Prolonged labor & bladder fistula

Townsend Letter for Doctors and Patients,  Oct, 2005  by Jule Klotter

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A bladder fistula commonly develops after days of labor; pressure from the baby produces a tear in the wall that separates the mother's bladder and vagina. This fistula results in uncontrolled leaking of urine from the vagina. Young teenage women who live in areas without medical care that can perform Caesarian sections are the primary sufferers. Their bodies are often too immature to deliver vaginally. In the "fistula belt" that stretches across Africa, just south of the Sahara Desert, over a million young women live with uncontrollable incontinence. This area has an extremely high number of early marriages, promoted by social and religious traditions and by poverty. Many women with bladder fistulas have been banished from villages and live in isolation or with other women in the same situation.

International Organization for Women and Development Inc., a nonprofit organization set up by Barbara Margolies of Rockville Center, New York, brings US surgeons to Niger to repair fistulas. In a total of nine trips between August 2003 and June 2005, 59 doctors volunteered their time and paid their own travel expenses to help 330 women. The doctors also brought over $1.5 million in supplies and equipment. The medical care and education that the women receive may help change local traditions that promote early pregnancy. Sabou Ibrahim, director of Niger's National Hospital, told The Wall Street Journal, "A fistula woman who is repaired and goes back to her village brings many changes.... All the women get together and they talk about the risk of having a baby so young."

Thurow, Roger. Married at 11, A Teen in Niger Returns to School. The Wall Street Journal 13 June 2005

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