Giving Compass' Take:

• Jared Watts shares his personal experiences working with women enduring and recovering from fistulas, which carry enormous physical and emotional consequences if left untreated. 

• How can funders support groups working to treat fistulas? How do education and information play a role in fistulas? 

• Find out how donors can make an impact for women with obstetric fistula. 

These women are from the Jahun VVF—vesico-vaginal fistula—Ward. For a number of different reasons, they have fistulas, or holes, between their bladders and vaginas—and even sometimes between their bowels and vaginas.

They come to the unit not only with their physical injuries but with terrible psychological trauma as they have been shunned by their families and society.

The fistulas in Africa and in Jahun mostly come from obstructed labor. Women are in labor for days and the baby becomes stuck in the birth canal, too big (sometimes for a small pelvis) or poorly positioned. The pressure of the baby's entrapped head stops blood flow to the surrounding tissue, which includes the vaginal and bladder walls. This tissue can then necrose, with the tissue dying, and a hole or 'fistula' forms between the vagina and bladder or sometimes the bowels.

Urine or feces escapes constantly through the fistula. Women affected by this often leave a trail of urine as they walk around, with an accompanying poor smell. Anything they sit on will become covered in urine. They can be made to leave the family home and live alone. With no support, they often start to starve.

Read the full article on fistulas by Jared Watts at Doctors Without Borders.