Giving women back their self-worth

In the heart of Lilongwe’s Bwaila District Hospital, a place once marked by despair now rings with the sounds of celebration. The Fistula Care Centre, through its life-changing surgeries and community outreach, is restoring dignity and hope to women who have long suffered in silence, writes Our Contributor JACK MCBRAMS

Nestled within the Bwaila Hospital in Lilongwe, the Fistula Care Centre may seem like an unremarkable place. However, its corridors resonate with stories of profound hope and redemption. On this particular Wednesday, a chorus of joyful songs and drums echoes through the hospital wing, celebrating a remarkable transformation. The chorus is emphatic and clear: “fistula yatha”.

Leading this chorus with exuberance is 35-year-old Alefa Jeffrey, a survivour, and now one of the centre’s most passionate advocates. “I got sick from fistula after I gave birth in 2016, and I really suffered as I was ostracised by my community for the smell,” she recalls. “But when they brought me here, I found many other women suffering from the same disease, and that gave me assurance and hope.”

Jeffrey’s journey from a suffering patient to a beacon of hope for others is short of inspirational. After her surgery, she returned to her village in Thyolo and became an ambassador for the centre. She has since brought 25 patients from Thyolo to the hospital, all of whom have had successful surgeries. “Seeing other women find the same hope motivates me every day,” she says.

The Fistula Care Centre, opened in 2012, is a 35-bed facility with a dedicated operating theatre and the capacity to treat over 400 women each year. The centre’s country director, Margaret Moyo, emphasises the critical role of ambassadors like Jeffrey. “More than 250 former patients or their family members act as ambassadors in their communities. They bring in half of our patients each year,” Moyo explains.

These ambassadors are pivotal in reaching women in remote areas who, otherwise, might never learn that help is available

In partnership with UNFPA Malawi, the centre also runs a capacity-building programme, training clinical officers and nurses from various districts to identify, screen, and refer fistula patients. The programme funds the training of clinical officers in key districts to perform simple fistula surgeries, while more complex cases are referred to the centre in Lilongwe. This decentralised approach ensures that more women can be reached and treated promptly.

Moyo points out that stigma and ostracisation are the biggest challenges faced by patients in their communities. “Because they are leaking urine or stool, they are not recognised in society and cannot engage in any activities. As a result, they are pushed to the margins, which is very sad,” she says. “We don’t just do the physical repair; we also focus on rehabilitation and reintegration back into society.” The psychological scars left by the condition can be deep, and the centre’s holistic approach aims to heal both body and mind.

UNFPA has been instrumental in funding the centre’s social reintegration programmes. They provide sewing machines and solar charging stations to patients upon discharge, empowering them to rebuild their lives. “These tools help women gain economic independence and restore their dignity,” Moyo adds. Many women, after their surgeries, are able to return to their communities not just healed but also equipped with new skills that allow them to contribute economically and socially.

During a tour of the centre, UNFPA’s regional director for East and Southern Africa, Lydia Zigomo, highlighted the importance of addressing fistula by focusing on young girls and women. “Our aim is to raise awareness in communities about the dangers of fistula and ensure that young girls under -18 stay in school and avoid early pregnancies,” Zigomo says. “Preventing early marriage and encouraging education allows girls’ bodies to develop properly, reducing the risk of fistula.”

Zigomo believes that reducing fistula cases will benefit Malawi economically by decreasing the money spent on repairs. “Investing in prevention and education is not only a health issue but also an economic one,” she explains. By preventing fistula, resources can be allocated to other critical areas of healthcare, thus improving overall public health infrastructure.

The centre’s impact extends beyond individual patients to broader community health. The stories of transformed lives serve as powerful testimonies to the effectiveness of the Fistula Care Centre. As more women receive treatment and return to their communities as advocates, the ripple effect grows, gradually shifting public perceptions and reducing stigma.