OBF is a global problem and this is why the United Nations (UN) has set aside May 23 of every year as an international day for the elimination of fistula.  A document published by the Ghana Health Service (GHS) in collaboration with the United Nations Population Fund (UNFPA) and copied to  Ghana News Agency said from January 2011 to June 2014, a total of 1,538 cases of OBF were seen in health facilities all over Ghana.

Women with OBF can be found in the 10 regions; however, most patients live in the Northern, Ashanti, Western, Central and the Upper East and Upper West regions. Research indicates that there will be approximately 1,300 new cases of OBF in Ghana each year.

From 2014-2015, an assessment of OBF commissioned by the GHS and the UNFPA, said about 560 OBF patient data was obtained and analysed. It said 53 per cent of OBF patients were married, 35 per cent had at least primary school level education and the average age at both first marriage and first delivery was about 21 years.

The majority of OBF patients are employed with 38 per cent into farming  and 43 per cent into trading.  All OBF patients have been pregnant at least once and 92 per cent of all fistulae occurred after delivery and most women with OBF had lived with the condition ranging from two weeks to 40 years.

Majority of OBF patients (80 per cent) said they felt helpless about their condition due to lack of information. About half of the OBF patients felt rejected or shunned by their families, at first attempt at repair, eight out of 10 OBF patients were successfully cured.

OBF has devastating physical, social, economic, emotional and psychological consequences for a woman’s life. Many women develop OBF suffer, a chronic skin condition, which is caused by the direct irritation of urine. Some patients develop blisters and sores around their thighs caused by the constant urinary incontinence and friction.

OBF is considered a social calamity in most parts of Africa. Many women who suffer this condition are unable to work outside the home or farm, thereby being unable to generate income. They are mostly shunned by their husbands, families and communities.

Eight of 10 women who develop OBF lose their babies from delivery, which causes the fistula. The situation is worsened by the fact that OBF patients often become isolated from their families and many women with the condition lose their self-esteem and are easily depressed because of their helplessness.

 OBF is not a consequence of sexually transmitted disease, it is not infectious or transferable, it is not a curse or a punishment from gods, it is not as a result of infidelity or witchcraft and it is a curable condition. One cannot easily tell if a woman has OBF just by looking at her, the reason is because women with OBF often adopt various ways of coping with the condition.

The coping strategies include eating and drinking very little so that they will not leak too much urine. They keep themselves generally clean by bathing regularly, using perfume and powder to mask offensive smell, putting calamine lotion on blisters and sores around their thighs and uses old pieces of cloth as diapers.

A woman with OBF usually isolates herself from social gatherings.OBF can be prevented by pregnant women seeking antenatal care throughout pregnancy and also seeking medical help as soon as labour starts and make sure her baby is delivered by a skilled birth attendant.

Health care providers should facilitate access to emergency obstetric care where necessary. Some women try to use herbs and other remedies to treat OBF, this is not a helpful practice as OBF cannot be cured by such means. Appropriate help is available by talking to your Midwife, Nurse or Doctor for guidance on what should be done if you have OBF.

OBF can be repaired through surgery, which yields a success rate of 80 per cent when carried out by a trained provider with the proper medical equipment.  However, some complicated forms of OBF may require more than one surgery to successfully repair the fistula.

 OBF is usually repaired by trained surgeon.

 Currently, there are two main hospitals in Ghana which offer dedicated OBF care.  They are Mercy Women’s Catholic Hospital at Mankessim, Central Region and Tamale Fistula Centre at Tamale Central Hospital, Northern Region.

Other hospitals include Upper East Regional Hospital, Upper West Regional Hospital, Tamale Teaching Hospital, Komfo Anokye Teaching Hospital, Korle Bu Teaching Hospital and some district hospitals. The cost of one fistula surgery is about the cedi equivalent of 400-500  dollars. This is however covered by the National Health Insurance Scheme.