A midwife saves the day
She was becoming more accepting of the condition and the fact that there was no treatment. She had given up all kinds of hope to find a cure or treatment. It was not until she went to the midwife in her area to seek advice to cope and live with her condition. “she was my last resort and my only hope.”
Fortunately, the midwife, Na’ama, in Marwa’s village had received support and training from one of the UNFPA funded programmes. Na’ama had undertaken a special community care programme that trains midwives on detecting and preventing obstetric fistula during pregnancy and childbirth.
The midwife, Na’ama, knew through training of an existing support mechanism funded by UNFPA and managed by the National Midwives Association, which treats obstetric fistula. Na’ama refers cases to the Association.
“Na’ama gave me hope to live life again. She showed me that I was not the only one who suffered from this condition. She told me that my condition was treatable and I could undergo surgery for fistula in Yemen.”
Upon confirming the diagnosis, Na’ama contacted the National Midwives Association and placed Marwa on the waiting list to undergo surgery.
“I was in continuous communication with the Association. One day they called me and asked me to travel to Sana’a within a week.”.
It was not an easy task to make it to Sana’a from Al Hudaydah. It was not a trip Marwa could afford; she had spent her savings searching for treatment. She received no financial backing from the family or former husband.
“I was not able to borrow money from anyone. People could hardly make ends meet because of the war.”
The number of fistula cases continue to rise in Yemen; five years of conflict has bought the health system to the verge of collapse, skilled birth attendants are limited, levels of malnutrition are rising, particulalry among pregnant women, and alarming rates of child marriage as means to cope with the economic hardships brought about by the conflict all contribute to increased cases of fistula.
UNFPA has supported the establishment of three fistula units across the country. Between 2018 and 2019, more than 100 fistula surgeries were successfully treated free of charge. UNFPA is also helping to build skills of health personnel in treating obstetric fistulas with advanced training. In addition, UNFPA has created and strengthened a network between community volunteers, community midwives, reproductive health and fistula experts countrywide to help women suffering from fistula get the services they need, including providing free transportation from rural areas.
The UNFPA-supported fistula programme covered all of Marwa’s travel expenses.
On the way to Sana’a, Marwa was accompanied by her sister to look after her and the baby; she was also accompanied by her male cousin, since women often need a male guardian to travel within the country.
At the obstetric fistula centres at Al Thawra Hospital, Marwa found many other women who were suffering the same fate. She stayed in the hospital for more than a week, and underwent a successful surgery. Since then, Marwa returned home in Al Hudaydah and resumed her normal life.
For the first time since his birth, Marwa is able to embrace her baby and life again with joy. “I forgot all the pain I had gone through. I just felt joy and happiness,” she said with a smile.
*Name changed to protect privacy
