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MSF treats women injured in childbirth

A new fistula patient arrives at the fistula camp in Boguila, CAR. Photo: Sarah
A new fistula patient arrives at the fistula camp in Boguila, CAR. Photo: Sarah Elliott/MSF
MSF Anaesthetist Emmanuel Ouazounam administers an anaesthetic that numbs the pa
MSF Anaesthetist Emmanuel Ouazounam administers an anaesthetic that numbs the patient from the waistdown
Zanaba Amidou (16). “I have suffered a lot; I didn’t lose much blood, but I suff
Zanaba Amidou (16). “I have suffered a lot; I didn’t lose much blood, but I suffered.
Women relax in one of the tents at the MSF fistula camp in Boguila, CAR
Women relax in one of the tents at the MSF fistula camp in Boguila, CAR
Esther Feibouko walks with her two-year-old daughter Abigail. Photo: Sarah Ellio
Esther Feibouko walks with her two-year-old daughter Abigail. Photo: Sarah Elliott/MSF
MSF midwife Sigrid Kopp sits with a fistula patient to make sure she drinks enou
MSF midwife Sigrid Kopp sits with a fistula patient to make sure she drinks enough water.
A fistula patient holds a bucket which collects her urine. Patients must drink l
A fistula patient holds a bucket which collects her urine. Patients must drink large amounts of water
Fistula patients wait outside the operating room for a consultation. Photo: Sara
Fistula patients wait outside the operating room for a consultation. Photo: Sarah Elliott/MSF
Robertine Djoumaze (32) has seven children and suffered a fistula four months ag
Robertine Djoumaze (32) has seven children and suffered a fistula four months ago when she was in labourfor 24 hours.
Patients must drink large amounts of water before and after their surgery so tha
Patients must drink large amounts of water before and after their surgery so that their urine is notconcentrated. Photo: Sarah Elliott/MSF
Approximately two million women worldwide suffer from an obstetric fistula, one of the most serious consequences of obstructed labour. A fistula is a hole between the vagina and the bladder or rectum, through which urine or faeces leak continuously. The injury is completely preventable and has almost disappeared in developed countries where there is universal access to obstetric care.

In addition to offering maternal health services to prevent delivery complications in numerous countries, in2010, MSF teams have operated and treated about 1,000 women suffering from obstetric fistula. Below impressions from a fistula camp in Boguila, Central African Republic.
Central African Republic - Fistula
A new fistula patient arrives at the fistula camp in Boguila, CAR.
Central African Republic - Fistula
Esther Feibouko (28). “I didn’t feel good about myself when I realised I had this problem. When Iwalked, I would leak urine, and it made me feel bad. I have heard that a lot of husbands leave their wivesafter they have such a problem, but my husband did not have an issue with it. Even though I know thesurgery may not work, I pray for healing.”
Central African Republic - Fistula
MSF Anaesthetist Emmanuel Ouazounam administers an anaesthetic that numbs the patient from the waistdown, while MSF surgeon Dr Volker Herzog looks on. The patient, Martine Nambousso (45), has had tenpregnancies, but has no surviving children. She has had a fistula for over 20 years.
Central African Republic - Fistula
Zanaba Amidou (16). “I have suffered a lot; I didn’t lose much blood, but I suffered. I didn’t want to get married, but myfather made me. Now I haven’t seen my husband for three months. My mother-in-law has been to visit me in the fistula camp, but my husband has not. I know he is aware what has happened to me, and yet he has not done anything for me."
Central African Republic - Fistula
Women relax in one of the tents at the MSF fistula camp in Boguila, CAR. 65 women had their fistulasrepaired during the six week-long camp in 2010.
Central African Republic - Fistula
Esther Feibouko walks with her two-year-old daughter Abigail.
Central African Republic - Fistula
MSF midwife Sigrid Kopp sits with a fistula patient to make sure she drinks enough water. Patients mustdrink large amounts of water before and after surgery so that their urine is not concentrated.
Central African Republic - Fistula
A fistula patient holds a bucket which collects her urine. Patients must drink large amounts of water beforeand after their surgery so that their urine is not concentrated.
Central African Republic - Fistula
Robertine Djoumaze (32) has seven children and suffered a fistula four months ago when she was in labourfor 24 hours. “When I realised I had this problem, I felt very bad. After I began leaking, my husband left meand my children. He comes to see us sometimes. In the village no one wants to see me or will come to myhome. Even if I make food, no one will come. People in the village do not like the smell. I feel moreconfident and welcome in the fistula camp.”
Central African Republic - Fistula
Patients must drink large amounts of water before and after their surgery so that their urine is notconcentrated.
Approximately two million women worldwide suffer from an obstetric fistula, one of the most serious consequences of obstructed labour. A fistula is a hole between the vagina and the bladder or rectum, through which urine or faeces leak continuously. The injury is completely preventable and has almost disappeared in developed countries where there is universal access to obstetric care.

Central African Republic. All photos by: Sarah Elliott/MSF
by Dr. Radut.