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Today, Edina Japheth is the happily married mother of a young child. But just a few years ago she was treated as a pariah in her own village, rejected by her neighbours and her family because of an injury she sustained during childbirth that left her incontinent.
“I was fetching water by the river near my home when labour started. I went to see my aunt, who is a traditional birth attendant. At first everything was fine, but the labour went on for many hours. Eventually my aunt sent me to the nearest medical dispensary. They said they couldn’t deliver my baby either, and I was referred to the district hospital.”
Edina was rushed into surgery for an emergency cesaerian section, but by then it was too late. Her baby had died. Discharged from the hospital and still coping with the trauma of her loss, she discovered that she was wetting the bed and dribbling urine throughout the day. She was suffering from fistula, a hole that can develop between the bladder and the vagina during childbirth.
“There was a smell that I couldn’t get rid of. People looked at me as though I was not a human being, and even my family started to keep their distance, refusing to eat with me because I was unclean. My husband rejected me. It was terrible.”
Edina suffered with the injury for three years, until she heard about the Ministry of Health and Social Welfare, Tanzania National Fistula Programme run in collaboration with AMREF and Women’s Dignity, a Tanzanian charity.
“Under this programme we now offer fistula repairs free of charge,” says Dr. Gaudens Konba. A gynecologist and obstetrician, Dr. Konba has received training from AMREF on three separate occasions and now works at a district hospital in southwestern Tanzania, where he performs the surgery on as many as 100 patients per year.
In 2008-09, AMREF and its partners trained seven doctors and eleven nurses and operated on 463 women in Tanzania — more than six thousand since the programme began, seven years ago. Fistula can be repaired with local anaesthetic and patients tend to recover quickly, making it a very effective medical intervention.
Edina was discharged after two weeks and went home to her family. A year later she was married to a young man in a neighbouring village, got pregnant, went straight to the district hospital, and delivered a healthy baby. She has put the years of stigma and discrimination behind her, but cannot forget them.
“When I think about the suffering of those years before, it seems very far away, but I think it is important that people understand that fistula is an injury, not a hygiene problem.”
In addition to our work with surgeons, AMREF is teaching midwives, traditional birth attendants, and other frontline health workers to identify labour complications and make quick referrals. We’re also educating communities about fistula to discourage stigma.
Our work in Tanzania is supported by the Federation of Gynecology and Obstetrics. | 
Dr. Asrat Mengiste examines some x-rays. Photo: Stevie Mann/AMREF
Goal 1: Train 100 health workersGoal 2: Reduce malaria prevalenceGoal 3: Improve borehole coverageGoal 4: Immunize 100% of kids
Project Photos & Video (to be added)
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