International Day to End Obstetric Fistula: Celebrating Partnerships

Astou looking directly at the camera as her photo is taken

International Day to End Obstetric Fistula: Celebrating Partnerships

Imagine living with incontinence. The constant smell. The enduring embarrassment of leaking onto sofas, beds, and chairs. Would you go out? 

Astou couldn’t. 

In fact, for almost twenty years, Astou hid herself away. Even on her sister’s wedding day.

“On the day of the wedding, I locked myself in my room,”

Astou explains.

“I told my family, ‘Don’t tell them where I am.’”

Twenty years earlier, Astou had woken up from an emergency caesarean, knowing something was very wrong. Not only did she endure the heartbreak of losing her baby but the long and traumatic birth left her with severe internal injuries – an obstetric fistula. 

“I stayed in bed for a month, I couldn’t get up or do anything else,”

she says, remembering how heavy her heart felt with grief.

“At that time, I started leaking urine. I couldn’t stop it.”

Her community saw Astou as unclean. Her husband abandoned her. She shut herself away from the world out of fear that she would leak and smell.

Astou’s new future

An obstetric fistula is a hole that forms between the birth canal and bladder or rectum, caused by prolonged, obstructed labour. The United Nations estimates that ninety per cent of pregnancies involving fistula end in stillbirth. And to add to the pain of losing a baby, it leaves women and girls leaking urine, faeces or both.  

Obstetric fistula is preventable yet the World Health Organisation estimates that around two million women in the world’s poorest countries live with the injury. And often the pain is far beyond the physical. Social isolation, chronic medical problems, depression and deepening poverty can continue for years.

Yet, with a simple surgery, women and girls can reclaim their lives again

One day, Astou heard on the radio that Mercy Ships was coming to Senegal. Finally, the day came and at long last, Astou heard the good news she had waited so long for – she could have free surgery. 

When Astou arrived at the hospital ship, she met other women who had spent years with the same pain she had suffered. She knew she wasn’t alone.

After their surgeries, the women rejoiced together in a special ceremony. These women had survived the darkest times of their lives. So here, on the hospital wards, they danced with joy as they reclaimed their dignity. 

“The pain in my body is gone,”

says Astou,

“I can’t wait to go back home.”

Now back at home, Astou’s life has changed. Before, Astou never made eye contact, her eyes filled with fear and sadness. Now, no longer in the shadows, her eyes shine like the sun.

Celebrating Freedom from Fistula

Today is International Day to End Obstetric Fistula. At Mercy Ships we are continuing to support the pioneering work that is underway to ensure women and children across sub-Saharan Africa can live lives free from the fear and shame of incontinence. 

Mercy Ships supports and partners with Freedom from Fistula in Sierra Leone and Madagascar to transform the lives of vulnerable women and girls. The Freedom from Fistula centres provide free surgeries to repair fistulas but also free maternity care to prevent fistulas and ensure safe childbirth.

Lois Boyle, Mercy Ships UK Trustee and Director of Operations and Communications at Freedom From Fistula, said: 

“Women and girls who have lived with fistula are the most resilient and inspirational people I have met.  Their faith and inner strength to survive the shame and isolation of incontinence is remarkable and it is a privilege to see them leave our clinics ‘dry’ and celebrating a fresh start in life.  

“Fistula is totally preventable with access to timely and quality maternity care and so its continued existence in Africa is such an injustice in 2024. Fistula treatment is important for those already suffering but prevention is the key to eradicating fistula for women and girls across the continent of Africa and beyond.”

Beyond the physical surgery, patients experience a rehabilitation course at the Freedom from Fistula centres. This is designed to break the cycle of poverty and reintegrate women and girls back into society, ready for all future opportunities. The Patient Rehabilitation, Education and Empowerment Programme includes business training, health education, literacy and numeracy classes and arts and crafts. 

We can work together to end obstetric fistula

Obstetric fistula is preventable. Through timely medical and surgical care, women like Astou would not be robbed of years of healthy life, for a condition that is easily treatable. This is unjust. But we can work together to end obstetric fistula.  

At Mercy Ships we believe everyone has the right to safe surgical care when they need it. Will you support us today to ensure that those in desperate need can receive the life-changing surgery they deserve? 



HELP ERADICATE DISEASES OF POVERTY