GNA Feature by Michael Foli Jackidy
Ho (V/R), Aug 11, GNA –The contours of her jaw line, once pleasant to men and a head gear could only be imagined as a beam of sun light pieced her almost shut window.
Ever since she had fistula, she has secluded herself from society and even family in order to avoid finger pointing and holding of noses when she is around.
Mavis, a 22-year-old fistula patient, hails from Sogakope in the South Tongu District of the Volta Region.
Tears blinded her as she shared her harrowing experience, recounting how obstetric fistula has ravaged and disrupted her life.
Once a vibrant seamstress, Mavis said the condition left her distraught and isolated for over three months due to the constant leakage, engulfing stench and associated stigma. She could not continue her work or even maintain close contact with family, friends and customers.
“I felt hopeless, the reek, my inability to withstand it,” she said. “I had no money to seek treatment and was too ashamed to even leave my home, deepening my woes. At a point, I thought of giving up on life.”
Mavis’ turning point came, when a radio advert indicated that the Ho Teaching Hospital (HTH) was to host fistula repair surgeries, free of charge at the facility, somewhere this year. She appeared at the facility courtesy financial support from family members, where the surgery was eventually performed successfully.
She is optimistic of resuming her dressmaking venture and return to normal life while passionately urging women experiencing similar symptoms not to delay seeking medical help.
“Don’t hide. Go to the hospital as soon as you notice something is wrong. There is help, and the treatment is free,” she advised.
Gertrude, another 20-year-old fistula patient, who was also ostracized and eventually losing her marriage due to the overburdening financial implications of the unpleasant condition, has become a beneficiary of the free treatment regime.
She has recovered fully and beaming heartily, away from name-calling and stigmatization.
Their recovery is a testament to the importance of access, awareness, and support for women suffering obstetric fistula in silence.
Thousands of women, like Mavis and Gertrude suffer from Obstetric Fistula across the Volta region, and Ghana, at large, and continue to live in silence and agony due to deep-rooted societal stigma, judgement and lack of financial resources, despite free repair services provided by the Ghana Health Service (GHS) and development partners through international initiatives.
What is Obstetric Fistula
Obstetric Fistula remains a severe maternal health condition resulting from prolonged or obstructed labour, where the baby’s head during delivery compresses soft tissues like the bladder for too long, often without timely medical intervention, creating an abnormal hole between the birth canal and the bladder or rectum, leading to uncontrollable leakage of urine and/or faeces.
The condition is most common in areas, where access to skilled birth care is limited.
Though preventable and treatable, societal neglect and systemic health gaps continue to endanger the lives of women.
A timely cesarean sections can prevent it, but many of these women deliver at home or in facilities without surgical capacity, compounding the situation.
Professor Wisdom Azanu, a Consultant Urogynaecologist at the Ho Teaching Hospital, told the Ghana News Agency (GNA) that, while Ghanaian women have relatively high attendance at antenatal clinics, the challenge arises during delivery.
“Many still opt for traditional birth attendants due to mistrust of health facilities or fear of being mistreated by healthcare workers.”
Even when diagnosed, most patients live in remote areas and isolated from treatment due to difficulties of transportation to regional centres like the Ho Teaching Hospital, which serves Volta, Oti, and parts of the Northern Region.
“They may receive a referral from a health facility, but if they can’t afford the trip to Ho, they simply stay at home. We often rely on community health nurses or public health officers to identify and help mobilize these women, but funding for such outreach is limited. “Prof. Azanu told GNA.
The GNA’s visit to the Fistula Ward at the Ho Teaching Hospital (HTH) on May 23, which marked the International Day to End Obstetric Fistula, revealed only six patients on admission.
Healthcare professionals expressed concern about the low turnout, repairing only 10 cases from January till July, 2025, which they attribute to both stigma and cost.
Prof. Azanu confirmed that even though there is a team of trained specialists and the equipment at the hospital, the number of women seeking treatment is low.
“The challenge is not just awareness. It’s about actively going into communities, identifying patients, and helping them to get here. Mobilization requires money,” he added, saying patients only accessed treatment due to direct intervention or emergency referrals.
According to medical protocol, once a fistula is identified, doctors assess the surrounding tissue and while some surgeries are straightforward, others are complex and require multiple procedures.
Despite all this, the repairs have a high success rate. Most women recover fully and usually return to a dignified life.
Mrs Stella Mawutor, Volta Regional Director of Department of Social Welfare, urged the public to abandon the myths surrounding fistula patients based on social and cultural grounds.
“In many communities, sufferers are accused of witchcraft or immoral behaviours and are ostracized by their families.”
“Traditionally, many communities still believe, pregnant women must endure birth pains during delivery and treats such abnormalities as normal phenomenon, which compounds the situation.”
“These women did nothing wrong. They got pregnant and attempted to give birth I am appealing to the chiefs, queens, opinion leaders, Assembly-members, NGOs and the media to join the advocacy drive to lessen the burden on fistula patients, when there is a free treatment regime.”
World Health Organization Data
According to the World Health Organization (WHO), an estimated 50,000 to 100,000 women around the world are affected by obstetric fistula each annually.
Globally, it is estimated that over two million young women are currently living with untreated obstetric fistula, particularly in Asia and sub-Saharan Africa.
However, obstetric fistula is largely preventable as WHO notes that the condition could be avoided through, delaying the age of first pregnancy, Ending harmful traditional practices, and Ensuring timely access to quality obstetric care.
Efforts to prevent and manage obstetric fistula not only reduce maternal deaths and suffering but also support the achievement of Sustainable Development Goal 3 (SDG 3), which aims to improve maternal health.
Obstructed labour, the primary cause of obstetric fistula, accounts for up to six per cent of all maternal deaths and remains a significant contributor to both maternal mortality and morbidity worldwide.
The Ghana Health Service, in collaboration with the United Nations Population Fund (UNFPA), the WHO, and the Ministry of Gender, Children and Social Protection, continues to work towards the global goal of ending Obstetric Fistula by 2030.
These efforts include education campaigns, community mobilization, and the provision of free surgeries. However, stakeholders say more needs to be done — particularly in financing transportation and strengthening community-based identification systems.
“It’s not just a health problem — it’s a social justice issue.” Prof. Azanu stressed. “We need more trained fistula surgeons, more centres across the country, and better support systems to ensure that no woman suffers in silence.”
He called on the public, local leaders, NGOs, and the media to help raise awareness and ensure that even women in the most remote communities are not left behind.
“If you know any woman who is leaking urine or faeces after childbirth, don’t hide it. Refer them to the nearest health facility. From there, they can be linked to centres like ours for free repair and support.”
Ghana’s Situation
Research indicates that approximately 1,300 new cases of Obstetric Fistula occur in Ghana annually, with an incidence rate estimated between 1.6 and 1.8 per 1,000 births.
However, despite the increasing number of cases, only 50 to 100 repairs are conducted each year—leaving a significant treatment gap and thousands of women living with the condition.
Compounding the challenge is the lack of recent national data. The most comprehensive assessment remains the Ghana Health Service (GHS) 2015 report, which put Obstetric Fistula cases between January 2011 and July 2014.
During that period, a total of 1,538 women were diagnosed, out of which 487 cases were referred to other health facilities across the country.
In terms of surgical interventions, 616 repairs were successfully conducted nationwide during the same period—representing 40.1 per cent of the total cases.
The findings highlight the urgent need for: Increased investment in Fistula repair services.
Wider awareness campaigns to encourage early reporting and reduce stigma should be all encompassing with conscious efforts on updated nationwide data collection to better inform healthcare planning and resource allocation.
It is imperative, without targeted interventions, many women will continue to suffer in silence, facing not only physical trauma but also social exclusion and emotional distress.
Obstetric Fistula treatment is available in all major teaching hospitals in Ghana, including those in Tamale, Cape Coast, Kumasi, and Ho, but many more repair centres are needed to reduce the burden on patients and their families.
As Ghana aims to meet the 2030 target, the lives and dignity of countless women depend on breaking the silence, removing the stigma, and ensuring access to life-restoring care.
GNA
Edited by Maxwell Awumah/ Samuel Osei-Frempong