Fistula is 99.9% a disease of extremely poor women. Nobody from the affluent families will suffer from it.

So long as its poor women, no one cares, says Dr Shershah Syed, the man responsible for setting up Koohi Goth Hospital, the only primary healthcare facility for women suffering from the condition called fistula. He has made possible the treatment of 10,000 women suffering from the unthinkable medical condition. Yet, it’s not enough.

Every year, the list of women who are suffering from a fistula increases by 5,000 approximately, and trained surgeons in Pakistan who can perform the surgery that can cure them are just 30! Yet, there is light at the end of the tunnel.

Selling goats to get treatment

Nineteen-year-old Noorbano from Khuzdar, Balochistan, is one such woman. She walks slowly towards the dining area from her bed in the recovery ward of the Koohi Goth Hospital. Her wounds are still raw. She has had three surgeries and has three more to go. “I developed the fistula during the birth of my second baby who did not survive. I would keep leaking all the time. Nobody even wanted to sit next to me,” she explains with the help of a translator. “It’s my husband who supported me. He had a few goats which he sold for my treatment. We travelled from Khuzdar to Hub and from there to Karachi. It was worth it,” she says with a smile.

As fistula is directly related to poverty and lack of resources, Balochistan has the most patients, followed by rural areas of Khyber-Pakhtunkhwa and Sindh.

Pakistan’s understated scandal

“Is it not the biggest scandal that 30,000 young women are dying every year due to pregnancy-related causes and no one cares?” says Dr Shershah.

The women suffering from obstetric fistula develop the condition when child birth is not done by trained medical persons and the nearest hospital is at times hours away in rural Pakistan with no infrastructure or money to travel.

“If the labour is prolonged, which is mostly when the woman is having her first baby, the baby’s head may get stuck in the birth canal in a way that it keeps pushing against the thin wall between the bladder or rectum and the wall of the birth canal, thereby causing and tear,” says Dr Suboohi Mehdi, one of the surgeons at Koohi Goth Hospital.

Another way a fistula may be formed is when an unskilled surgeon performs a surgery and by mistake causes a cut in the bladder or rectum.

Apart from treating women at the Koohi Goth facility, completely free of cost, a midwifery school is training midwives to help women deliver safely. Surgeons are trained to perform the surgeries, and teams then setup small units all over Pakistan. The patients are taught life skills and vocations during the long rehabilitation process. The hospital relies on donations for its running.

The answer lies in efforts for better maternal health for the women of Pakistan.

“The dream is simple – that every woman has a right  to basic obstetric care, in case of an emergency, at her doorstep, free of charge. And it can be done,” says a hopeful Dr Shershah.