In Zimbabwe’s remote villages, a silent epidemic is affecting countless women. Obstetric fistula, a debilitating condition characterized by continuous urine leakage and an unpleasant odor, has impacted the lives of many, including 22-year-old Janet Munetsi. Since 2019, Munetsi has struggled with the condition, which began after she gave birth alone in her small village of Nyamhondo in Mberengwa, Midlands province.
“I had accepted my fate because I didn’t know what was happening,” Munetsi said. As an orphan who lost her parents under tragic circumstances, she now faces a different kind of tragedy that has stolen her dignity and left her isolated and desperate for attention.
Obstetric fistula, as described by the World Health Organization (WHO), is an abnormal connection between the vagina, rectum, and/or bladder that can develop after prolonged and obstructed labor. This condition leads to continuous urinary or fecal incontinence if not corrected. Globally, between 50,000 and 100,000 women are affected annually, with low-income countries in Africa and Asia bearing the brunt of the condition.
In Zimbabwe, the exact rate of obstetric fistula is unknown due to a lack of awareness and data. However, given the country’s high maternal mortality ratio, the prevalence is likely significant. The most recent Multiple Indicator Cluster Survey from 2019 highlights this issue, indicating a devastating maternal health situation.
Munetsi’s ordeal began when she went into labor alone while working as a caretaker on a farm in Masvingo. Without access to help or communication—her phone battery was dead—she endured labor throughout the night. The local hospital was too far to reach on foot, especially at night. “My body was weak, and I wasn’t in the mood to leave the house,” Munetsi recalled. The labor pains worsened around 11 p.m., but she had no way to call for help.
The next morning, a young boy came to her house looking for a lighter to make a fire. When he couldn’t find her, he told his mother, who rushed to Munetsi’s aid. She found Munetsi lying in a pool of water, exhausted from a night of intense labor. In a frantic rush, the woman took Munetsi to the hospital, only to find the maternal ward overflowing with patients.
“I couldn’t get admitted right away because the maternity ward was fully booked, and all the midwives were attending to other patients,” Munetsi said. Despite the chaos, she gave birth to a baby boy. However, this joyous moment was overshadowed by the onset of obstetric fistula, a condition she would silently endure for nearly a year.
Obstetric fistula not only affected Munetsi physically but also subjected her to societal stigma and misconceptions. Many people believed she was cursed. “I didn’t know that obstetric fistula was a medical condition that could be treated,” she said. Her situation changed when a young woman visiting her village for the holidays encouraged her to seek medical attention, leading to successful surgery at Parirenyatwa Group of Hospitals.
Amnesty International’s research underscores the limited access to maternal healthcare in Zimbabwe, exacerbating the issue. Many women and girls, especially in remote regions, have little to no access to essential maternal health services. “Our research has revealed that obstetric fistula appears to affect the most marginalized members of society: poor, young, and often illiterate girls and women in remote regions of the country,” said Roselina Muzerengi, campaigns coordinator at Amnesty International. “Access to maternal health is limited as most people live far from public health facilities.”
Mercy Rukudzo, another sufferer from Chirumanzu in the Midlands province, has endured the misery of obstetric fistula. “I’ve had genital sores for two years, and the wetness stops them from healing,” she said. Fear of public shame has kept her isolated. “The last time I attended a function, the terrible odor made people shy away from me. It repulsed them.”
Obstetric fistula, deemed the “most devastating birth injury” by WHO and the United Nations Population Fund, is treatable with high-quality care. However, Zimbabwe’s healthcare system is strained by economic challenges and inadequate funding. Daniel Molokele, chairperson of the Parliamentary Portfolio Committee for Health and Child Care, described the situation as dire. “The government has failed to assign sufficient resources to the health sector,” Molokele said. “Despite declaring a policy of free maternal services, implementation is lacking.”
The prevalence of obstetric fistula reflects a broader failure to provide timely, appropriate, and accessible maternal care, breaching women’s right to health. Molokele urged the government to fund and operationalize a comprehensive public maternal healthcare policy aligned with international standards.
The high cost of motherhood in Zimbabwe extends beyond physical suffering to social and economic dimensions. Women with obstetric fistula often face isolation, shame, and financial hardship. Addressing this epidemic requires a multi-faceted approach, including increased public awareness, improved healthcare infrastructure, and better funding.
In response to these challenges, organizations like Amnesty International and local NGOs continue to advocate for women’s health rights and provide support. These efforts are crucial in bridging the gap between policy and practice.
The silent suffering of women with obstetric fistula in Zimbabwe highlights the urgent need for improved healthcare infrastructure, awareness, and treatment. Addressing this epidemic requires concerted efforts from the government and the international community to ensure that women receive the care they deserve. The prevalence of this condition serves as a stark reminder of the broader systemic issues within Zimbabwe’s healthcare system. By taking decisive action, the government can help restore dignity and hope to countless women like Janet Munetsi and Mercy Rukudzo.
Source: Newsday
