BOUAKÉ, Côte d'Ivoire – When Blandine was pregnant, she didn't go to the hospital for regular prenatal check-ups. On the day she gave birth, she delayed in going to the health centre. Her doctor told her that's why the birth had complications which resulted in her developing obstetric fistula.

Obstetric fistula is one of the most serious and tragic childbirth injuries. A hole between the birth canal and bladder and/or rectum, it is caused by prolonged, obstructed labour without access to timely, high-quality medical treatment. Fistula leaves women leaking urine, faeces or both, and often leads to chronic medical problems, depression, social isolation and deepening poverty.

To make matters worse, Blandine was dealt a triple blow because she also lost her baby and was soon left abandoned by her husband due to her condition.

Blandine suffered from fistula for three years until 2013, when she learned more about the condition while listening to a radio broadcast by the United Nations Peacekeeping Mission Radio in Côte d’Ivoire. She finally understood the cause of the pain and how to deal with her trauma. Blandine's mother then advised her to seek fistula repair treatment at a UNFPA-supported clinic in Bouaké, 340 kilometres north of the Ivorian capital Abidjan.

The surgery was a success, and it turned Blandine's life around. She felt like she had been reborn from her ashes once her fistula healed completely.

"I have a new taste for life. I met another man and was able to have another daughter," she told UNFPA.

Blandine went back to school and earned a vocational training certificate. While she looks for a new job, she volunteers to raise awareness about fistula by sharing her experience with other women in her community. She urges them to get regular prenatal check-ups and always follow the advice of their midwife or doctor to prevent life-threatening complications in childbirth like fistula.

Blandine's treatment was made possible by an $8 million partnership between UNFPA and the Ivorian Ministry of Health, funded by the Korean International Cooperation Agency (KOICA). Since 2012, the programme has carried out almost 3,400 free fistula surgeries, with a success rate of 77 per cent.

“In most cases, fistula survivors face stigma, are isolated by the community and cannot afford to take care of themselves," said Caspar Peek, UNFPA Representative in Côte d’Ivoire. "With surgery, fistula survivors find a way to get healed, to be reintegrated in the community and give a new direction to their life."

In Côte d’Ivoire, 26 per cent of births are not attended by skilled medical personnel, a factor contributing to the country’s high morbidity and maternal death rates, including fistula.
 
Despite strong political will and efforts by development partners, the unmet need for fistula repair is still very high across Côte d’Ivoire. Fistula survivors are found in both urban and rural settings, and they face many obstacles to access health care in addition to the isolation and loss of dignity caused by fistula.

In order to achieve the ambitious goal of ending fistula by 2030, the way forward is to accelerate efforts on prevention and treatment and to raise awareness about how fistula impacts women’s lives.

"Fistula is a medical condition that has severe social, psychological and human dignity repercussions. The victims often suffer in silence and total isolation," said Seo Dong Sung, KOICA country director in Côte d’Ivoire. "Through this project, KOICA wishes to stand with these women by curing them from fistula, by helping them to regain their dignity in the society, and most importantly by helping with the maternal health system to care for pregnant women in order to avoid the joy of maternity turning into a nightmare."