By Pemphero Malimba:
Malekano Dalikeni endured a difficult three years alongside his wife, who suffered from obstetric fistula from 2020 to 2023.
The World Health Organisation (WHO) defines obstetric fistula as an abnormal opening between a woman’s genital tract and her urinary tract or rectum.
The development of obstetric fistula is closely linked to one of the primary causes of maternal mortality: obstructed labour.
According to the WHO, women with obstetric fistula experience persistent incontinence, shame, social isolation and health issues.
The WHO recently reported that at least 100,000 new cases of this condition occur globally each year.
Dalikeni, from Khwathali Village, Traditional Authority Chakhaza in Dowa, can be seen as a man who truly honoured his marriage vows, pledging to stand by his partner through adversity.
His wife started experiencing fistula in January 2020 during the delivery of their first child at Kasungu District Hospital.
Despite the surgery, the condition persisted and she was eventually discharged from the hospital.
As the condition worsened at home, Dalikeni remained steadfast in his support.
“I took on all the household chores as she was unable to do any. I understand that many men might not cope with such a situation but I stayed with her because I wanted us to find a lasting solution together,” he recalls.
Dalikeni remembers the stigma and bullying his wife faced from other women in their village.
“She was subjected to cruel name-calling because of her condition. I encouraged her to keep hope alive, believing that every problem has a solution,” he says.
Dalikeni took his wife to a nearby health facility, which referred them to Kamuzu Central Hospital in Lilongwe.
There, they were directed to the Fistula Centre at Bwaila District Hospital, where surgery was scheduled for May 4, 2022.
However, they were informed on the day of the procedure that the facility was not operating fully due to Covid restrictions.
“We returned home, worried about my wife’s continued suffering,” Dalikeni says.
His wife, Alifonsina Sankhulani, remembers her husband’s constant encouragement.
“He was always there for me, urging me to remain hopeful and believe that one day the problem would be resolved,” Sankhulani says.
The couple persevered until April 2023, when Sankhulani returned to the Fistula Centre at Bwaila District Hospital.
“We decided to go back. Doctors operated on May 2, 2023, and I was discharged on May 18, 2023. It felt like a dream but it was real,” she adds.
Sankhulani is now overjoyed and grateful to her husband.
And Dalikeni is proud of her recovery and pleased that she has returned to her previous routines.
“Despite the loss of our stillborn baby during her delivery, we are relieved that she is well now and are looking forward to our future together,” he says.
The Government of Iceland, through the Government of Malawi and United Nations Population Fund (UNFPA), has been supporting efforts to end this health condition.
To date, at least 6,000 women in the country have been successfully treated.
Country Director of the Fistula Centre Malawi Programme, Margaret Moyo, has pledged continued efforts to treat more women.
Moyo says the centre at Bwaila District Hospital repairs about 350 women annually.
“We are continuing our prevention messages and intensifying our efforts. We are engaging various stakeholders to disseminate information and ensure that women understand the causes of fistula and know where to seek treatment,” Moyo adds.
She identifies inadequate resources for health personnel and frequent staff transfers as key challenges in their fight against fistula.
“Training health personnel takes time and resources. We need the ministry to assign passionate and dedicated clinical officers and nurses to the fistula care centres,” Moyo explains.
UNFPA Deputy Representative Ezizgeldi Hellenov reaffirmed the agency’s commitment to improving the health and dignity of women and girls.
“Through strong partnerships and the leadership of the Ministry of Health, we aim to achieve the ambitious goal of eradicating obstetric fistula by 2030,” Hellenov said.
Deputy Minister of Health Halima Daudi highlighted ongoing initiatives to defeat fistula, including capacity building for health personnel.
“The most important thing is to encourage women to visit health facilities for treatment. Fistula is treatable and early diagnosis is crucial,” Daudi advises.
Currently, there are approximately 20,000 women living with obstetric fistula in Malawi.
