USAID/Guinea: Guinean society to Suspension of Official

FEBRUARY 11, 2008

Guinean Society Takes On Fistula

The Mayor of Kissidougou and USAID Director Clifford Brown

Kissidougou Mayor Paul Keita and USAID director Cliff Brown

The mayor of Kissidougou praised USAID’s EngenderHealth project, saying it not only helped women suffering from fistula, but assisted local health authorities in such diverse activities as budget and resource management, and improving communication between local officials and the public.

Following the USAID Director’s visit to Kissidougou in January 2008, the city’s mayor, Paul Keita, lauded the beneficial impact of the project on the women of the region, and praised it positive effects on governance. “The EngenderHealth project fostered a good relationship with the commune of Kissidougou,” said the mayor in a letter to the USAID Director. “This translated into communal advisors training on legal aspects of their operations, development and implementation of the communal budget, building their capacity to manage the resources.”
Since 2005 USAID has financed the EngenderHealth in collaboration with Guinea’s Ministry of Public Health to prevent fistula injuries. Obstetric fistula is an injury caused by obstructed labor, and can be fatal for both baby and mother if prompt medical attention is not available. EngenderHealth concentrates its efforts in the provincial capital of Kissidougou where it works as partners with the district health management team.

USAID’s project focuses on:

• Strengthening the capacity of hospital centers to provide fistula repair
• Educating communities and health facilities to better understand fistula and its prevention
• Gathering and using data to strengthen the quality of fistula services
• Strengthening the supportive environment to institutionalize fistula prevention, repair, and reintegration programs
• Improving the quality of governance at the community level to better assess Fistula care. This initiative entails training members of the Urban Council of Kissidougou on rule of law, civic rights, financial management, and gender equality
In 2007 the program results were quite encouraging:
• Kissidougou commune rented facilities to receive women affected by Fistula, including women living in neighboring Sierra Leone, Liberia, and Mali. The commune created ten Village Safe Motherhood committees to identify early complications in pregnant women. Because many women live in remote areas, the committees facilitate transportations to first care health centers. They also ensure that pregnant women receive four initial care visits and that newborns receive immunization services.
• Communities responded with a considerable increase in activism to prevent fistula.

Success stories from 2007:

In Kissidougou, 40 women receive surgical repair and 30 were successfully discharged from the facility. The success rate during the reporting period was 75 percent.
In Conakry, 28 of 40 women who requested surgical procedures were successfully treated.
The Safe Motherhood Village Committee reached 473 pregnant women, and reported a 52 percent increase in pregnant women seeking for Pre-Natal care.
Kissidougou organized a one-day session in July to sensitize men on the risks, consequences and prevention of fistula.
In addition, the commune of Kissidougou inaugurated a social center to welcome fistula-affected women from neighboring countries.
USAID’s program helps women recovering from fistula treatment develop income generation skills such as sewing, embroidery and soap making. These activities assist in their re-integration in the community. Currently 14 women are involved in soap making.

One Girl’s Story

Fistula can have a horrendous impact on women Guinea where physical torment is frequently followed by social isolation.
Mariama Barry is a young girl who once lived in an isolated rural area of Guinea far from any medical facility. As the time to deliver her child neared, members of her village transported her via hammock for three painful days to the district hospital of Telimele. But they arrived too late. The baby died and Mariama was diagnosed with a fistula.
As a result of the stigma associated with fistula, Mariama was shunned by her village and her family and lived in complete isolation following the death of her baby. After eight years of loneliness she received a clinical screening and she was referred to Kissidougou facility where her fistula injuries were successfully treated. Today Mariama lives with a host family in Kissidougou, and a sense of dignity has returned to her life.

Story and photo by Francesca Munzi