 midwives, 15 lab technicians, and numerous health workers. These health professionals are working to repair fistulas for female patients who have been subjected to FGM as part of ubiquitous cultural practice. Anecdotal evidence suggests that nearly 95 to 100 percent of girls aged 4 to 11 in Somaliland experience FGM to some degree. The results are devastating: death from severe blood loss, contraction of HIV or hepatitis, or obstructed labor due to the stitching and closure of the anterior vagina. Women who suffer the painful outcomes of fistula are often ostracized by their communities and rejected by their families.
The team at Edna Adan Hospital routinely performs surgeries to repair fistula and treat women who have suffered from FGM. They also have begun a longitudinal qualitative study examining the prevalence rates of FGM in Somaliland and its effects on women’s health. The hospital team is successful in its endeavors because it not only addresses the immediate health needs of these women in a region lacking healthcare access, but it also educates the community about how these practices continue to endanger women.