Abode of hope for Somali women.

Mogadishu, March 27 – Thousands of Somali women some as young as 16 years old have found an abode of hope at a makeshift medical facility jointly run by the African Union peacekeepers in Mogadishu and a grassroots women coalition called COGWO offering counseling and free surgical treatment to correct fistula, an abnormal condition that leaves its victims stigmatized and traumatized within their closely-knitted Somali culture.

Fistula is an abnormal condition between the birth canal and the rectum or bladder resulting in uncontrollable passage of urine and/or feces. There are two primary causes of fistula in women in developing countries namely childbirth, causing obstetric fistula and sexual violence, causing traumatic fistula.

Fatuma Aden Maalim who hails from the agricultural-rich central city of Baidoa is one of the minors who has immensely benefited from this programme. She can now afford a smile and has even been employed as a cleaner at the same facility where she does not have to worry about going through the horrendous experience she has been through at the tender age of only 14 when she was married off to a 60 year old man as a second wife.

“I no longer worry about the odor and stigmatization I have gone through for a whole year with fistula which came as a result of the long painful labour and torrid time I unsuccessfully went through trying to deliver my first child at home. I have no words to express my joy after the surgery. I have healed and can now live a normal life. I even have a job as a cleaner here thanks to COGWO and a house too, life is good so far, this place has been an abode of hope for so many women with fistula,” She said with a smile.

Just like many of the other Somali women fistula patients at the fully packed tented hospital, Fatuma was abandoned by her husband whom she did not wish to name. But after word reached him she was well and even prettier from the good care she received at the hospital, she claims he now wants her back.

“He had the audacity to call me and ask if we could reunite again. I told him off and I now fear going home because my parents might force me to go back to him. I have gone through a lot of pain and he never supported me and has never come to see me in hospital,” She added, taking a break from her daily cleaning chores at the hospital together with other young women who have grown through the same traumatic experiences.

According to medical experts fistula is a condition that is preventable. In the case of Somalia it is highly recommended that early expecting mothers must be encouraged to deliver in hospital where fistula can be prevented.

Captain Dr. Niyonzima Pierre Claver is the head of the fistula programme at the peacekeepers hospital in Mogadishu. He says in Somalia, fistula is mostly caused by the long labour pains under-aged girls go through during childbirth and calls upon the Somali women to seek medical help in order to avoid living in dejection and pain.

“As a father and husband I would wish to tell Somali men who have made it a habit to abandon their wives whenever they get fistula to stop being inhuman. In fact just like any other ill person these women badly need you most when they are in that condition. The issue of early childhood marriage would hard to totally eradicate it in a culturally sensitive community like the Somalis but if all expectant mothers can deliver in hospitals fistula would be greatly reduced,” the Burundian doctor said.

Many of the Somali women patients whom were themselves married off between the ages of 13 to 16 consequently suffering from fistula for many years do not see the culture of early childhood marriages declining in Somalia.

Nunay Maaday, 53, who has also been constantly leaking urine for the past 19 years due to fistula says her daughters would be married off before they turn 18 simply because she has no powers to stop their father from doing so.

Unlike other younger women at the clinic, Maaday was never abandoned by her husband. She says she suffered from the fistula after her second birth in 1990 when Somalia was still stable. She was partially treated at Banadir hospital in Mogadishu, the biggest ante-natal hospital in Somalia and was asked to return after few months.

But then the government collapsed before her next appointment was due forcing her to live with the constant urine leakage for 19 years.

“The 19 years of smelling urine all the time and not being able to keep yourself clean was so traumatic. The last thing you need as a woman is to be unclean because cleanliness is in our genes. I can never thank AMISOM and COGWO for the free treatment which I could never have afforded,” Maaday said, looking at ease and happy.