Dr. Joseph K. Ruminjo is the Senior Medical Associate with the Safe Motherhood program at EngenderHealth.
I am writing from the FIGO World Congress of Gynecology and Obstetrics in Kuala Lumpur, where the important issue of traumatic fistula is being addressed on this international stage. In recent years, the international health community has increased its focus on obstetric fistula. This tragic condition, usually the result of complicated childbirth, causes women to leak urine and/or feces, and often makes them social outcasts.
Unfortunately, traumatic fistula - an injury most often caused by sexual violence - has until now received little international attention, perhaps due to its taboo nature or the great shame that women feel as a result. Traumatic fistula appears to be especially common in countries experiencing conflict, although it can occur anywhere.
After undergoing what are often life-threatening attacks, survivors must endure the double stigma of having been raped and then smelling of urine or feces. Sufferers are also more susceptible to HIV and other infections and must wrestle with issues such as unintended pregnancy.
