Freedom from fistula? First abandon FGM!


31 July 2012

 As soon as I landed in Pakistan in 2010, the cultures struck me.  People with long salwahkameez or pashtun hats, were mixed with business suites and Bedouin style dress, evident event at the airport.  I travelled by Landrover towards theKashmir border – the best part of a day’s ride away – after picking up essential supplies for the hospital. 

 I had gone to the hospital to learn basic anatomy, midwifery and obstetrics in order to prepare to work in anti-FGM work.  Apart from studying in daily classes in Urdu, I worked from 8am often until 10pm and I attended 19 births, observed in theatre and performed basic nursing skills on the wards – before being allowed to help as a midwife, and helped “10 women with their baby out”!

 During our morning break for cups of sweet chai, I learnt from the nurses and midwives that a form of FGM type 4 was practised in the area – though this was very secretive.  Accordingly to a number of surgeons I met, there is a clear link between FGM, obstructed labour, and fistula (incontinence) that also leads to maternal and/or child mortality.  The following story deals with some of these issues.

 Maryam, 24, had suffered from fistula for most of her adult life.  Married at 17, she became pregnant right away.  No one told her how many things go wrong during childbirth, and she was alone when her labour began.  A traditional birth attendant was sent for on the second day.  After four agonising days of pushing, Maryam was taken to a regional hospital.  But it was too late.  The baby was delivered still born, and Maryam had developed a fistula.  Her husband abandoned her, refusing to take her back because she was leaking urine.  Fortunately, Maryam’s family took her in.  Three months later she made an arduous journey across the mountains where one of the fistula centres is located. Because the damage she sustained was so severe, her first surgery could not correct the problem.  It was several years before Maryam could afford to make the long trip again.  But she has no intention of remarrying.  Instead she will help her brother and his wife raise their children.

 Although we aim to focus mostly on ending FGM, it cannot be separated from its’ links with forced marriage, fistula and maternal & child mortality.  Help us to improve education in these areas, by volunteering, campaigning or donating to our cause.  Email us at info@28toomany.org or donate on our Paypal button.  Keep up to date with our latest news on Facebook  and Twitter .