A fistula is an abnormal connection between two hollow spaces, such as blood vessels, intestines, or other hollow organs. Fistulas are usually caused by injury or surgery, but they can also result from an infection or inflammation. Fistulas are generally a disease condition, but they may be surgically created for therapeutic reasons.
In botany, the term is most common in its adjectival forms, where it is used in binomial names to refer to species that are distinguished by hollow or tubular structures. Monarda fistulosa, for example, has tubular flowers; Eutrochium fistulosum has a tubular stem; and Allium fistulosum has hollow or tubular leaves.
However, the good news about the highly stigmatizing ailment is that several non-governmental organizations in Africa have devised ways of using technology to assist women most especially those in the rural area to seek treatment for the childbirth complication.
Through various mobile money transfer platforms such as M-Pesa in East Africa, NGOs like the Freedom From Fistula Foundation, a U.K. charity organization are sending money to fistula patients in the remote parts of the continent to cover their transport and treatment costs.
The program, which is partly funded by Western governments, is playing a critical role in minimizing cases of fistula in Africa especially since the high cost of treatment has been the main barrier to accessing treatment for most patients.
Currently, fistula repair costs between 300,000 and 600,000 Central African francs ($520-$1,050), an amount that very few women in rural Africa can afford.
In countries like Sierra Leone, where access to cell-phones is still low, charity organizations reimburse the patients at the end of their journeys, and give them free accommodation and meals throughout the treatment process.
They also use telephone hotlines to share important information about fistula with patients in the remote areas.
“We use M-Pesa in Kenya a lot to help women access free treatment, but for example in Sierra Leone, almost none of our patients have a mobile phone,” Lois Boyle from the Freedom From Fistula Foundation was quoted by Reuters.
Other NGOs involved in this project include the United Nations Population Fund (UNFPA), Healing Hands of Joy, and Foundation Orange.
Prevention Is Better Than Cure
While these initiatives have helped many women resume their normal lives, the organizations appreciate the fact that the best way to fight the condition is to ensure it does not occur.
To this end, the groups are training fistula survivors to serve as “patient ambassadors” back in their communities. They are taught how to educate other women on the dangers of early pregnancies, which are regarded as the main cause of fistula.
These ambassadors also offer advice on safe deliveries, and assist in identifying and referring fistula cases for treatment. At least 524 patient ambassadors have been trained in Ethiopia by the Healing Hands of Joy group.
A similar program has been going on in Malawi for the last two years courtesy of Freedom From Fistula. Male volunteers are also being enlisted to assist in the campaign.
Obstetric fistula occurs when a hole develops between a woman’s birth canal and bladder or rectum during child birth. With this injury, a woman is left leaking urine, stool or both.
Unfortunately, many African communities associate the condition with witchcraft or curse, thus scaring patients away from seeking treatment.
But with concerted efforts by all stakeholders, Boyle is confident that fistula can easily be eradicated in Africa like it did in Western countries a century ago.