According to United Nations reports, Ethiopia is one of the least developed countries in the world, with a high rate of maternal mortality and disability. The country lacks adequate infrastructure to facilitate travel from remote areas to towns and cities. As a result, it is very difficult for women in rural areas to access medical care during obstructed labor. Medical facilities are often under-staffed and ill-equipped to handle complicated birth. Many women do not access medical care due to prohibitive costs, as well as the fear of poor treatment by hospital staff.
Approximately three million Ethiopian women become pregnant each year; 0.3 percent of these women develop obstetric fistula. In total, an estimated 100,000 women in Ethiopia currently suffer from this condition, with an additional 9,000-10,000 new obstetric fistula cases developing each year. Although the fistula hospital is able to treat 1,200 women per year, thousands of other women remain untreated. Many women, particularly in rural areas, are often are unaware that their condition can be cured.
Obstetric fistula is a small tear in the bladder and/or rectum caused by the physical strain that women experience during prolonged labor. This happens for many reasons including the delay in accessing adequate medical treatment, the unavailability of Cesarean section, and women‘s inability to make decisions regarding her reproductive health and childbirth. It is not uncommon for girls to be married at a young age and forced into pregnancy when their bodies are underdeveloped. Often, the baby dies in the process of prolonged labor. Women’s bodies may also be put under strain due to inadequate development stemming from chronic malnutrition. Traumatic fistula, a less well known and less studied phenomena, occurs as a result of severe physical trauma during rape. Traumatic fistula often goes unreported, due to the shame and stigma surrounding sexual assault.
Fistula sufferers leak urine and/or fecal matter, resulting in an offensive odor. It is difficult for sufferers to keep themselves and their homes clean; it is often impossible for them to work. As a result, fistula sufferers may be ostracized by their families and communities. If a fistula sufferer is fortunate enough to hear about the possibility of treatment and access the money to travel to Addis Ababa, she may be able to seek treatment at the fistula hospital. By this point, the sufferer has endured not only the trauma of labor, but often the stillbirth of her child and rejection from her community.