“Now that my fistula is repaired, I feel as if I was born again. From now on I will live a normal life, like any woman should live” These are the words of Mariam Douba, with whom we talked in the recovery room of the Center for Reproductive Health and Fistula Repair (CNSRF) in N’Djamena, Chad.

Mariam is only 45, but during 15 years she lived with an obstetric fistula that made her incontinent, isolating her from all professional activity, from any kind of social interaction and even from her family. Last February, she was operated by WAHA’s specialists at the CNSRF, and now she has the opportunity to take her life back step by step.

Mariam’s life was disrupted 15 years ago, when she developed a fistula after her second stillbirth. As it is common in her community, she gave birth at home, without any professional help and in company of only her family. However, after four days of obstructed labor, she had to be transferred to the Fianga Hospital, which is located in Mayo Kebbi Est, 40 Km away from her home village.

Shortly after and already incontinent, she became pregnant and had a third complicated labor that resulted in the loss of yet another baby. A few years later her husband abandoned her, leaving her ashamed and lonely. She was helped by her family, but she still had to face rejection and the reticence of the community to take her back.

Her first surgery after 14 years of incontinence had failed. She was disappointed and envisaged the rest of her life living in this condition. It was then that she learned that she could be treated by specialists from WAHA at the CNSRF in N’Djamena, where she headed last month and is recovering at the moment.

Mariam is healed today, she feels liberated and confident, looking upon her future with serenity. “You cannot imagine how free I feel, I feel reassured and positive”, she says to us. She is impatient to go out, to take her life back, to go work in the fields and to enjoy her family.

Unfortunately, Mariam’s story is not uncommon in Chad. In 2012, maternal mortality reached 1,100 deaths per 100,000 live births, a ratio that places Chad among the countries with the highest maternal mortality in the world. In 2011, only 22.24% of women received professional care during childbirth and, though it is difficult to obtain precise figures of fistula and other childbirth complications, many women face this risk as there is little access to medical services and a high prevalence of cultural practices that impede women to turn to professional care givers for assistance during pregnancy or childbirth.

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