Kabul, Afghanistan – Exhausted and worn as if ending months of weary travel, seven female patients sleep under heavy blankets at Malalai Maternity Hospital in Kabul. They are recovering from fistula surgery, and more importantly, from years of exclusion from society. Because of the constant smell of urine that caused them heartbreak and shame, they were shunned from everyday life and abandoned by their husbands.
Obstetric fistula is a devastating injury acquired during prolonged or obstructed labor without timely access to emergency obstetric care, resulting in a hole between the vagina and bladder or rectum, which leaves women leaking urine or feces. The fistula ward in the Malalai Maternity Hospital, supported by UNFPA (United Nations Population Fund) and Afghanistan’s Ministry of Public Health, is one of few places in Afghanistan women can receive free emergency obstetric care and surgeries by trained female surgeons.
Fistula surgery is the solution to a problem that often seems unapproachable in Afghanistan. In some ways, women with fistula issues are considered the lucky ones, surviving the high maternal mortality rate that haunts Afghanistan; though none of them would think of themselves as lucky. A lack of maternal care and education, malnutrition, child marriage, remote villages on rarely traveled roads, society’s powerless role for women, not to mention ever-raging war, all stack up against women who suffer this problem.