Scholastica Daudi developed obstetric fistula during a difficult delivery when she was just 17 years old. Now 23 and healthy, Scholastica is running her own business, supporting her growing family, and helping other women recovering from this physically and psychologically painful condition.
Obstetric fistula is an abnormal opening between a woman’s vagina and her urinary tract or rectum, resulting in the leakage of urine, faeces, or both. This debilitating condition is most often caused by obstructed or prolonged labour, and is directly linked to early marriage and motherhood, FGM/C, and a lack of access to high-quality healthcare. The World Health Organization (WHO) estimates that, worldwide, up to two million women may be living with fistula. However, the stigma that surrounds the condition means that many cases go undiagnosed and therefore untreated, sometimes for years or even decades.
Amref Health Africa provides comprehensive support to women living with fistula in Tanzania. Working with local partners, we provide repair surgery and ongoing psychosocial support, along with entrepreneurship training and seed funding so that women can start up small businesses, boosting their confidence and helping them achieve financial independence. The women we work with are extremely brave: having survived physical and psychological trauma, many go on to work as ambassadors, supporting other women who are living with fistula and addressing stigma in their communities.
23-year-old Scholastica Daudi is one of them. She lives in Simiyu Region with her father and stepmother, along with some of her siblings, nieces and nephews. "When I get up in the morning I clean the house, wash some dishes, and cook for the children," she says. "After that I’m free to go and do my own work. I sell vitumbua (sweet cakes made from rice flour). I make between 100 and 150 of them every day, and distribute them to different shops in the area, where they are sold for 100 shillings each." Scholastica launched her business after attending entrepreneurship training delivered by Amref and its partners.
Life has changed a lot for Scholastica in the past few years. She developed fistula during a difficult delivery in 2012, when she was just 17. Sadly, she lost her baby.
"When I was first diagnosed with fistula, I didn’t know what it was," she remembers. "I contacted my birth mother and explained my symptoms. She was convinced I’d been bewitched, and suggested I go to the traditional healer for help. But my stepmother had a different view. She said, ‘No, you’ll be wasting your time; you need to seek medical help.’
"When I first became ill, my father wouldn’t let me cook for the family because he was afraid I would transmit my condition to others. He said, ‘It’s not proper for you to do this; I can’t eat this.’ I was isolated from my family and from the main house. I was confined to my room.
"My stepmother was different. She was supportive; she was keen to persuade my father not to discriminate against his own child. But it was difficult, because my father told her, ‘You’re not her mother. I am her father, and I know what’s best for her.’ But she persisted, and after some time she managed to convince my father that there was nothing to fear. He agreed to take me to the hospital in Magu. They confirmed that it was fistula, and they referred me for surgery. Unfortunately, the operation was not successful*, and two weeks later the problem recurred. So I had to continue recovering from the surgery, knowing that the problem hadn’t been solved. It was a very difficult time.
"When I had recovered from the surgery, my father sent me back to Magu. They examined me again, and this time I was referred to a bigger hospital in Dar es Salaam. This time, the surgery was successful."
In November 2017, Scholastica gave birth to a healthy baby boy, Shadrach Jackson. "I wasn’t scared when I found out I was pregnant again," she remembers. "I knew that it’s possible to have another baby after you have recovered from fistula. You just need to make sure you see the doctors, and you have to be straight with them: you have to tell them that you had this experience before. This way they know to treat you in a special way.
"I still feel that I’m not fully respected in the community. I don’t have the same status I had before this happened to me. But for now, I want to focus on running my business and taking care of my kids. I am expecting again; the baby is due in five months."
Scholastica is relishing her new role as an ambassador. "I really aspire to learn more every day. I want to engage myself more in educating women in other villages. I want to help more of the women out there.
"When I first spoke at church about my own experiences, I spoke in disguise: I told them that I had heard of somebody who was experiencing these symptoms, just to see what the reaction would be. I was a bit sceptical about how people would take it. When I saw that the reaction was positive, I felt more comfortable.
"I think the church is a good avenue to deliver messages and spark discussion. I think small social gatherings are the ideal situation. That way you can meet people, you can talk, and you are a bit more focused. I also think it could be done in business settings, because you already have something in common: one is selling vegetables, the other is selling vitumbua. In business you have peak hours and you have idle hours where you can start chatting and exchange information and knowledge. I think people would be more attentive in these circumstances, because they already know you.
"I really want to learn more about how to challenge thinking: how to counter beliefs about witchcraft, for example. I want to inform people that these things can be medically corrected, and that the services are free and available. I want them to know that people can deal with these situations; that there is support out there: so many people who care about these women."
* It is not uncommon for the surgery to be unsuccessful first time.
Interview conducted in September 2018. Image © Sam Vox for Amref Health Africa UK.