Inter Press Service News Agency examines the prevalence of obstetric fistula in the southern region of Senegal. According to state reproductive health officials in the town of Kolda, 58 percent of births take place at home without medical assistance. “Women in the region suffer from exceptionally high rates of fistula,” which “occurs when extended pressure damages the soft tissue in a woman’s pelvis during the process of giving birth” and can lead to debilitating complications and ostracization from their families, IPS writes.

For every 20 deliveries at the Kolda’s regional hospital, at least nine women develop fistula, said the hospital’s medical commission President Charles Antoine Diatta. He said it is the result of inadequate monitoring during pregnancy. 

“In our southern regions, girls are married off between the ages of 13 and 15. They are right in the middle of adolescence and from a morphological perspective, their pelvic girdles are not yet fully developed. This is one of the causes of fistula because at delivery, labour is prolonged,” Diatta said, adding that the cost of medical care for a woman who has a fistula is between 70,000 and 150,000 CFA francs, about $320.

“The extreme poverty in these communities means that fistula sufferers stay away from health facilities and often do not return after a consultation. Being ashamed of their condition also keeps them away, as well as their awareness of the odour they give off,” according to Diatta, because the condition can cause leakage of urine or feces.

A shortage of health workers and equipment also contributes to the pervasiveness of fistula, according to Jacques Diam Ndour, head doctor in Kolda district. According to the WHO, there are seven doctors in Senegal for every 100,000 people, and one midwife for every 400,000 people. The article includes additional comments from a local religious leader, a UNPFA worker, a Kolda high school student and a public health leader in the area (Adigbli, 6/30).