I lost both of my parents when I was very young and I started living with my aunt. Around the age of 16, my breast was rounded and fully developed; my aunt saw this and told me she is marrying me off so I will not get pregnant out of marriage and heap shame on her.
They forced me to get married to a man I never liked and a couple of months after the marriage I was pregnant for him.
When the time came for me to’ put down’ I had enormous pain and I could not go to the health center which was very far from Fanima Wonde in Bo, the village were I was living.
My aunt took me to an elderly woman whom they say has experience in child birth.
She tried and the baby’s head started coming out but got stuck halfway.
The Woman tried everything but was unsuccessful so she told us to go to the big hospital in Bo.
I was placed in a hammock and we started the journey to the big hospital.
Halfway into our journey the child came out suddenly with heavy force.
Since then I cannot control my urine from dripping out and also my stool (excreta) – I was also paralyzed. The husband they forced me to marry abandoned me because of my situation.
All of this happened in 1991.
I continued to live with the suffering and shame until 2005 when Mercy Ship fixed me up.
Like Augusta Koroma, hundreds if not thousands of girls and women in Sierra Leone are living with fistula.
This condition has been blamed to a large extent on the poor and unaffordable health service delivery in the Country.
Sierra Leone continues to stand on the bottom rung of the human development ladder because of the high rate of pregnancy related deaths each year. Yet the deaths are just the tip of the iceberg: For every death, at least 30 more women suffer serious illness or debilitating injuries.
According to Justin Hane the Public Relations Officer of Mercy Ship in Sierra Leone, Fistula is an abnormal opening between the vagina and the bladder or rectum (or both) that results from extreme pressure and tissue damage during prolonged or obstructed labor, when the fetus will not fit through the mother’s pelvis. If a Caesarean section delivery is not available to end the ordeal, the baby is usually stillborn and a fistula forms, permitting the uncontrollable passage of urine and excreta into the vagina.
Coomber Koroma (26) a victim of this ailment, says that Fistulas can abruptly transform young women on the threshold of motherhood from objects of societal admiration into pariahs shunned by even their own families.
She recalled when she had the problem and lost her baby; how her husband abandoned her to live in isolation for almost 5 years – leaking urine – before Mercy ship came to her rescue.
She maintained that she developed fistula because she was poor and could not readily afford the costly medical service available. Coomber, whose condition has now been rectified by the clinic, is now working for Mercy Ship, helping other girls like her.
Because the women with fistula uncontrollably leak urine and excreta a foul odour usually accompanies them wherever they go. It is this smell which principally leads to their being ostracized (cast out) by their husbands, family and friends, condemning them into a life of destitution.
The ailment is more prominent among very young women delivering their first born; women whose growth has been stunted because of poor nutrition or childhood illness, and women in rural areas.
The Mercy Ship PRO could not give an estimated number of women who suffer from fistula but pointed out that they are in the hundreds and scattered all over the country.
He blamed the lack of professionalism, high cost for birth delivery as being responsible for pushing the pregnant woman to Traditional Birth Attendants (TBA) who mostly could not handle all the complications surrounding child birth. “TBA’s sometimes sit on the chests of pregnant women to push the baby out of the womb during labour” Mr Hänes revealed. Explaining her own ordeal Coomber said that the doctor was forcing the baby out of her womb with something they called forceps for the three days she was in labour and when the doctor was unable he abandoned her in the hospital. Coomber said that amidst all this the doctor was asking for money.
When she finally gave birth to the baby it was already dead but she also developed fistula.
“I went to Good Shepard Clinic and they did surgery to rectify the problem after I paid thre hundred and fifty thousand Leones. The operation was not successful and I had to go back for another operation which was also unsuccessful.” Comber related. She went on “I was already resigned to my fate when Mercy Ship came in 2005. I went there and was surprised to discover that it was completely free, they also gave us free meal three times a day and all the doctors and nurses were very nice to us. It was completely different from the other services I had and all of it was free.”She had the surgery and it was very successful – Hänes said she was one of their first patients in the clinic.
Smiling with joy Coomber showed me her two-year old baby which she got a year after her fistula operation.
Augusta Koroma had relied on Traditional Birth Attendants in her village which never worked. She lost the baby and developed fistula, and even when she went to the big hospital in Freetown they could not help her, even after she had paid money for treatment.
The issues of high medical service and lack of professionalism continue to condemn more and more women to fistula forcing them to live destitute lives of rejection. “Sierra Leoneans have to know in the first place that health is a right” said Charly Cox, the Information & Training Adviser of Save the Children, an organization now pushing for free health services in Sierra Leone for Women and children.
In her view, if there was this awareness among Sierra Leoneans then people will start asking the right questions about their access to health and government will start listening and prioritize health service delivery.
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