600 rape victims recently interviewed by a Liberian non-governmental
organisation, 90 percent of the women were found to be suffering from
fistulas – a vaginal tear which results in loss of bladder control and
Aid workers say the statistic, provided
by the Women of Liberia Peace Network (WOLPNET) from surveys conducted
in April 2008, shows the horrifying prevalence of rape and of a
phenomenon which Liberian medical officials say they are ill-equipped
to respond to.
“These women are living with a serious scar and they are not getting access to treatment,” said Una Thompson, head of WOLPNET.
According to local health workers two types of fistula cases are prevalent in Liberia.
One is obstetric fistula, which is a vaginal tear resulting from prolonged obstructed labour.
recent health survey showed that over average 994 women die for every
100,000 who give birth, a higher rate than was estimated during
Liberia’s civil war. Doctors say the most common cause of death is
vaginal haemorrhaging following childbirth.
workers and officials say the spike is a result of improved data
collecting. However others say fewer births are being attended by
trained medical professionals, who diminished in numbers through the
end of the 1990-2003 war, partly because of migration. Read an IRIN report on maternal mortality in Liberia
other common cause of fistula in Liberia is traumatic gynaecologic
fistula that is a vaginal injury resulting from violent sexual assault
or when objects are forcibly inserted into the vagina.
crime and rape especially of children are common in Liberia, and police
and justice systems have proven ineffectual at ending impunity for
these crimes. Read an IRIN report on crime in post-conflict Liberia
John Mulbah, head of the maternity centre of Liberia's biggest referral
hospital, the John F. Kennedy Hospital in Monrovia, said resources are
limited to repair the damage.
“We have only five staff trained
to conducted fistula treatment and all of them are based in Monrovia
[the capital]", he told IRIN.
"The unit only has 30 beds… our
facility is overwhelmed with patients and some have to wait for a long
time before being attended to.”
The unit was created in
February 2007 after the UN sponsored a survey which identified 351
women suffering from fistulas in rural Liberia. The unit is 100 percent
funded by international donors, not the government, Mulbah said.
drugs and supplies and the only vehicle conducting outreach in rural
parts of the country were provided by the UN Population Fund (UNFPA).
Treatment at the unit is free," Mulbah said.
minister, Walter Gwenigale, told IRIN that transporting fistula
patients from rural areas to Monrovia for the treatment is a major
constraint on broading treatment.
"Bringing those patients to
Monrovia requires funds. We are aware that there are lots of fistula
cases upcountry but the national health budget for Liberia is just
US$11 million which is totally inadequate to deal with all health
problems," Gwenigale said.