For many victims of the fistula disease, life is often a long nightmare. However, a number of survivors of the dreaded disease in Liberia’s Bong County are a happier lot today as a better future awaits them thanks to the vocational skills they acquired recently.  

In collaboration with Liberia’s Ministry of Health and Social Welfare and the Phebe Hospital in Suakoko District of Bong County, the United Nations Population Fund (UNFPA) has been equipping fistula survivors with vocational skills to enable them overcome the stigma attached to the disease and reintegrate into society.

Sixteen of the survivors, majority of whom had the disease through unsuccessful delivery by traditional midwives, were recently awarded certificates after receiving training at the Fistula Rehabilitation and Reintegration Centre at the Phebe Hospital. The Centre was established by the UNFPA with support from the Ministry of Health and Social Welfare.

Obstetric fistula is an injury caused by the lack of obstetric care when a woman has a long or obstructed delivery, resulting in the development of an abnormal communication between the vagina and the bladder or the vagina and the rectum or both, which culminates in the leaking of urine and/or faeces.

The psychological, economic and social consequences of the disease can be devastating. The victims often find themselves ostracized by husbands, friends and families. The stigma and the malodour prevent the women from working or participating in social activities.

The survivors of the disease, who were trained in pastry-making, tie-and-dye, dress-making, hair dressing, soap-making, and cosmetology at the Rehabilitation Centre, have harrowing stories of how they became social outcasts, rejected by their husbands, family members, friends and the entire community.            

Speaking at the certificate-awarding ceremony, the Manager of the Liberia Fistula Project, Dr. John Mulbah, said the Fistula Project has three components -- prevention, treatment, and rehabilitation. He cited rehabilitation as a major problem as cooperation of the entire community to accept survivors back into society is crucial. Dr. Mulbah, one of Liberia’s only two fistula surgeons, said 93 per cent out of the more than 950 fistula cases operated upon since the project began in 2007 had been successful.

The 16 women, one of whom comes from Sierra Leone, were each given startup kits and US$100 to begin small businesses in their communities. In addition, they were each given a cell phone to enable them to be in regular touch with the Liberia Fistula Project for monitoring purpose.

Overwhelmed by the new lease of life given them, the survivors put up a drama piece depicting how they contracted the fistula disease, and the challenges of coping with the stigma attached to it, advising pregnant women to always seek medical service from hospitals and clinics, and avoid going to traditional midwives, whom they claimed were the main cause of the disease.

In all, more than 40 fistula survivors had received vocational skills training at the centre since the fistula survivor rehabilitation and reintegration programme was moved from Jacob Town in Monrovia to Phebe in August 2010.          

While the exact prevalence of obstetric fistula in Liberia is not known, it is estimated that many new cases occur every year. The disease seems to be common among rural women due to the lack of access to maternal health, particularly emergency obstetric care.

However, as Liberia slowly recovers from the devastation caused by the civil conflict, hopes are high of better access to medical care and less number of fistula cases.