News / Health

Q&A with Kate Grant: Helping Women with Fistulas

FILE - Women receiving treatment for obstetric fistula inside a clinic in Uganda.
FILE - Women receiving treatment for obstetric fistula inside a clinic in Uganda.
Frances Alonzo
The stories are heartbreaking - pregnant women in remote rural areas in Asia enduring a long or often difficult labor, some losing their babies. The women are left with incontinence and leaking wastes from obstetric fistulas. Some husbands abandon their wives, while others try to find help, but the road is long and the women are often ostracized by their communities for these birth injuries. 
However, the Fistula Foundation is one of the groups that have been supporting women, telling every woman with a fistula that it is possible to be cured and to feel hopeful once again. VOA's Frances Alonzo spoke with Kate Grant, the CEO of the Fistula Foundation.

GRANT: It’s basically a hole between an internal organ and the outside world that shouldn’t exist. In this case, it’s holes in bladder, vaginas, sometimes rectum that leave a woman incontinent. So again, it’s a childbirth injury that occurs because women don’t have access to emergency obstetric care that leaves them incontinent. The good news is most of the time those fistulas can be sewn up by a trained surgeon and that woman can be given back continence and health.
ALONZO: How many women in Asia are affected by this?
GRANT: We don’t have exact numbers, Frances, and it’s not that we don’t want them. The W.H.O. doesn’t have them, the U.N. doesn’t have them, because this happens to women in usually the remotest part of developing countries. We don’t have a specific number, we have a global number of one million women that are affected, a proportion of those in Asia, the balance in sub-Saharan Africa.
ALONZO: Is there a social stigma to having a fistula?
GRANT:  There is incredible social stigma in having a fistula. And the reason is that women that have this are usually the poorest women in the poorest countries in the most remote areas. So trying to deal with incontinence if you are living in a remote rural area where you’ve got a dirt floor, that incontinence becomes something that makes your day-to-day very difficult to manage. And also because of a lack of understanding about what causes it, that it’s a birth injury rather than occurred for no fault of the woman. There can be belief systems that demonize that woman for the reason that she got this was something that she had done, something bad. And that she had gotten this injury as kind of a punishment. That’s not true either. 
ALONZO: Does it matter how old the mother is? Her age?
GRANT: Generally we see most fistulas happening on a first birth which means the woman is usually younger, late teens, early twenties. The earlier a woman has a child the more trouble you are going to have with fistula and with other birth injuries. So, yes, a teenage mother, one that is 13, 14, 15, where their pelvis is not yet fully developed, is more likely to get a fistula than an older mother. But, even older mothers get fistulas, it’s not just about age.
ALONZO: Can you tell me what Asian countries are making strides in helping women, and what are those countries that are lagging behind?
GRANT: Unfortunately, the same countries where we see high infant mortality rates, we see high maternal mortality rates. These things tend to go together. When the women die, the babies die too. The countries which lag behind and have still the highest maternal and infant mortality rates are Afghanistan, Pakistan, Cambodia and even Bangladesh, although Bangladesh has made some strides in recent years.
The countries that have done much better, obviously they are very developed Asian countries… like Japan, Singapore, South Korea has extremely low maternal mortality rates.
Some countries that are kind of in the middle that have made progress that have a ways to go would be Philippines, Vietnam, Thailand, even China. But those countries, the last four that I mentioned are definitely moving in the right direction [and] have rapidly dropping child and maternal mortality rates. And it’s that initial list that I gave you, the Afghanistan, Pakistan, where there is still a great deal of work to do.
ALONZO: What keeps you going? Is there something that fuels you to say, “I’m ready to face this again and I’m ready to help women with this issue?”
GRANT:  That’s a very good question about what’s important in continuing to progress. It’s easy. We have pictures all over our office of the women we have been able to help, the courageous doctors that we are funding to do this work. And we have in our conference room a huge map of the world where we have all of the sites where we are funding and a big graph on the wall that shows the number of surgeries we are able to fund every year has grown dramatically.

We’ve tripled the number of surgeries we are able to fund just in the last four years. And behind those numbers are women. Individual women. I’ve met them. I’ve met them in Bangladesh, I’ve met them in Pakistan. Women who’ve suffered like no woman should have to suffer simply for trying to bring a child into the world. 

Fistula is a tough concept because talking about incontinence, where you have to talk about it. If you want to understand it, you have to talk about feces and urine and vaginas and rectums. It’s a taboo subject. And one can understand this, one can understand this is not something pleasant to understand. The human impact is so profound that people shy away from it. So the more people come forward and say, “yeah, I’ll do my part” to broaden the circle of awareness about this problem, the more women we know we will be able to help.

You May Like

Nearly Every Job in America Mapped in Detail

A nifty map pinpoints practically every job in the United States, revealing the economic character of America’s metropolitan areas, which also helps to inform the local culture

Corruption Busting Is Her Game

South African activist is building 'international online community of thousands of corruption fighters'

Former SAF Businessman Gives Books, Love of Reading to Students

Steve Tsakaris now involved in nonprofit Read to Rise, which distributes books in Soweto, encourages lower-grade primary school students to read

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
With HIV, Can We Get to Zero?i
Carol Pearson
November 29, 2015 1:23 PM
The theme of this year's World AIDS Day is "Getting to Zero." The U.N. says new HIV infections have been reduced by 35 percent since 2000 and AIDS-related deaths are down by 42 percent since the peak in 2004. VOA's Carol Pearson takes a look at what it might take to actually have an AIDS-free generation.

Video With HIV, Can We Get to Zero?

The theme of this year's World AIDS Day is "Getting to Zero." The U.N. says new HIV infections have been reduced by 35 percent since 2000 and AIDS-related deaths are down by 42 percent since the peak in 2004. VOA's Carol Pearson takes a look at what it might take to actually have an AIDS-free generation.

Video Political Motives Seen Behind Cancelled Cambodian Water Festival

For the fourth time in the five years since more than 350 people were killed in a stampede at Cambodia’s annual water festival, authorities canceled the event this year. Officials blamed environmental reasons as the cause, but many see it as fallout from rising political tensions with a fresh wave of ruling party intimidation against the opposition. David Boyle reports from Phnom Penh.

Video African Circus Gives At-Risk Youth a 2nd Chance

Ethiopia hosted the first African Circus Arts Festival this past weekend with performers from seven different African countries. Most of the performers are youngsters coming form challenging backgrounds who say the circus gave them a second chance.

Video US Lawmakers Brace for End-of-Year Battles

U.S. lawmakers are returning to Washington for Congress’ final working weeks of the year. And, as VOA's Michael Bowman reports, a full slate of legislative business awaits them, from keeping the federal government open to resolving a battle with the White House over the admittance of Syrian refugees.

Video Taiwan Looks for Role in South China Sea Dispute

The Taiwanese government is one of several that claims territory in the hotly contested South China Sea, but Taipei has long been sidelined in the dispute, overshadowed by China. Now, as the Philippines challenges Beijing’s claims in an international court at The Hague, Taipei is looking to publicly assert its claims. VOA’s Bill Ide has more from Beijing.

Video After Terrorist Attacks, Support for Refugees Fades

The terrorists who killed and injured almost 500 people around Paris this month are mostly French or Belgian nationals. But at least two apparently took advantage of Europe’s migrant crisis to sneak into the region. The discovery has hardened views about legitimate refugees, including those fleeing the same extremist violence that hit the French capital. Lisa Bryant has this report for VOA from the Paris suburb of Cergy-Pontoise

Video Syrian Refugees in US Express Concern for Those Left Behind

Syrian immigrants in the United States are concerned about the negative tide of public opinion and the politicians who want to block a U.S. plan to accept 10,000 Syrian refugees. Zlatica Hoke reports many Americans are fighting to dispel suspicions linking refugees to terrorists.

Video Thais Send Security Concerns Down the River

As Thailand takes in the annual Loy Krathong festival, many ponder the country’s future and security. Steve Sandford reports from Chiang Mai.

Video Islamic State Unfazed by Losses in Iraq, Syria

Progress in the U.S.-led effort to beat Islamic State on its home turf in Iraq and Syria has led some to speculate the terror group may be growing desperate. But counterterror officials say that is not the case, and warn the recent spate of terror attacks is merely part of the group’s evolution. VOA National Security correspondent Jeff Seldin has more.

Video Belgium-Germany Border Remains Porous, Even As Manhunt For Paris Attacker Continues

One of the suspected gunmen in the Nov. 13 Paris attacks, Salah Abdeslam, evaded law enforcement, made his way to Belgium, and is now believed to have fled to Germany. VOA correspondent Ayesha Tanzeem makes the journey across the border from Belgium into Germany to see how porous the borders really are.

Video US, Cambodian Navies Pair Up in Gulf of Thailand

The U.S. Navy has deployed one of its newest and most advanced ships to Cambodia to conduct joint training drills in the Gulf of Thailand. Riding hull-to-hull with Cambodian ships, the seamen of the USS Fort Worth are executing joint-training drills that will help build relations in Southeast Asia. David Boyle reports for VOA from Preah Sihanouk province.

Video Uncertain Future for Syrian Refugee Resettlement in Illinois

For the trickle of Syrian refugees finding new homes in the Midwest city of Chicago, the call to end resettlement in many U.S. states is adding another dimension to their long journey fleeing war. Organizations working to help them integrate say the backlash since the Paris attacks is both harming and helping their efforts to provide refugees sanctuary. VOA's Kane Farabaugh reports.

VOA Blogs