Felista’s Fable Shows a Woman Struggling with the Stigma of Fistula

3 September 2014 by Joe Dramiga, posted in Uncategorized

Felista’s Fable swept the second annual Uganda Film Festival Awards held on Friday. It took home the awards for Best Screenplay, Best Actor (Isaac Kuddris), Best Feature Film, Film of the Year and Director of the Year (Dilman Dila).

The film is about a woman struggling with the stigma of fistula, one of Ugandas least recognized problems. A woman which suffers from this childbirth injury is left with chronic incontinence and in most cases, her baby is still born. Unable to control her flow of urine or feces, she is often shunned by her local community because of her foul smell.

Obstetric fistula is mostly caused by prolonged obstructed labour and a small pelvis. During labour contractions, the baby’s head is constantly pushing against the mother’s pelvic bone damaging the tissue in this area due to lack of blood flow to this area. After several days of obstructed labour, the affected tissues die off and a hole develops between the bladder and birth canal (vesico-vaginal fistula) and/or the rectum and birth canal (recto-vaginal fistula) leading to permanent incontinence.

In most cases, the baby dies and the young mother is left suffering with severe physical, emotional and social consequences. Due to the constant leaking of urine and stool, the mother is likely to develop ulcerations in the vaginal tract and easily contract infections. She may become afflicted with a condition known as “foot drop”, making it difficult or impossible to walk because of extreme nerve damage to the lower limbs caused by prolonged squatting during labor.

Fiona Onyaka conceived after going through a traumatic experience of being defiled on the eve of her 15th birthday. She was a primary seven pupil. Unfortunately she lost her baby during delivery. Then a few days later, she discovered that she was passing urine and stool at the same time. She was forced to abandon her studies.

It is a similar story for Diana Mugisha: Mugisha was 17 when she got married and a year later the young couple was expecting their first child. The child died in the womb three days before it was removed, but not before it had damaged its mother’s uterus. Her husband abandoned her two months after the delivery upon realizing that Mugisha was suffering from fistula.

These girls suffer profound psychological trauma resulting from their loss of status and dignity in addition to their physical internal injury.

Obstetric fistula exists because health care systems fail to provide accessible, quality maternal healthcare, including family planning, skilled care at birth, basic and affordable comprehensive emergency obstetric care. Fistula is an indicator for the deteriorating reproductive health and rights situations of women in poverty stricken rural African settings.

Like maternal mortality, fistula is almost entirely preventable. It can be avoided by delaying the age of first pregnancy and by timely access to quality obstetric care. Women with uncomplicated fistula can undergo a simple surgery to repair the hole in their bladder or rectum. The treatment cures up to 90 per cent of fistula patients.

The end of anguish is in sight if we only start now.

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