Doctors restore dignity of the fistula patients after surgery

At just 24, Adut Bol, a mother of three has been through hell and back. She has been through the agony that typifies troubles that young mothers who develop fistula have to bear. It is a path that is filled with embarrassment and sometimes social alienation in some societies that least understands the condition.

But she and her uncle’s wife regained their dignity after undergoing a successful corrective operation at the Primary Health Care Centre of Reconciliation Lutheran Church earlier this week. 

She lay on her bed smiling in Juba and raring to forget her past as she thanked the doctors for the successful treatment. She was readying for a task: spreading the message to those suffering from the same condition.

“I shall spread the message. I shall find a telephone number of one of my relatives in Renk who has this condition to come to Juba for the operation. God says help me and I will help you. I thank Doctors and pray that God helps them,” she said wearing a bunch of recovery smiles.

Bol is just one of the patients that have passed through the hands of surgeons specialising in fistula operations, who joined hands under Evangelical Lutheran Church in America, started operating the patients in Juba on Saturday last week. 

Already four fistula patients operated on Saturday are recuperating at the facility.

Fistula is one of the infections where patients battle with uncontrolled passage of urine from the female genital organ and sometimes stool.

Like Bol, many patients looked at the positive things the future can offer and had binned their shameful past. 

They called upon the government to extend medical services to villages through the Primary Health Care Centre based in Mia Saba to combat this medical condition.

The 22-year-old Akuach Malek, a mother of two recollected how she felt neglected after developing the condition. She said that many people thought that it was not a serious sickness so she felt the condition would end until she heard the awakening call over the radio.

“I felt like it would cure all alone but I heard about this hospital over the radio. We should not ignore free services like this. Many women are suffering from this condition out there who need to be enlightened. The government needs to extend these services to rural areas,” Malek said.

Successful operations

Adut Bol got married in 2013 at the age of 16 years while Akuach Malek got married at the age of 17 in 2016. The administrators at the centre stressed that cultures within the country which encourage early child marriages play a key role in causing this medical condition.

They pointed out that untrained medical workers could instigate this during women delivery through unspecialised operations.

Eliana Lyatuu, senior Administrative officer at the centre, said patients who had undergone operations remained within the centre for a week being monitored as they are provided were with soft foods, soft drinks and porridge. She added that they also provided soaps and beds for them to use before they are discharged.

She requested the government to help the centre with extension officers who could spread the message to rural areas where such patients live to come and benefit from the services.

“We don’t mind about the number of people, what we mind about is them not getting messages to come. 

She called upon the government to sensitise communities to encourage education. 

She said that the patients testified that a local doctor mishandled them and led to their development of the medical condition. That many women suffered in silence.

She stressed that there was a need to train medical workers as well as averting cultures that encourage early marriages and educate people on the dangers of such bad practices.

Need for school

She reiterated that if children were taken to school, they would not have time to engage in early sexual intercourse and possibly get involved in such early marriages and defilements.

“What the government should also help us with is to provide training to people affected by fistula because some of them feel shy to come. Most of these people in the society feel marginalised, they are not comfortable with life. Many of them are divorced because of their conditions so they are abandoned with their children to struggle with them,” she explained.

“First of all, we find that in our country, many women or many girls are suffering from Fistula, so we thought of expertise which can help them, like a doctor because we are unable to carry out operations in a private hospital. These services sometimes are there at Juba Teaching Hospital but not all people can come there. We shared the idea with the Ministry of Health so they gave us go ahead,” said Angelina Michael, an Administrator at the Primary Health Care Centre. 

She said that they collaborated with their partner, the Evangelical Lutheran Church in America (ELCA), to champion the fistula operations in Mia Saba, Juba.

“They said that it is a good idea, we have doctors specialised in the fistula. They have doctors from all over the world like Australia, Tanzania, United Kingdom, and so specialists from all over the world came together through ELCA and decided to come. And we are not the ones to pay them, they are volunteers,” she said. 

Michael said that the fistula operations were free of charge to help women in South Sudan in Particular. She called upon all the patients suffering from Fistula to rush before the exercise closes. 

She said that it was the sixth time they were carrying out the operations and the turn up has been amazing.

“The number is increasing, last time in March, we made operation for 39 patients and the first time we started we started by 15, so now it is increasing. It is free of charge, we only ask them to come through radio, television or Newspapers,” she added.

What is a fistula?

A fistula is defined as an abnormal connection between two body parts, such as an organ or blood vessel and another structure. They are usually a result of an injury or surgery. Infection or inflammation can also cause a fistula.

Fistulas can form between an artery and vein, bile ducts and the surface of the skin as a result of gall bladder surgery, the cervix and vagina, the neck and throat, the space inside the skull and nasal sinus, the bowel and vagina, the colon and surface of the body which might cause faeces to exit through an opening other than the anus.

It forms in the stomach and the surface of the skin, the uterus and the peritoneal cavity which is a space between the walls of the abdomen and internal organs.

It also happens between an artery and veins in the lungs which makes blood not pick up enough oxygen in the lungs and the navel and the gut.

Inflammatory bowel disease like ulcerative colitis or Crohn disease may lead to fistulas between one loop of the intestine and another. 

An injury as well can cause fistulas to form between arteries and veins. However, the operation is recommended to be the best solution to it.