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Abusing young girls. Young girls who become pregnant before their reproductive
system is ready for pregnancy and delivery suffer from a heinous disorder
that is popularly known as fistula which is an abnormal hole connecting
the bladder, vagina and the rectum, resulting in a continuous foul discharge.
Embarrassing and wretched -filthy life. Those who are afflicted by this
condition cannot control neither their bowel movement nor bladder and
continuously drip urine mixed with feces. This is a very embarrassing
and rather unhygienic situation for a young woman who just had a traumatic
labor and delivery which may have resulted in a morbid or even fatal product
of conception.
Bad custom and irresponsible parents. The real cause of the problem is
the custom in some African countries where young girls are married as
early as eleven years of age to older men by arrangement with the family.
This normally takes place in remote villages where there is no access
to primary health care or any sort of modern reproductive or family planning
services.
Abusing a young body. The young woman gets pregnant when her body is not
ready to carry a pregnancy and the delivery becomes literally dangerous
to her and the baby. Some of these girls could have an additional burden
of genital mutilation or cutting which makes the labor even worse. After
prolonged and dangerous labor, her reproductive organs and especially
the birth canal literally tears up creating abnormal communication between
the reproductive canal, bladder and the rectum, creating a perpetual fistula
or hole where there is continuous discharge of urine and feces and the
young woman literally smells and stinks.
Social isolation and depression. The young woman is soon shunned by her
older husband and her families and becomes an outcast of society and becomes
destitute within a short period of time. She is left to the harsh realities
of poverty, isolation and illhealth that she cannot address.
Fistula is a preventable social problem. The saddest aspect of this problem
is that it is totally preventable and the young girls can do very little
to change their plight and future. If young girls are not forced to marry
when they are still teenagers, fistula and its complications may never
happen. The parents who are the normal custodians and guardians of their
child’s development need to be educated as well as restrained by
strict legal system that discourages or punishes such criminal social
customs.
The public health campaign. The current system of public health campaign
should be directed in changing this criminal culture and behavior by making
it illegal to get young girls married before the appropriate age and circumstances
where young women are given a chance to grow and develop to make choices
for themselves. Creating a series of Fistula hospitals and focusing only
on the poor victims of fistula may sound humane, but in the end if it
is not supported by a strong public health and legal campaign it looks
that society is treating it like any other disease and perpetuating the
problem. It is critical that we do not condone this crime by not addressing
the cause of the real problem.
The time has come for action. Fistula is a shame on all of us as we can
literally stop it within a short time. Government, public health and social
institutions should empower young women with education and the decision
support system that is needed to make it history. Families and those men
who marry such young girls should be restrained, penalized and most importantly
educated to change their behavior. Fistula is a neglected inhumane child
and human rights abuse whose time has come and we need all to act soon.
Belai Habte-Jesus, MD, MPH |