From Sunrise to Sunset

“In Mali, it is said that childbirth should not last longer than from sunrise to sunset.”

Obstetric fistula is a lesion that forms between the vagina and the bladder and/or the rectum following a problematic childbirth. It causes constant leakage of feces and/or urine, resulting in the social exclusion of the affected women. According to the World Health Organization (WHO), this condition affects 2 million women worldwide. In West Africa, it accounts for 3 to 4 cases per 1,000 births, but no one knows the exact number in Mali.

Primarily affecting women with low socio-economic status in rural areas where medical coverage is poor, fistula is mostly linked to the fact that women do not have access to prenatal care or cannot give birth in health centers with qualified personnel. Adolescent girls who become pregnant before reaching full physical development are the most affected.

Because of their bad odors, these women are often excluded from their communities, abandoned by their husbands, and rejected by their families, in addition to having lost the baby during childbirth in 90% of cases. Often isolated and in a state of depression, an expensive surgical operation is the only way to cure them. Many women do not know that treatment exists and do not have access to the facilities where these interventions are performed. For several years, NGOs have been implementing prevention, repair, and reintegration campaigns to cure this condition, which impacts women both medically and socially.

The eradication of obstetric fistula remains a major challenge for this country, which is facing a security and political crisis, one of the consequences of which is the weakening of public services over a large part of its territory.

Bamako, Mali – February 2022