In search of fistula cure amid Covid-19


Motherhood is said to be joyous; yet sometimes complicated and deadly. The latter is the case for a 20-year-old woman who has been confined to her house for about a year now, REBECCA CHIMJEKA writes.

From a distance, 20-year-old Alinafe Jason from Nkhoma in Lilongwe looks a happy woman, with everything about her being at perfect peace with nature.

But a closer look at her exposes a miserable life for the woman who has been leaking urine and excreta from the time she gave birth to a baby boy last year.


She has a medical condition known as obstetric fistula. A hole developed in her birth canal during childbirth resulting in incontinence of the human waste.

The condition has almost completely chained Jason to her home as she cannot stomach the ridicule from people who would grimace at the smell flowing from her privates.

“If I want to go out, I have to place rags in my underwear to stop the urine and faeces from running down my legs,” says the crest-fallen Jason.


Her legs are covered with sores from urine burns.

Like many other women in rural areas in Malawi, Jason started off for the hospital to give birth a bit too late.

“I went to the hospital three days after my labour pains had started. When I got to the hospital, which is about 30 Kilometres away, I gave birth to a baby boy,” she recalls.

Her ‘bundle of joy’ died before she could even hold him in her motherly arms. Afterwards, she realised she could no longer hold urine and excreta.

Then, while listening to a local radio station, she heard about a foundation that was assisting women and girls with fistula where she learnt several of those who had sought the foundation’s help had totally been cured.

“I told my parents and elders in the village about the foundation. They contributed money to facilitate my trip to Bwaila Hospital where I was on the waiting list to be operated on,” Jason explains.

After being admitted to the hospital in February this year, it was her hope that she would smile again as the following month would be her turn to go under the knife.

Her joy was short-lived.

The emergence of the Covid-19 resulted into the closure of the ‘fistula treatment section’ at the hospital, sending Jason home without having her condition repaired.

“I was waiting for my day of freedom. What I got was doctors telling us that we should be getting prepared to return to our respective homes as the section for fistula patients was to be turned into a Covid-19 treatment centre.

“I literally cried. The shame that had shrouded me due to my condition would continue until I got helped. I don’t know when that will happen,” Jason says, her head clasped in her palms.

Just like many other women who had faith in the government hospital, Jason cannot afford to pay for her treatment at a private facility.

Thus, she is confined to her home at Nkhoma without any hope of when she will be operated on. Urine and faeces keep flowing down her groins.

Lilongwe District Director of Health and Social Services, Alinafe Mbewe, said she is not sure when the ‘fistula section’ will start serving patients like Jason again.

“The issue is being discussed at the highest level. The Secretary for Health and other stakeholders are still discussing the way forward,” Mbewe said.

That hundreds of women have had their fistula conditions repaired has somehow been offering some hope to Jason. On the other hand, it also tells a story of how big the problem is in the country.

In 2018 and 2019, 403 and 418 women respectively smiled again after their conditions were repaired.

And international institutions such as United Nations Population Fund have been calling on all stakeholders in the health sector to redouble their efforts to end obstetric fistula in the country.

They want collective interventions in preventing more women from enduring this devastating injury.

The United Nations General Assembly, in its resolution 69/148 of December 2014, also called upon all stakeholders to triple efforts to meet the internationally agreed goal of improving maternal health by making relevant services accessible by all.

Such calls can only be seen to have been heeded if women such as Jason have their conditions treated so that they can once again bask in the glory of a body that is not emitting any bad smell.

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