Challenging the Taboo of Obstetric Fistula

L'organisation mondiale de la sante estime qu'entre deux a trois millions de femmes et de filles souffrent de la maladie de fistule obstetrical en Afrique sub-saharienne et en Asie.La fistule obstetricale est la constitution d'une ouverture anormale entre le vagin et le rectum et entre la vessie et le vagin survenant a la suite d'une grossesse complique et prolonge.la femme n'est plus capable de retenir ses urines et ses defections.

Au Burkina Faso elle est communement appele maladie de la honte et les femmes qui en souffrent sont souvent marginalisees par leurs familles et la communaute,elles sont incapables de travailler a cause d l'handicap et la mauvaise odeur provoques par le fait qu'elles n'arrivent plus a contenir leur vessie ou  leur selles ou les deux en meme temps.Elles sont largement blamees a cause de cette situaton,aussi parce qu'il ya un manque de connaissance a propos du traitement medical de la fistule obstetricale.Dans beaucoup de cas cela conduit a des troubles  emotionelles des femmes    et les taux de depressions et de suicides sont eleves.

La condition peut etre prevenue plutot par des soins prenataux accessibles et abordables et plus de 90% des cas de fistules obstetricales peuvent etre soignes par une operation chirurgicale basique,aussi en fesant une large diffusion de campagne de prevention dans les communautes rurales au Burkina Faso.

La fistule obstetricale est l'une des grandes causes de mortalite infantile,et en faisant notre campagne de sensibilisation nous contribuons enormement a l'atteinte des objectifs de AVO qui est d'aider le femmes et les orphelins dans la communaute.nous etions determines a rendre justice aux femmes et a apporter notre contribution pour rompre le mystere et les stigmates de cette maladie.

Quand nous sommes arrives a Nadiala nous avons recu un acceuil chaleureux de la part du representant charismatique de la communaute.un cercle de femmes et d'hommes s'est forme autour de nous et nous avons commence notre presentation en fabriquant du savon liquide,car nous avons remarque que  cela nous permettait de nous familiariser avec les habitants des village lors de nos precedentes sensibilisation.

Pour la premiere fois,les volontaires britaniques etaient capables de presenter un sujet en langue nationale moore et les volontaires burkinabes ont montrer aux habitants de Nandiala les methodes de prevention et de traitement telles que les visites medicales regulieres pour les femmes enceintes,augmenter l'age des premieres naissances et  faire accoucher les femmes dans des centre de sante.l'audience est reste attentive et receptive a notre presentation a travers leurs interrogations et leurs apport aux reponses.

A la fin de notre presentation nous avons prie les villageois de bien vouloir partager l'information avec toute la communaute .Pour plus d'information les femmes nous ont pose des questions sur le planning fammilial et la contraception et ont montre le desire de reduire leur maternite preuve qu'elles ont compris les risques et le stress que cela peut avoir sur leur corps.

La sensibilisation a Nandiala a ete d'une grande reussite a telle enseigne que nous avons recu quatres poulets en guise de remerciement.Nous avons partage un moment de triomphe avec tout le groupe et c'est avec une grande satisfaction que nous avons regagne la ville de Koudoudou.

Il etait evident que la communaute a apprecie le fait que nous avons quitte la ville pour venir nous entretenir avec elle.La campagne de sensibilisation entrait directement dans le cadre d'accomplissement des objectifs de AVO en touchant les femmes des communautes environnantes de la ville de koudougou,en aidant egalement a ameliorer les connaissances sur les soins prenataux et en mettant en relief l'accessibilite de la chirurgie et brisant l'aspect tabou et honteux de cette maladie.

 

The World Health Organisation estimates that between two and three million women and girls suffer with an Obstetric Fistula across Sub-Saharan Africa and Asia. An Obstetric Fistula is a hole between the vagina and rectum or bladder that is caused by prolonged and obstructed labour. It leaves the woman incontinent with urine or faeces or both.

In Burkina Faso it is commonly referred to as a 'shameful illness' and women who suffer from Obstetric Fistula are often ostracised from their families and communities, unable to work due to the handicap and smell that comes with incontinence of the bladder and bowel or both. They are largely blamed for having the condition, as there is a lack of knowledge about the medical causation of Obstetric Fistula. In many cases this leads to emotional turmoil for the women and the rates of depression and suicide are high.

The condition can be prevented with accessible and affordable midwifery care and a staggering 90% of all vaginal fistulas can be repaired with basic surgery, making the widespread prevalence of this condition in Burkina Faso's rural communities all the more disturbing.

Obstetric Fistula is one of the highest causes of maternal mortality, making our awareness raising very important to the aims of AVO to support orphans and widows in the community. We were determined to do the women justice and make our contribution to challenging the taboo and stigma that surrounds this condition.

We arrived at the rural village of Nandiala and received a warm welcome from the charismatic representative of the community. A crowd of women and men formed and we began our presentation by making liquid soap, finding that it had been a good ice breaker at previous awareness raising sessions. We were encouraged that the women and also one man from the crowd was keen to try mixing the soap and had six women assist in the preparation of the soap.  

For the first time, UK volunteers were able to introduce topics in the indigenous language Moore and the Burkinabe language. We shared vital prevention and treatment methods such as regular visits to the clinic during pregnancy, increasing the age of first pregnancy and hospitalisation when labour complications arise. The audience kept close attention and were receptive throughout their explanations, highlighting how important talking openly about the condition is.

As the presentation came to an end, we were thanked for sharing the information with the community and broad questions were asked. Most notably, the women asked for further information about family planning and contraception, showing a desire to reduce the amount of children they bare, understanding the stress and risk it can pose to their bodies.

The success of Nandiala's awareness raising was shown as the community presented us with a thank you gift of four chickens. We shared a moment of triumph as a group and departed in high spirits on our bus back to the city.

It was clear that the community had appreciated the time we had taken to travel to their community from the city. The awareness raising had directly helped the aims of AVO's by reaching women from the wider, rural Koudougou communities, helping to improve their knowledge on midwifery care, highlighting the accessibility of surgery and challenging the taboo and 'shame' that surrounds the illness.

Words by Kiera
Translation by Cheick
Photographs by Rubaiyath, Rebecca and Nelly 

Putting the 'forest' into 'Reforestation'

Situé environ 12 km à la sortie Est de Koudougou, Doulou est une ferme d’AVO. C’était notre deuxième sortie à Doulou et nous étions motivés. Nous partîmes à vélo avec de l’eau dans les gourdes malgré quelques difficultés rencontrées, le mauvais état de la route, les secousses et la chaleur mais nous avons gardé le moral haut et un meilleur esprit d’équipe.

Ce jour trois volontaires étaient malades, le début était difficile, sous un soleil ardent nous nous désaltérions á chaque fois que nous pouvions. Cela nous a permis de nous surpasser, après avoir pédalé environ 45 minutes, nous arrivions á Doulou. Le sentiment de parcourir une immense distance était achevé.

Notre tâche était de reboiser le champ de Doulou avec les pépinières. La vente des produits de ces plantes permettra à AVO d’améliorer plus précisément les conditions de vie et l’éducation des veuves et des orphelins. L’objectif premier d’AVO et ICS étant d’impacter dans la continuité, il est important que les volontaires mettent en pratiques un plan de continuité. Ces plantes sont aussi excellentes comme source de nutrition en protéine, vitamine B6 et E et acide amine et aussi pendant la grossesse. Malgré la température et les contraires de temps qui étaient les barrières qui causent le ralentissement de travaux, nous étions animés d’une grande volonté de mener cette action de développement. D’une manière générale, Doulou bénéficie de terres fertiles et la ferme de AVO ne fait pas exception. Cependant, travailler la terre peut etre difficle et nous avons apporté notre aide en mettant en terre 50 anacardiers.

Novices, nous étions venus dans un grand esprit positif. Aidé par le fermier du champ, nous avons creusé des trous espacés de 10 mètres. Le travail a été fait avec beaucoup de soin car les plantes étaient très petites et fragile.  Nous avons fini le travail avant le temps de déjeuner. Le retour était difficile à cause de la fatigue, le ventre creux, nous étions regroupés pour revenir. Cependant nous nous sommes arrêtés pour une pause dans un atelier de peinture que nous avons admiré et encouragé ses travaux.

De retour à AVO, nous étions animés d’un sentiment de grande satisfaction car notre but de la journée a été atteint.  Cette expérience nous a permis de comprendre combien les travaux champêtres sont pénibles pour les personnes qui exercent ce métier  dans les zones rurales.

Doulou is the AVO owned farm 12km outside of Koudougou, where AVO produces crops and animal produce to sell for profit. This was our second trip to Doulou, and twice as exciting! There’s something about riding our bicycles on the bumpy (ok, pot-holey), windy, orange tinted backstreets of Burkina Faso that is very exhilarating. Maybe it’s the cliché wind in our hair or the tough workout and humid heat drenching us in our own sweat (a bucket shower's worth), but for many of us it has been the best part of volunteering so far and boosts morale for the whole team.

With three volunteers down due to illness, the cycle there was no easier than the first time. You cannot hide from the heat of the African sun- how much water can we fit in our baskets? For those that don’t regularly do exercise it was increasingly tough, combined with the bicycles breaking down at any time they feel like (I guess they’re tired too?) it makes a worthy challenge. We got there in 45minutes, and we had never been so delighted to see the sign to Doulou (que, cheesy sign pic). The feeling of achievement is immense!

Our task at hand was to help the farmers at Doulou reforest the land with cashew plants. These plants will eventually grow into cashew trees, producing cashew nuts which will provide a sustainable income for AVO to further improve the livelihoods and education of widowed women and orphaned children. Sustainability is a primary goal of AVO and ICS; it’s important that the volunteers implement structures, ideas and projects which can continue after we have left. Cashew nuts are also an excellent source of nutrition, containing: protein, fibre, vitamins b6 and E, folic acid (essential during pregnancy), and good fats. Doulou has a lot of fertile land and the farm at Doulou is no exception, however working all of that land can be difficult which is where the volunteers come in, with our help we were able to plant 50 cashew trees.

We arrived in great spirits (exercise euphoria, dehydration, or delirium, who knows?) and were greeted by many farmers to show us how it’s done. We were given a wheelbarrow of cashew plants, and measured out 10 metres between each plant (these trees get BIG). The farmers are so skilled; they’ve been doing this work since they were very young so they flawlessly dig holes all day in the scorching heat. Despite the heat, all the volunteers had a go and were practically fighting over who could plant next. We finished the work around lunchtime, feeling like the robin hood of plants, giving the team a great boost. We were ravenous for some food, but first the 12km home was needed. This was difficult; two bikes had flat tires and proved that hanger is real. Some of us swapped bikes for those who were struggling and soldiered on home (now that’s teamwork!). On our way, we spontaneously passed a painter who was very keen for us to see his artwork; tired, hungry and knackered we were initially hesitant. However, seeing his paintings was the pick me up we needed after such a long day and we all bought some beautiful pieces, wishing we had brought more money for more.

We got back to the AVO office feeling very pleased with our day’s work and got an insight into how hard farm work is for the people who do this every day to make a living.

 

Words by Saffron
French translation by Rony
Photographs by Saffron, Aisseta and Rubaiyath