Restoring fistula survivors’ dignity

Back in 2000, Asiyatu Tambala, aged 20 at the time, hoped to become a mother for the first time.

She looked forward to the journey of motherhood and carefully followed all the advice from health workers at her local clinic.

Each time Tambala visited the nearest clinic, she pictured the moment she would finally hold her baby. A week before her due date, she checked into the maternity ward at the local hospital to ensure a safe delivery.

“Everything was going well,” she recalls. “However, I was a bit nervous since it was my first time, but I looked forward to holding my baby in my arms.”

After five days in the hospital, Tambala started feeling strange changes in her body. She quickly informed the medical staff, who assured her that labour was near. That evening, her contractions grew stronger.

The nurses and doctors did all they could to help her deliver, but the baby still wouldn’t come. As her condition worsened, the medical team decided to perform an emergency caesarean section to save both Tambala and her baby.

“I didn’t mind the procedure as long as it ensured a safe delivery,” she says.

The operation was a success, and at last, she held her newborn in her arms. But the baby was struggling to breathe and was quickly taken to a special care unit.

Just a few hours later, Tambala was given heart-breaking news that her baby had not survived.

“I was shattered when they told me my baby had died,” she says.

Tambala was discharged after spending two days in the hospital to recover from the surgery.

But upon returning home, she noticed something strange—she was constantly leaking urine. As a young woman with no knowledge of such a condition, she turned to her mother in-law for answers, but she too was baffled.

“I went back to the hospital, but all they gave me were painkillers,” she recalls. “They didn’t help at all. When I told my husband, he wasn’t supportive.”

A month later, her worst fear came true—her husband told her he could not stay with a wife who was leaking urine.

Heartbroken and abandoned, Tambala had no choice but to return to her parents’ home in Nkhotakota. There, she sought help from different hospitals, but none could provide a solution.

A second chance

In 2005, Tambala met a man who accepted her despite her condition. They married and had four children together, but the burden of her condition remained.

A turning point came in 2015 when she received a call from her aunt, who worked at Bwaila Hospital in Lilongwe.

“She asked if I still had the condition,” Tambala recalls. “When I said yes, she told me about a new clinic treating my condition and urged me to go.”

She hesitated for 15 years, seeking answers with no success. But with persistent encouragement, she finally made the journey to Lilongwe.

Doctors at Bwaila examined her and diagnosed her with obstetric fistula, a condition that affects thousands of women in Malawi, yet remains preventable and treatable.

“It was my first time hearing about this condition,” she says. “When the doctors asked if I was ready for treatment, I told them I could stay in the hospital for a year if it meant getting better!”

She underwent surgery, and for the first time in 15 years, she woke up dry.

“I couldn’t believe it. It felt like a dream,” Tambala explains.

Entrepreneurship

As part of her reintegration into society, UNFPA, through the Bridging Hope Project funded by the Government of Iceland, provided Tambala with a sewing machine.

She also attended a week-long training at Bwaila Fistula Centre to help her master tailoring skills.  Part of the programme empowers fistula survivors to rebuild by supporting them with start-up capital for small businesses.

“When I returned home, I quickly set up my sewing business,” Tambala says. “I started making reusable sanitary pads and bags, which I sell to women and girls in my community.”

Within a short period, her products gained a strong market, particularly the reusable pads, as conventional menstrual products remain expensive for many women.

“There’s a high demand for the pads,” she says. “The bags sell well too, and together, my business brings in about MK20 000 per week.”

For Tambala, this is more than just a business—it’s a second chance at life.

“For 15 years, I lived in solitude. I had no friends, no income, and no dignity,” she says. “This project has given me my life back.”