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  • Liz Gillespie

Power the movement to end obstetric fistula

Manjeri Esaete's painful journey with obstetric fistula began when she was just 14. Her aunt had arranged for her to marry an elderly man, becoming his second wife. Manjeri tried to object, but her family pushed back, insisting her husband-to-be "was the one with money and capable of taking care of me, unlike the young, impoverished boys,” she recalls.

Terrewode Women's Community Hospital Co-Founder Alice Emasu visits fistula survivor Manjeri Asaete. Photo by Lynne Dobson

Manjeri gave birth to her first child less than a year after the forced marriage. It was a difficult delivery, but not nearly as grueling as the prolonged labor that led to the birth of her second child, which tore a small hole between her birth canal and her bladder that leaked urine — a fistula.

Obstetric fistula is a traumatic childbirth injury that is both treatable and preventable


Young women and girls are especially vulnerable to fistula when they live in impoverished communities, where forced early marriages are common, and access to maternal healthcare is scarce. They're more likely to experience prolonged and obstructed labor because their bodies are not yet fully developed.

In 9 out of 10 cases, the baby dies during delivery, and the grieving mother is left with a hole between her birth canal and vagina or rectum (or both). Uncontrollable and continuous incontinence lead to social isolation, discrimination, depression, chronic health problems, increased incidents of gender-based violence, and extreme poverty.

While delivering her third child, Manjeri's small fistula ripped into a gaping hole that leaked urine constantly and uncontrollably. “I started wrapping tattered clothes around myself whenever I was home, but the stench was ghastly,” says Manjeri, now 77 and living in Kateta, Uganda.

Manjeri lived this way for 57 years. She knew about fistula camps organized by medical aid groups, but never went in for surgery to repair her fistula. Her children feared she would not survive the procedure. They all changed their minds when they learned that about Terrewode Women’s Community Hospital, where Manjeri would receive holistic care by highly trained doctors and nurses — before, during and after surgery — as well as counseling, support from Fistula Solidarity Groups, and more.

Manjeri Esaete found healing and hope at Terrewode Women's Community Hospital. Photo by Lynne Dobson

Today, Manjeri is a fistula survivor — one of more than 1,000 women who have received comprehensive, holistic treatment to repair their fistulas at Terrewode Women's Community Hospital since the state-of-the-art medical facility opened in 2019.

“For the first time in my life, I felt a huge relief,” Manjeri says. “I’m so excited. I’m now OK.”


A world without fistula is possible.

Your support moves us closer to it.


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