Restore Hope: Help End Fistula in Ethiopia

“She told me that she is not able to control her urine and I realised that was why she was unhappy … she told me that it would have been better if she died.”
– Addisu*, Meseret’s husband

Death or a life-destroying injury called obstetric fistula. These are two outcomes that thousands of women in Ethiopia still face when giving birth.

But there is a third possible outcome: a healthy and safe birth where both mom and baby survive, and women like Meseret never have to experience the humiliation and pain of living with fistula.

You can make the third outcome possible for women right now. 

Addisu remembers the moment when he realised his heavily pregnant wife, Meseret, was likely going to die.

She had been in agonising labour at home for more than 10 hours when they made the decision to drive six hours to the nearest hospital.

But on the way to the hospital, Meseret’s labour suddenly ceased. She told Addisu that she couldn’t feel the baby moving anymore. And a few minutes later, she too was unresponsive.

“She was unconscious when we reached the hospital,” Addisu says. “The doctors told me that her uterus was ruptured and that she bled a lot inside her abdomen.

“I told them to do anything to save her life. I saw them giving her blood and I realised that it was a serious issue and I started to cry because I felt that she was going to die.”

Meseret didn’t die that day — but tragically, her baby did.

Image: Meseret

And if waking up to learn that her baby was stillborn wasn’t traumatic enough, Meseret was dealt two more devastating blows:

She would never be able to have another child, as the doctors made the decision to remove her uterus in order to save her life.

And she now lived with an obstetric fistula, a condition that caused her to become incontinent.

If Meseret had gone into labour under the care of a trained professional, her baby might be alive today.

She might never have known the indignity of constantly wetting herself in public and being shunned by her community due to the persistent stench of urine.

Addisu might never have had to hear his wife tell him that she wished she’d died along with their baby.

When Meseret woke up at the hospital, she was devastated to learn her baby had been stillborn.

All of their suffering could have been prevented. Donations will help our local partner run a radio awareness campaign across Ethiopia that will help to destigmatise fistula and raise awareness about its prevention and treatment. 

During a prolonged labour, like the one Meseret experienced, a baby can become stuck in the birth canal. The contractions force the baby’s head to press against the mother’s pelvis, which restricts blood flow and causes soft tissue to die, leaving a hole between the mother’s birth canal and her bladder and/or rectum. This leaves women unable to control their urine or faeces, or both.

Most women are abandoned by their husbands and families due to deep shame and taboo surrounding the condition. They are unable to get a job or financially support themselves because they become ostracised by their community. Many develop nerve damage and can no longer walk.

The physical and psychological impacts of this condition impact women’s lives in such a catastrophic way that they have been described as dead women walking.

But one doctor is determined to bring these women back to life; Dr. Ambaye.

Dr Ambaye and she is a leading fistula surgeon who studied under Dr Catherine Hamlin — the pioneer of fistula surgery in Ethiopia.

This year, Dr Ambaye took over the management of three fistula hospitals in her area in order to reach as many women living with the condition as possible.

Through her organisation, and our new project partner, Hope of Light, Dr Ambaye offers women free obstetric fistula repair surgery. But the care doesn’t stop there.

As she says, she works “to treat the whole patient, physically and mentally. There is rehabilitation and counselling. We must think to educate and empower women so they have control over their bodies and lives.”

Dr. Ambaye and her team have an incredible challenge ahead of them. You may not know this but Ethiopia still has one of the highest rates of fistula in the world. While most other countries have eliminated the condition completely, about 3,000 Ethiopian women will develop it each year. There are also an estimated 36,000 women living in hiding with untreated fistula.

Did you know it costs Dr. Ambaye $902.00 each month to run radio awareness campaigns so we can reach these women in hiding? Then, to identify a woman and transport her to hospital for surgery, it costs $108.74. And, at the hospital, it costs $659.57 to perform the life-saving surgery including post-operative physiotherapy, counselling and nutritious food plus a new dress or shawl to wear home.

It was Dr Ambaye who helped Meseret. She remembers seeing the devastated young woman for the first time:

“When a patient like Meseret enters an examination room, it is not difficult to diagnose when she suffers from obstetric fistula,” Dr Ambaye says. “Their small build, the clothes soaked with urine, the smell that comes into the room, their shyness to be examined, the sadness on their face. I could see how much Meseret was suffering.”

Due to the complex nature of the fistula, it took more than four hours for Dr Ambaye to operate and 18 days for Meseret to recover. But when her bladder catheter was removed and Meseret was finally able to control her urine, everyone was ecstatic.

“She was so happy to have her dignity returned,” Dr Ambaye says. “We all shared Meseret’s happiness.”

Meseret has since gone on to become a Safe Motherhood Ambassador with our other partner, Healing Hands of Joy. She will now dedicate her time to helping other women learn about fistula prevention and encouraging other women living with the condition to come forward and be treated.

Hope of Light is funded entirely through donations and with three hospitals to run, in the middle of a global pandemic that is still very present in Ethiopia, times are incredibly tough.

Donate now