In Benin, obstetric fistulas caused by difficult childbirth afflict three out of 1000 mothers, according to the epidemiological study conducted by Dr. Jacques SAIZONOU in 2008. A fistula is an injury caused by prolonged labor or the tearing of normal tissue when mothers deliver a baby.

When left untreated, a fistula could lead to urinary or fecal incontinence. Social contempt stigmatizes women suffering from fistula.

Even though fistulas are easily repaired by surgery, most women are prevented from seeking this surgical procedure for lack of knowledge or access to a skilled surgeon or a clinic.

In 2008, Benin adopted a National Strategy to Eliminate Fistula. Since then, the U.S. Government, through USAID, has enabled numerous women to benefit from fistula repair aboard the Mercy Ship “Africa Mercy” when it docked in the port of Cotonou. In 2010, funding from the American people supported the training of two Beninese surgeons in fistula repair. Fistula repair and prevention became an integral part of USAID’s maternal and reproductive health programs for Benin.

Today, USAID operates in the departments of the Zou-Collines, Atlantique -Littoral and Ouémé–Plateau. It does so in part by conducting social mobilization to identify women and supporting the cost of transportation to one of the two repair sites in Benin and the in-patient costs associated with the surgery. Two physicians in northern Benin, Dr Tamou at Bembereke and Dr Oliveira at Kandi performed fistula repair surgery under the supervision of Dr Steven Arrowsmith, a renowned surgeon with 24 years of experience in fistula repair. Dr Tamou and Dr Oliveira received further training in 2010 with Mercy Ships. On the ground, the NGOs ALDIPE and GRAFEP facilitated the logistics of the repair missions. Between January and April 2011, 39 women underwent fistula repair surgery successfully.

To reduce the incidence of obstetric fistula, USAID funds prevention activities and training for health workers on best practices to apply during labor and delivery. Prevention activities are proving effective in reaching out to women. Of the women identified with fistulas in April 2011, 56 percent stated that the information they received from opinion leaders (religious chiefs, local elected officials), mutual health organization officials, and community health helped them decide to undergo the intervention.

USAID’s partnership with Benin health services and communities is helping thousands of women of reproductive age avoid obstetric fistula and help dozens receive treatment and reclaim their life and dignity.

By Frantz Simeon, URC-CHS and Paula Agbemavo, PSI/ABMS