Introduction

Obstetric fistula is an abnormal communication between the vagina and the bladder or rectum. It typically occurs after a difficult childbirth and leads to uncontrollable leakage of urine or feces. Women who suffer from it often face stigmatization, rejection, abandonment, exclusion, shame, and even suicide. Yet, it is a preventable and treatable health problem. In Cameroon, 78.9% of women affected by fistula are seeking treatment, while only 17.4% of those with symptoms undergo surgery. The International Day for the Elimination of Obstetric Fistula, celebrated on May 23, will provide another opportunity to raise awareness about this disease.

Causes

The primary cause of obstetric fistula is difficult childbirth. This occurs when the baby cannot pass through because its size is too large in relation to the mother’s pelvis, or because the pelvis is too narrow for a baby of normal weight. Labor becomes prolonged, and the baby’s head exerts pressure on the urinary tract tissues, particularly the bladder. When these tissues are compressed for too long, they are no longer supplied with blood, leading to necrosis. A few days later, this necrosis causes an abnormal opening between the organs, known as a fistula.

Risk Factors

Among the main risk factors are early marriages, which often lead to early pregnancies. Since young girls’ bodies are not fully developed, they often experience complications during childbirth, which can lead to a fistula. Poverty is another aggravating factor: poor women often have limited access to healthcare. However, fistula does not only affect impoverished women; any woman facing poorly managed difficult labour is at risk.

Treatment

The treatment of obstetric fistula involves three components: (1) The medical-surgical component, which consists of repairing the fistula through surgery; (2) Psychosocial support, aimed at helping the woman regain self-confidence; and (3) Socio-economic reintegration, enabling her to rebuild her life and return to an active life.

Prevention

Prevention remains the most effective way to eradicate obstetric fistula, both in Cameroon and elsewhere. It is essential to put an end to early marriages and pregnancies. Furthermore, proper management of pregnancy and childbirth is crucial. Women must give birth with the presence of qualified healthcare personnel who can timely identify high-risk pregnancies.

Conclusion

To eradicate obstetric fistula, an integrated approach is needed: strengthen health systems with specialized centers and trained staff, strictly enforce laws against early marriages, and raise awareness in communities to break taboos. International cooperation and political commitment are essential. Every action counts to offer women a life of dignity without stigmatization.