It is estimated that in Senegal there are 400 new cases of obstetric fistula [Source: Department of Reproductive Health, Ministry of Health] every year and that the Tambacounda region is one of the most affected. The mortality rate in Tambacounda is 395 deaths for every 100,000 live births. The right to information is a fundamental pillar that allows people to know better their rights to reproductive health and access to healthcare. ARTICLE 19 has implemented a series of activities in the region to reduce the maternal mortality rate that stems from obstetric fistula.
An obstetric fistula is a bladder injury or recto vaginal injury resulting from a prolonged and difficult labour. There are multiple causes for obstetric fistula, including pregnancy at a young age, female genital mutilation, and closely spaced pregnancies. However, these causes are not well known by the majority of the population, especially those who live in rural and deprived areas. Often, the most affected regions are those that are the most remote with a very high level of poverty, where access to healthcare remains limited, and where harmful cultural practices continue to be imposed upon girls and women.
Since June 2012, ARTICLE 19 West Africa has been working on a programme on the right to access information in maternal health, and more precisely, in the fight against obstetric fistulas in Senegal, particularly Tambacounda region.
From December 2012 to March 2013, ARTICLE 19 undertook a number of activities (research, field surveys and training sessions) in Tambacounda with the aim of tackling the mortality rate obstetric fistula through access to information.
The results show that attending ARTICLE 19’s training, participants were convinced of the need to access information to improve their daily life and to boost their decision-making power.
During the training session, Right to Information in the Fight Against Fistula in Tambacounda, on 22 and 23 March 2013, the participants (19 men and 39 women) were able to discuss how to challenge the stigmatisation of obstetric fistula. Due to lack of information, several participants recognised that they had stigmatised women suffering from fistulas prior to their ARTICLE 19 training.
As a result of the training, participants felt equipped to provide information about fistulas, and now consider themselves authoritative voices to ask for and share information.
“Since my training, I now have the courage to knock on my local doctor’s or nurse’s door to ask for information”, says Alassane Camara.
Below are a few impressions from participants who attended the workshop organised in Tambacounda.
Mamadou Ba, Neighbourhood Development Counsellor, 44 years old
“Yes, access to information is important as the fistula is curable and it’s thanks to this training session that I now know this, and that I have since shared this information. It’s good to be informed, it helps you prevents certain illnesses and to be knowledgeable.
Yes, I shared this information by helping a woman (a mother of four) from one of the surrounding villages to cure her fistula and with the help of a Badiènou Gokh [1], Sinthiou Sow, she is now being monitored in the regional hospital of Tambacounda.”
Ngolo Tamega, Development Counsellor of the Pont neighbourhood
“After the training, I went online to get more information about the dangers of the fistula and this allowed me to gain a lot of knowledge on the subject, and to share this information with my friends and the people in my neighbourhood. I even detected a woman with a fistula. ARTICLE 19 is really welcome, information is a right for all the world’s citizens, just like the right to eat, to dress, to be medically treated.”
Diouma Sow, Matron
“Access to information allows us to be informed about the dangers and the consequences of certain illnesses and other things, and this is why it is important in improving a person’s life.
After the training session, I made enquiries at the Gourel health centre where they gave me information consistent with the information given during ARTICLE 19’s training.
I am a matron and I am in direct contact with Fula parents in the village. After the training session, I made them aware about the dangers of early marriage and female circumcision as these practices can lead to a fistula.”
Maguette Dione, 56 years old, Saré Guilel, Badienou Gokh
“What I have most taken from the training is the information about early marriages. The training really affected me. I am real proof of it as I was given in marriage at the age of 16 and they stopped my studies which I regret today.
After the training session, I went to the head nurse of our neighbourhood health centre and they gave me information consistent with what I learnt with the help of ARTICLE 19.
I shared the information I had gained by making some home visits.”
Ramatoulaye Ba, 45 years old, traditional birth attendant, Saré Guilel
“After the training session, I made enquiries at a doctor’s surgery who told me to avoid childbirth at home and also spoke to me about early pregnancies causing fistulas.
Afterwards, I also went to my home village (Dialoubé foulabé), 15 km from Tamba, to share the information with the people there and to make them aware about the dangers of home childbirths and early marriage. I called a meeting with the women of the village to share information and increase awareness.
Frankly, information is important as it has allowed me to understand that a fistula is curable and this allows me to bring it to the attention of those concerned.”
Aminata Diallo, Badienou gokh in Darou Salam, 49 years old
“After the training session, I went to meet Mr Babacar Gaye (UNFPA). He gave me some posters and documents so that I could organise an awareness raising activity on the subject of the fistula.
Afterwards I went to the older brother of a woman with a fistula and I took her to hospital”.
Soumkhary Sané, Shopkeeper, 50 years old
“From the training, I took out of it that women had the courage to express themselves.
I talked to our health centre nurse and the Badiénou Gokh who told me that we mustn’t stigmatise women with fistulas and that a fistula is curable.
I had met a Fula woman who showed signs. I approached her and put her in touch with Aminata Diallo, a Badiénou Gokh, so that she help her to get better treatment from healthcare centres. We also organised awareness raising activities in the neighbourhood with young people and girls who are still not at a marrying age with the aim of preventing fistulas.”
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[1] Badiénou Gokh is a volunteer effort in the community where older women mentor younger women in techniques that can help them lead a healthier life, for themselves and their families.