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Voices From the Field: DR Congo

Yesterday was International Day to End Obstetric Fistula, a serious injury that can occur from complications in childbirth. The World Health Organization used this day to call on the international community to significantly raise awareness and intensify actions towards ending obstetric fistula.

An estimated 2 million women in sub-Saharan Africa, Asia, the Arab region, and Latin America and the Caribbean are living with this injury, and some 50,000 to 100,000 new cases develop each year. Yet fistula is almost entirely preventable. 1 Its persistence is a sign that more can be done.

We took a moment to talk with Dr. Esperance Ngondo*, staff in DR Congo, about this injury and our work in DR Congo to treat and prevent fistula.

What is fistula?

Obstetric and traumatic fistula presents as a hole between the tissues of the vaginal canal and bladder, vaginal canal and rectum or all three.

What causes Fistula?

We see fistula caused by a number of circumstances. Obstetric fistula occurs when girls whose bodies aren’t yet fully developed try to give birth. Young girls under the age of 16 are at greatest risk of developing obstetric fistula. Traumatic fistula, however, is typically the result of a violent rape. In the Congo, where rape is frequently used as a weapon of war, we focus most of our work on this type of traumatic fistula.

How did World Relief DRC begin working with women with this injury?

For more than ten years, the World Relief DR Congo office has been active in humanitarian programs and in projects promoting health, agriculture, microfinance, peace & conflict resolution, savings and institution building among churches and communities, 82% of our beneficiaries are women and children – the most vulnerable demographic across the board, but especially in Congo. As World Relief DR Congo implemented its numerous programs in the rural areas, it has been increasingly clear that sexual and gender-based violence (SGBV) against women and young girls (ages 2 to 60) must be addressed.

What are the effects of fistula for a women in DR Congo?

When fistula occurs and is not treated, many women become incontinent and are often cast out by their families as shameful and dirty. Not only do women experience horrible physical effects of fistula, but there are painful social and emotional effects as well. In Congo, women who are raped face terrible rejection and stigmatization. If a woman is married, not only her own family, but her husband and husband’s family cast her out of the home leaving her feeling rejected and humiliated. Oftentimes these women become homeless. In fact, many of our volunteers find these women living hopeless and alone in the forest.

What programs does World Relief DRC offer to support women suffering from fistula?

World Relief has implemented a number of programs to provide medical, psychosocial and economic support to women who are survivors of sexual violence as well as women who have developed obstetric fistula. In partnership with a local hospital women receive treatment, often surgery, for fistula. After the initial surgery, programs are in place to support women; Income generating programs are offered to women to restore their dignity, as well as provide them with the opportunity for economic independence.

How successful are the programs?

In general, fistula repair surgery has an average 80% success, but for World Relief and our partner hospital, we see a 95% success rate. We see God blessing our work again and again. Desperate and hopeless women are finding hope and experiencing a renewed sense of self-worth and dignity.

1. World Health Organization. Retrieved May 23, 2019 from

*Dr. Esperance Ngondo is a World Relief DRC’s Sexual and Gender Based Violence (SGBV) & HIV/AIDS Health Officer. After completing her degree in medicine from the University of Goma, DRC in 2013 she worked at Bethesda Baptist Hospital in Goma in a program supported by Doctors without Borders, specializing in diagnosing and treating cases of SGBV. She began working as WR’s SGBV-HIV/AIDS Health Officer in 2015. Dr. Ngondo and her husband, Innocent, have three young daughters.

Dana North serves as the Marketing Manager at World Relief. With a background in graphic design and advertising and experiences in community development and transformation, Dana seeks to use the power of words and action to help create a better world. Dana is especially passionate about seeking justice for women and girls around the world.

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