Dignity restored and lives regained through fistula repair in rural Bangladesh
Country: Bangladesh Source: United Nations Population Fund SHERPUR, Bangladesh โ Banessa Bibi, now in her nineties, cannot remember how many children she brought into this world. She only recalls the three daughters and two sons who survived. In her village, childbirth once meant labouring in the dark corner of a room into the hands of an unskilled birth attendant. Little had changed even by the time her two daughters, Jamena and Jamila, had children. For both, the consequences were devastating. Jamila, now 45, experienced severe complications as she delivered her second child at home. Prolonged obstructed labour caused an obstetric fistula, a traumatic childbirth injury. Preventable and treatable Obstructed labour is a deadly condition if not urgently treated โ and treatment is both well established and available in most referral health facilities. Usually, this means a Caesarean section delivery. When women are unable to access care, the consequences can include death of the baby, death of the mother, or long-lasting physical injuries like obstetric fistula. The fistula, a hole in the birth canal, often causes incontinence and stigma. Women with this injury are often ostracized. Preventing and treating obstetric fistula is a human rights imperative, according to UNFPA, the United Nations Population Fund, which is the UNโs sexual and reproductive health agency. A flicker of hope After her obstructed labour, Jamila was left with regularly leaking urine and a foul odor coming from her body. Out of shame and humiliation, she withdrew from public life for two decades. Even her own granddaughter refused to go near her, she described. Jamila still shudders recalling years of feeling trapped in isolation. When she first learned her fistula could be cured by doctors at the UNFPA-supported Dhaka Medical College Hospital, she finally felt a flicker of hope. Two free surgeries followed, bringing the miracle of recovery. โThey gave me my life back,โ Jamila said. โAt first, I was scared of what would happen to me. But their kindness, counselling and stories of other recovered women gave me strength. For the first time in nearly a quarter of a century, Jamila could breathe freely, sit comfortably beside others and live with dignity. Jamena, 55, also developed an obstetric fistula while delivering the first of her seven children. For years, she concealed her injury, fearing she might lose her job as a domestic worker. In 2025, after hearing about her younger sisterโs surgery, she started to believe that healing might be possible for her too. With support from a UNFPA-supported fistula coordinator, Jamena sought treatment. Today, both sisters are healthy. They laugh, work, socialize and move through their community without fear or shame. A better future For as long as anyone can remember, gaps in maternal healthcare services in Sherpur had left pregnant women at high risk of fistula. But today, midwives conduct weekly outreach sessions, bringing maternal healthcare directly to local community clinics and reaching women who might otherwise never seek care. This includes midwives deployed by UNFPA with funding from Global Affairs Canada. UNFPA has also trained healthcare workers in the area, helping to dismantle long-standing barriers to care. As maternal health services improve, childbirth complications are being addressed, helping to prevent obstetric fistula from happening in the first place. And health teams are in place to provide comprehensive follow-up and treatment if it does occur. Even deep-rooted notions that home births are cheaper and less "troublesome" than going to a hospital are shifting through public awareness campaigns supported by UNFPA and the Government of Bangladesh. Banessa and her daughters lived a painful reality, one shared by generations of women in the past โ but not the future.