Healing Obstetric Fistula and Restoring Women’s Lives

A patient recovering from fistula repair surgery is examined at Dayniile Hospital in Mogadishu, Somalia. © UNFPA/Usame Nur Hussein

In Somalia, where six out of ten births take place without a doctor, childbirth is often a matter of survival.

For women like 38-year-old Farhiya from rural Beletweyne, the consequences can be devastating — a painful obstetric fistula, a hole in the birth canal that left her incontinent, isolated, and cut off from her community.

“I was stressed, constantly worried, and isolated from my community. I was living in my house as if I had some sort of contagious disease,” she said.

The condition affects millions of women worldwide, with those in the Arab region — especially Yemen, Sudan, and Somalia — among the most impacted, according to the UN sexual and reproductive health agency (UNFPA). This is largely due to limited access to basic and essential maternal health services.

“An estimated 171,000 pregnant women are struggling to access life-saving maternal health care,” reported UNFPA.

In addition, the ongoing humanitarian crisis in Somalia is worsening the situation. Malnutrition among pregnant and breastfeeding women has reached critical levels, further increasing the risk of pregnancy and birth-related complications such as premature delivery and low birth weight, according to the agency.

Journey to healing

Although recovery is long and arduous, it is often marked by support and compassion from friends and communities.

For Farhiya, a neighbour raised money for her to travel to Mogadishu for treatment. Unfortunately, the USD 800 surgery cost meant help was still out of reach.

Hope emerged when another woman told her about a fistula campaign – a major community outreach initiative offering free fistula repair surgeries – at Dayniile Hospital.

With support from the Federal Ministry of Health, Physicians Across Continents, and UNFPA, and funding from KSrelief (the King Salman Humanitarian Aid and Relief Centre), Farhiya once again found strength in her community.

Their collective support enabled her to travel to Mogadishu, where she finally received life-changing repair surgery.

“Most of the patients who come to us are from rural areas, and each one has her own story — each more painful than the other,” said Dr Aisha Abdulkadir Abdullahi, a member of the medical team at Dayniile Hospital.

“With ongoing awareness and surgical campaigns, I am hopeful that the numbers will gradually decrease and that one day fistula will be fully eradicated,” she added.

For Nince, a 35-year-old mother of three, fistula surgery has been truly life-changing.

“For five years, I hadn’t visited any relatives or been invited to weddings. I was too ashamed to use public transport,” she shared. “Now that I have had the surgery and am no longer leaking urine, I have decided to visit my relatives.”