The following is the story of Sumaiya* from the Western Region of Sudan. She is 18 years old and suffered from obstetric fistula resulting from an obstructed labour.
“I was married at the age of 16. I was the eldest daughter of three; all of whom were married at about my age. In my society, girls barely receive any formal education.
My early marital days went by slowly but happily. When I became pregnant, I was unable to attend the antenatal clinic follow-up programme. This was because my people are nomads. We move around all year round looking for grazing grounds for our cattle and sheep. So, most of the time, we are far away from any health facility that provides basic medical care. However, my mother and aunts always reassured me regarding childbirth; that it is a natural innate process for all women.
When the time came and my labour pains started, it felt anything but natural. The pain increased unrelentingly. After three agonizing days there was still no sign that the delivery was imminent. It was then that my husband and father decided that it was high time to seek medical assistance. I was taken to the nearest hospital, which was about half a day’s travel by camel. When we arrived at the hospital, the doctor in charge examined me and decided to perform a cesarean section. I was in bad shape and wanted the pain to end.
Unfortunately, the baby was stillborn. After the operation, I was kept in the hospital for a few days. I felt so weak that I could hardly move or walk. My right leg was numb. Before I was discharged from hospital, I noticed that I was continuously leaking urine. I complained to my doctor who after examining me informed me that as a result of the difficult labour I had developed an obstetric fistula. He explained that this was an abnormal opening between my bladder and my birth canal. He added that I needed an operation to rectify this. He offered to refer me to Dr Abbo’s National Fistula and Urogynaecology Center in Khartoum which is the largest specialized fistula management center in Sudan.
My husband could not stand the smell of urine, and divorced me a few months later. So I was left shattered by the loss of my husband and the mourning of my first born.
My father and mother took me to Dr Abbo’s National Fistula and Urogynaecology Center where I was examined. When I complained about the pain and weakness of my left leg , the doctor told me that this was also the result of the difficult labour. While waiting for surgery, and since I had no next of kin in Khartoum, I was admitted to the Social Reintegration and Rehabilitation center. There I received physiotherapy exercises for my numb leg before and after the repair operation.
The repair was successful and I was ready for the next step: the rehabilitation. I received physical and psychological rehabilitation sessions by professional staff at the rehabilitation and reintegration center where I regained my self confidence and self esteem. I was also offered vocational training where I learned some incoming generating activities like knitting and baking cakes. Now I can start my own small business when I get back to my community. I can also remarry and start a new family of my own and have children.
However, I was advised to abstain from sexual intercourse for the first 6 months following the operation. After that I can use contraception to avoid pregnancy for another 6 months. After these 12 months, if I become pregnant, I should report to the nearest hospital and present the card with my operation details so that the doctor can arrange for my follow up and delivery by cesarean section.
Upon discharge, I was informed that I should return for follow up after 6 months, but since our village is far away, I was given a contact number that I can call at anytime if I have any complaints or cannot attend the follow up.
The staff is very comforting and welcoming; I could never forget their help. They arranged for us to return home; we were even given free tickets.
Words cannot express the happiness and joy that I now feel. I’m a complete healthy person again, thanks to the staff of Dr Abbo’s National Fistula & Urogynaecology Center. I shall remain indebted to Dr Abdelrahman and Dr Maisoun for every help that they offered me. I intend to name the children that I shall have in the future after these two doctors. I hope that this will show them how much I’m grateful to them.
When I go back to my village, I’ll speak to women in social gatherings about fistula and how routine follow up in pregnancy can prevent it.”
*The patient’s name has been changed to preserve her privacy
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