Help for Malawi's victims of obstetric fistula

The condition is easily preventable, for instance, by switching to a cesarean during difficult birth. But in countries like Malawi, women often do not get help in time.

Malawi has one of the highestmaternal mortality rates in sub-Saharan Africa. Progress in this area is slow: a national health survey of 2015 shows maternal mortality fell from 675 to 439 per 100 000 live births in the space of five years. While the government in Lilongwe remains optimistic about its ability of further reducing the death rates, health rights activists are skeptical, seeing no serious commitment to the task by the authorities.

Women who survive complicated labor are often affected with obstetric fistula, a condition which makes their life miserable. At the Bwaila Fistula Foundation Centre over 300 women get surgical treatment for obstetric fistula every year.

A woman's hell

29-year-ol Beatrice Kumanje from Phalombe district is one such woman. Not only did she lose her child, she also lost her dignity. She lived with the condition for two years. Her husband divorced her and she could not attend social and religious gatherings. "At that time, I was always wet. I could not even walk or associate with anyone. I even stopped going to church. But now that I have had my condition repaired, I am able to move freely and go to church. I have gained a lot at this centre," Kumanje told DW.

Obstetric fistula is an injury women sustain during prolonged and difficult labor. Their baby's head exerts pressure on soft tissues creating a hole between the vagina and bladder or rectum. This results in a fistula which causes constant leaking of urine or feces through the vagina. Girls and women affected suffer immensely.

Pointing the finger at the authorities

In Malawi, complications resulting from child birth are rife among young girls due to high sexual activity among youths. Added to that, maternal mortality is high and worse in rural than urban areas. Activist Mathias Chatuluka, accuses the government of not allocating enough resources to the health sector: "We still experience inadequate access to services by women and then we have sometimes inadequate supplies in health facilities where women are supposed to deliver." According to Chatuluka, there is also a lack of qualified personnel among service providers.

This year, the government allocated ten percent of its budget to the health sector. Malawi signed the Abuja Declaration in which governments agreed to earmark at least 15 percent of their annual national budget into the sector.

And while maternal mortality has gone down, Chief Director of Health Services Charles Mwasambo admits that Malawi is still far from reaching the United Nation's Millennium Development Goal it was meant to meet by the end of last year. Mwasambo told DW: "As government we are not sitting back, we have put measures in place so that we don't lose women from preventable deaths."