by James Murray, Programmes Officer, Amref UK
Equity and equality are not the same thing - while equality means treating everyone the same, regardless of their circumstances, equity acknowledges that different people have different circumstances that impact what they need to succeed.
For women living with obstetric fistula, equity is critical. These women face unique challenges that require tailored solutions, which include access to specialised medical care, education about managing their condition, and support to rebuild their self-confidence and reintegrate into their communities.
Achieving equity for women living with obstetric fistula means more than just providing them with the resources they need. It requires deliberate effort to address the social, cultural, and economic factors that contribute to their condition in the first place. This means investing in education and awareness-raising to reduce the stigma around fistula, improving access to maternal healthcare to prevent fistula from occurring in the first place, and promoting gender equity more broadly to reduce the barriers that women face in accessing healthcare and education.
In 2019, with funding secured through Amref UK, two projects started in Uganda and Tanzania that aimed to reduce the medical, social, and economic burden that women living with fistula suffer. Both projects incorporated international best practices into their design, while also adapting their approaches to the unique needs of the communities in which we work. The work takes place through four intervention areas: increasing access to life-changing restorative surgery; awareness-raising; psychosocial support; and livelihood opportunities.
Esta Laurent, fistula survivor
The story of Esta Laurent, a 32-year-old mother of four from Tanzania who is a fistula survivor, highlights the devastating impact this condition can have on a woman's life and why providing equitable and holistic fistula care is so important.
Esta contracted fistula during her sixth pregnancy when her unborn child died while she was six months pregnant. After undergoing surgery to remove the stillborn baby, she began experiencing urine leakage and had no idea why.
Esta's condition had a profound impact on her life. She felt embarrassed and ashamed of her situation, isolating herself from others and avoiding social contact. Her husband and family remained supportive, but Esta still struggled with the physical and emotional pain of living with obstetric fistula.
Surgery and support
Fortunately, Esta eventually learned about her condition from a project-trained Fistula Ambassador who explained to her what the condition is, how it can be managed, and what support and treatment options are available to her.
After six months of suffering and living in isolation because of fistula, Esta underwent successful surgery to treat her condition. She has now fully recovered and is back to living a normal life, running a shop that helps her financially and is physically able to work on her daily chores to help her family around the house.
For women like Esta Laurent, who have lived with the pain and isolation of obstetric fistula, equity is not just a nice-to-have - it's a must-have. It's what informed Amref’s approach that enabled her to access the care and support she needed to recover and reclaim her life. And it's what will enable other women living with obstetric fistula to do the same.
Gender equity should be a fundamental part of every society's DNA. It means recognising and addressing the structural inequalities that keep women from reaching their full potential - from unequal pay and limited job opportunities to limited access to education and healthcare. And it means actively working to dismantle these barriers and create a more just and equitable society for all.
So, as we celebrate UK Mother’s Day, let's commit to #EmbraceEquity and work towards a world where all women - regardless of their circumstances - have the resources, support, and opportunities they need to thrive.