Footsteps to Healing: About the Problem

A mother and her young son sitting in a patient care bed smiling
In Ethiopia there is a silent epidemic of women suffering from conditions related to complications of child birth such as obstetric fistula, urinary incontinence and pelvic organ prolapse.

An obstetric fistula is a hole that develops between the vagina and rectum or bladder due prolonged obstructed labor. This is primarily due to lack of access to adequate obstetric services. This injury, if left untreated, causes constant leakage of urine or feces, or both, resulting in social isolation, shame, psychological and physical trauma.While obstetric fistula is very rare in developed countries that have access to timely cesarean section or operative vaginal delivery, an estimated 8,000 new cases affect Ethiopian women every year. Contributing further to this burden is a profound shortage of trained obstetrician-gynecologists in Ethiopia.

More long-term consequences of obstructed labor may compromise pelvic floor support. This leads to pelvic organ prolapse, where organs within the pelvis or vagina such as the uterus, the bladder, or the rectum may protrude into the vagina and outside of the body. Because of a lifetime of heavy physical activity such as carrying water from the river, wood for fuel, or children, in addition to having multiple vaginal deliveries, Ethiopian women are at a high risk for pelvic organ prolapse and obstructed labor. If prolapse occurs, these women have difficulty emptying their bladder and bowels, engaging in normal physical activity, or being intimate with their partners.

Many women have little to no access to appropriate conservative or surgical management of this condition in Ethiopia. This is because, there are few to no health care providers specifically trained in pelvic floor reconstructive surgery in Ethiopia. Furthermore, the cost of surgery, even if it was available, is often prohibitive to most rural women who are extremely poor. 

These pelvic floor conditions are preventable and treatable. Join us in our mission to reduce the devastating physical, social, and psychological burden of these conditions on Ethiopian women.