In Madagascar, little help for difficult pregnancies

August 22, 2012 by Andreea Campeanu

When she was 20 years old, Alphonsina Zara was pregnant with her first child. After three days of excruciating labour, though she was in a health centre, her baby was stillborn.

Doctors found that she had developed a hole in her birth canal, a severe medical condition called obstetric fistula. She not only lost her baby, it disrupted her life for the next 14 years.

The injury is usually caused by complications during childbirth, such as a prolonged labour that can cause muscle tissues to tear, creating a hole in the .

If left untreated -- as it is for tens of thousands of -- it causes them to urinate or defecate continuously.

Fistula can occur when care is inadequate, when women give birth at home, at an early age, or with .

"It is really a problem of poverty," said Edwige Ravaomanana of the UN Population Fund, and a simple and cheap operation could turn around many lives.

The condition was eradicated in wealthy countries in the 19th century, but the says it still afflicts two million women in Africa and developing Asia.

"It's also because women can't go to a (clinic). Maybe because of the distance, maybe because they don't know," said Ravaomanana. "The women who live far try to give birth with a matron," a traditional ."

Madagascar, one of the world's , alone accounts for 2,000 of the more than 50,000 new fistula cases each year around the globe, according to UN data.

Eighty-one percent of the population on this island nation off southeast Africa live on less than $1.25 a day.

Health facilities are widely scattered across the country, the world's fourth-largest island where 80 percent of the population lives in rural areas.

About 65 percent of them reside more than 10 kilometres (six miles) from their nearest health centre, according to the health ministry.

That distance often is travelled by foot because Madagascar has few roads and little transport, forcing women to at home with traditional midwives.

-- Money she doesn't have --

Widespread fistula here is also blamed on early pregnancy, which is very common in Madagascar.

"It's also the tradition. Starting from 18, they are considered old. At 30, a woman can already have 10 children," Ravaomanana said.

A surgical procedure that costs about $300 can close the hole and return a woman's life back to normal.

But until 2011, only two doctors on Madagascar could perform the operation. A 300,000-euro ($374,000) campaign by the and the UN Population Fund has trained 14 more, and performed 106 operations in the tourist beach town of Tulear.

Aphonsina was one of them.

In the soft red sun of a winter afternoon, Alphonsina said her baby's father left her because of the constant smell of urine.

"People were talking about me, they were saying I smell bad. When I was getting close to people, they would leave," Alphonsina said with a shy voice.

Fortunately, her parents did not reject her. She lived with them and worked as a fish vendor for years. She consulted the nearest hospital, which eventually sent her to Tulear.

"When I came here, the doctor made me come every three months and still didn't heal me," she said. In Tulear, she started selling fabric.

"Where I live right now, I'm making friends, not like before. Though I still don't have a lot of friends," Alphonsina said. She lives in a small grass hut on a sandy road, has a mattress and very few objects in her house, which she rents for about $5 a month.

Her life has improved, but she's not cured, having the misfortune to be among the 10 percent of women who aren't completely healed after the surgery.

Alphonsina's doctor said she needs another operation which, with medicine, will cost $100 -- money that she doesn't have.

Explore further: Madagascar battles surge in TB cases

Related Stories

Madagascar battles surge in TB cases

July 9, 2012
After enduring six months of pain that grew so intense she could no longer work, Perline Razanadravao finally decided to go with her equally sick baby to see a doctor.

Pregnancy still a death sentence for many Liberian women

June 5, 2012
Hawa Kollie lies on her back screaming in pain, her head throbbing and body aching after the loss of first her baby, and then her uterus. Like many Liberian women, she got to the hospital too late.

Making bad worse for expectant mothers

June 22, 2012
Some Norwegian women with birth anxiety face additional trauma in their meeting with the country's health service, according to research carried out in Stavanger.

Births at home and in midwifery units could signify cost savings for the NHS

April 20, 2012
Giving women who have previously given birth and who are at low risk of complications the opportunity to give birth at home or in a midwifery unit saves the NHS money, is safe for the baby and improves outcomes for the mother, ...

Recommended for you

Amber-tinted glasses may provide relief for insomnia

December 15, 2017
How do you unwind before bedtime? If your answer involves Facebook and Netflix, you are actively reducing your chance of a good night's sleep. And you are not alone: 90 percent of Americans use light-emitting electronic devices, ...

Warning labels can help reduce soda consumption and obesity, new study suggests

December 15, 2017
Labels that warn people about the risks of drinking soda and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.

Office work can be a pain in the neck

December 15, 2017
Neck pain is a common condition among office workers, but regular workplace exercises can prevent and reduce it, a University of Queensland study has found.

Regular takeaways linked to kids' heart disease and diabetes risk factors

December 14, 2017
Kids who regularly eat take-away meals may be boosting their risk factors for heart disease and diabetes, suggests research published online in the Archives of Disease in Childhood.

Simulation model finds Cure Violence program and targeted policing curb urban violence

December 14, 2017
When communities and police work together to deter urban violence, they can achieve better outcomes with fewer resources than when each works in isolation, a simulation model created by researchers at the UC Davis Violence ...

One in five patients report discrimination in health care

December 14, 2017
Almost one in five older patients with a chronic disease reported experiencing health care discrimination of one type or another in a large national survey that asked about their daily experiences of discrimination between ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.