Istahil's extraordinary journey unfolds within the heart of a small village in the Bardhere district, nestled in the southwestern Gedo region of Somalia. Her challenges echo those faced by countless women and girls grappling with the profound repercussions of obstetric fistula, exacerbated by the harsh realities of unattended births and the impact of Female Genital Mutilation/Cutting (FGM/C). At the tender age of 9, Istahil underwent FGM, a practice prevalent in Somalia, where 99 percent of girls and women between 15 and 49 have endured its effects, heightening the risk of complications. Forced into marriage at 14, she navigated the complexities of teenage pregnancy, unaware of the critical importance of healthcare. Her lack of medical assistance or antenatal care during pregnancy led to three consecutive days of labor at home. Tragically, the prolonged and obstructed labor resulted in the stillbirth of her baby. The very next day, Istahil discovered she had developed vesicovaginal fistula (VVF), causing a constant and distressing leak of urine and feces. This condition, a common consequence of obstructed labor, adds to the staggering statistics, estimating Somalia's fistula burden between 3953 to 13337 cases, with a prevalence rate of 1.17 – 4.05 per 1000 women.
Istahil, much like most others suffering from fistula, found herself cast out from her home and community—her husband severed ties, and she sought refuge with her sisters. Hope dawned when a UNFPA supported mobile outreach team informed her that her condition was treatable, leading her to the life-changing fistula repair surgery at Daynile General Hospital in Mogadishu. Her journey from her village to the hospital, driven by the hope of affordable treatment, culminated in a thorough screening, assessment, and successful surgery by the hospital's skilled specialists—all provided at no cost.
“I am very happy that after a very long time, I can sleep without wetting my bed. It has been good days here at the hospital, and doctors say I will get better as time goes by,” Istahil expressed gratefully. “I would like to thank the hospital and all the doctors and nurses for the free care and the surgery.”
Istahil's story is a powerful example of the impact of the support provided by King Salman Humanitarian Aid and Relief Center (KSrelief) to UNFPA through the project, "Providing Reproductive Health Services to Pregnant Women and Girls in Somalia”. With support from KSrelief, UNFPA was able to provide essential supplies, life-saving commodities, and trained professionals to four BEmONC, two CEmONC (Comprehensive Emergency Obstetric and Newborn Care) centers, and Fistula repair centers across Somalia. These centers provide critical care to pregnant women and girls, including those who have developed fistulas due to obstructed labor.
KSrelief's support also strengthened mobile outreach teams, extending their reach and bringing basic reproductive health services to remote populations. This has made it possible for women like Istahil to be aware of and access the medical care they need.
Istahil's journey is a testament to the transformative impact achievable through strategic interventions. The provision of essential supplies, the fortification of healthcare facilities, and the reinforcement through mobile outreach teams emerge as pivotal components in breaking barriers to medical care for women like Istahil. Such holistic support extends beyond mere health improvements, resonating as a force for empowerment that enables individuals to reclaim their dignity and seamlessly reintegrate into their communities. The ripple effect of such concerted efforts manifests in tangible transformations, where access to medical care becomes a catalyst for holistic recovery and societal reintegration.
