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

Video Indiana Controversy Points to Divergent Notions of Religious Freedom

Gay-marriage opponents are looking for ways to maintain their beliefs in face of changing culture, one writer says More

UNICEF Denies North Korean Measles Outbreak

Agency dismisses Russian media report after government, WHO assurances More

Turkey Seen Taking Harder Stance Against Militant Kurds

Stance comes as President Recep Tayyip Erdogan is being seen as moving closer to generals More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Indiana Controversy Highlights Divergent Meanings of Religious Freedomi
X
Jerome Socolovsky
April 01, 2015 1:41 AM
Indiana’s state government has triggered a nationwide controversy by approving a law that critics say is aimed at allowing discrimination against gays and lesbians. The controversy stems from divergent notions of religious freedom in America. VOA's Jerome Socolovsky reports.
Video

Video Indiana Controversy Highlights Divergent Meanings of Religious Freedom

Indiana’s state government has triggered a nationwide controversy by approving a law that critics say is aimed at allowing discrimination against gays and lesbians. The controversy stems from divergent notions of religious freedom in America. VOA's Jerome Socolovsky reports.
Video

Video Nigerians Welcome Buhari's Return to Power

Crowds of jubilant Nigerians nationwide have celebrated the return to power of former military ruler Muhammadu Buhari. The retired army general won this year's presidential election with more than 2 million votes more than incumbent President Goodluck Jonathan. Buhari's supporters hope he can strengthen the country's economy and security once he takes office in late May. Zlatica Hoke has this story.
Video

Video Report: State of Black America a 'Tale of Two Nations'

The National Urban League has described this year's "State of Black America" report as a "tale of two nations." The group's annual report, released earlier this month (March), found that under an equality index African Americans had only 72% parity compared to whites in areas such as education, economics, health, social justice and civic engagement. It’s a gap that educators and students at Brooklyn’s Medgar Evers College are looking to close. VOA's Daniela Schrier reports from the school.
Video

Video Film Tells Story of Musicians in Mali Threatened by Jihadists

At this year's annual South by Southwest film and music festival in Austin, Texas, some musicians from Mali were on hand to promote a film about how their lives were upturned by jihadists who destroyed ancient treasures in the city of Timbuktu and prohibited anyone from playing music under threat of death. As VOA’s Greg Flakus reports from Austin, some are afraid to return to their hometowns even though the jihadists are no longer in control there.
Video

Video Gamma Ray Observatory to Open Soon in Mexico

American and Mexican scientists have completed construction of the world's largest gamma ray observatory, situated high in central Mexico’s Sierra Negra Mountain. The observatory's huge array of water-based detectors will soon start discovering secrets about black holes and supernovas. VOA’s George Putic reports.
Video

Video Ebola Vaccine Trials Underway in West Africa

Ebola has claimed the lives of more than 10,000 people in West Africa. Since last summer, researchers have rushed to get anti-Ebola vaccines into clinical trials. While it's too early to say that any of the potential vaccines work, some scientists say they are seeing strong results from some of the studies. VOA's Carol Pearson reports.
Video

Video Philippines Wants Tourists Spending Money at New Casinos

Tourism is a multi-billion dollar industry in the Philippines. Close to five million foreign visitors traveled there last year, perhaps lured by the country’s tropical beaches. But Jason Strother reports from Manila that the country hopes to entice more travelers to stay indoors and spend money inside new casinos.
Video

Video Civilian Casualties Push Men to Join Rebels in Ukraine

The continued fighting in eastern Ukraine and the shelling of civilian neighborhoods seem to be pushing more men to join the separatist fighters. Many of the new recruits are residents of Ukraine made bitter by new grievances, as well as old. VOA's Patrick Wells reports.
Video

Video Islamic State Prisoners Talk of Curiosity, God, Regret

Islamic State fighter, a prisoner of Kurdish YPG forces, asked his family asking for forgiveness: "I destroyed myself and I destroyed them along with me." The Syrian youth was one of two detainees who spoke to VOA’s Kurdish Service about the path they chose; their names have been changed and identifying details obscured. VOA's Zana Omer reports.
Video

Video Germanwings Findings Raise Issue of Psychological Testing for Pilots

More is being discovered about the co-pilot in the crash of Germanwings Flight 9525 in the French Alps. Investigators say he was hiding a medical condition, raising questions about the mental qualifications of pilots. VOA's Carolyn Presutti reports.
Video

Video Liberia's Almost Last Ebola Patient Grateful but Still Grieving

Beatrice Yardolo was to make history as Liberia’s last Ebola patient. Liberians recently started counting down 42 days, the period that has to go by without a single new infection until the World Health Organization can declare a country Ebola-free. That countdown stopped on March 20 when there was another new case of Ebola, making Yardolo’s story a reminder that Ebola is far from over. Benno Muchler reports from Monrovia.
Video

Video Cambodian Land Grabs Threaten Traditional Communities

Indigenous communities in Cambodia's Ratanakiri province say the government’s economic land concession policy is taking away their land and traditional way of life, making many fear that their identity will soon be lost. Local authorities, though, have denied this is the case. VOA's Say Mony went to investigate and filed this report, narrated by Colin Lovett.

VOA Blogs

Circumventing Censorship

An Internet Primer for Healthy Web Habits

As surveillance and censoring technologies advance, so, too, do new tools for your computer or mobile device that help protect your privacy and break through Internet censorship.
More