Fighting fistula

Decades of conflict have torn South Sudan a part and women and children have paid a particularly heavy price. Rape has been used as a weapon of war and while men fight many women carry the day by day burden of taking care of their families. With one of the highest maternal mortality rate in the world becoming pregnant can also mean a death sentence to women specially in the most remotes areas of the countries. For each woman that dies in childbirth, an estimated 20 additional women suffer from devastating childbirth injuries like obstetric fistula (WHO 2014). Political instability, internal displacement, economic crisis combine with lack of access to health facilities, early marriage and teenage pregnancy have left thousands of women with obstetric fistula condition health groups estimates, officially there are no reliable statist on fistula rates in South Sudan. Unicef had reported that 52% of girls in the country have been married before 18 years old.


At Aweil State Hospital Ajok Athian, 18 years old cries on a bed while talking to a nurse. She has gone to a full fistula recovery surgery after complications during birth. Ajok had complications on delivery when she was in her village, her baby died during birth and the only help she got was from a TBA (traditional birth attendant) who didn’t had the knowledge required causing her the fistula. In a collaboration between the State Government, UNFPA (United Nations Populations Fund) and MSF a fistula campaign offered free corrective surgeries to 40 fistula survivors.  Many women suffer from the condition but most of them do not seek treatment because they being mocked by people in the area. Fistula survivors endure psychological trauma, depression, deteriorating health, increased vulnerability to poverty and social stigma from family and friends. Due to lack of access to treatment and associated isolation, many survivors tend to live with the condition for years or even decades.
Ajok Athian, 18 years old, recovering from a fistula repair surgery at Aweil State Hospital in Aweil, Northern Bhar El Ghazal, South Sudan. Ajok had complications on delivery when she was in her village, her baby died during birth and the only help she got was from a TBA (traditional birth attendant) who didn’t had the knowledge required causing her the fistula.
Patients recovering from a fistula repair surgery at Aweil State Hospital – South Sudan.
Women at the Aweil State Hospital after receiving fistula repair surgery.
Bakita Awein, 19 years old, at Aweil State Hospital in Aweil, South Sudan. Bakita is part of the more than 40 women’s who with the support of UNFPA received the fistula repair surgery. Bakita was on her first pregnancy when during labor her baby died and the fistula occurred.
Patient recovering from fistula surgery at the Aweil State Hospital in Aweil, Northern Bahr El Ghazal – South Sudan. UNFPA supported the action that made possible the reparation of more than 40 women’s.  Fistula survivors endure psychological trauma, depression, deteriorating health, increased vulnerability to poverty and social stigma from family and friends. Due to lack of access to treatment and associated isolation, many survivors tend to live with the condition for years or even decades.
Rebeka Abuk Kuol is a fistula survival she had the condition for more than 20 years. She was hit by a car in Kharthoum and suffered many injuries including the fistula. Often the only people who support a fistula survivor are the family members, Rebecca lost her husband and 8 of her 11 children.