First National Conference on the Role of the Church in the Prevention of Obstetric Fistula Held on the 27th of March 2025

Opening of the First National Conference on Obstetric Fistula

Prayer(Secretary of State Dr Inocêncio, Seretary General of CICA Rev. Agostinho, Director of Operations for Votoka Mary Chimbili)

Votoka, together with our partner the Council of Christian Churches in Angola (CICA), held the first national conference on obstetric fistula on Thursday, March 27, 2025, with the theme "The Role of the Church in Preventing Obstetric Fistula". The event, which focused on prevention measures for this terrible birth injury, was held with the support of Votoka donors: Hope for Our Sisters, Fistula Foundation, and SafeBirth4All Initiative. His Excellency, Secretary of State for Hospital Services, Dr. Leonardo Europeu Inocêncio, opened the event on behalf of the Minister of Health, Dr. Silvia Lutucuta. An obstetric fistula is a hole in the vaginal canal, either to the bladder or the rectum - the hole causes the woman to become completely incontinent of urine and/or feces. It is a complication of childbirth caused by obstructed and prolonged labor. Obstetric fistula can also occur due to medical error during surgery, or due to trauma from an accident or sexual abuse. The inspiration behind Votoka, Dutch nurse Petra Jobse, who has dedicated more than 20 years of her life to the health of Angolans, always says that "prevention is better than treatment. While obstetric fistula can be cured through surgery, there are still women who can never be cured surgically and have to live the rest of their lives incontinent because of this birth injury. With treatment alone, we will never end obstetric fistula. We have to prevent it!" We estimate that there are more than 20,000 Angolan women living with the suffering and indignity of obstetric fistula - and each year the number increases. This event brought together several stakeholders working in the area of ​​obstetric fistula treatment and prevention including: obstetric fistula program technicians from Votoka (Mary Chimbili, Elisa Raul, Chilombo Veronica Jolomba, and Agostinho Sambaca), fistula surgeon and Director of Camama Maternal and Child Hospital Dr. Manuela Mendes, fistula surgeon and maternal health program coordinator at the IESA Evangelical Hospital in Kaluquembe Dr. Priscila Cummings, and Obstetric Fistula Aftercare Reintegration Program Coordinator at the Lubango Evangelical Medical Center (CEML) Mrs. Edme Cachicata Francisco. There were also lectures by Dr. Rev. Alexandre Raul of the Evangelical Alliance of Angola on Family Planning in the Religious Context, and Dr. Mansitambi Luz of the National Directorate of Public Health on the importance of breastfeeding, nutrition and prenatal consultations. Guests included representatives who traveled from Moxico, Lubango, Kaluquembe, Huambo, and Cabinda.

The aim of the event was to raise awareness among all churches in Angola about obstetric fistula and about concrete actions they could take to prevent more women from dying in childbirth or suffering from obstetric fistula. Preventing obstetric fistula will also save the lives of many babies, because 95 out of 100 women with fistula lose their baby during childbirth. Prevention of obstetric fistula is comprehensive and multisectoral. But this doesn't mean it's impossible!

At the event, fistula survivor Isabel, who was cured in 2024, told how she suffered for 11 years with obstetric fistula. She spoke of the abuse, of being abandoned by her family, of the psychological effects, and even of her desire to no longer live. Isabel said she still doesn't believe she is cured, and that the psychological healing from trauma continues. Votoka and CEML offer trauma counseling as part of their reintegration programs, and this has helped Isabel. Obstetric fistula is more than a physical injury, it also creates so much psycho-emotional suffering. Treatment must be physical, psychological and spiritual!

Every contribution, no matter how small, makes a difference. Even if it saves just one woman from the indignity and suffering of obstetric fistula, it is a huge contribution to that woman's life! And if we can prevent a fistula from occurring, we can even save the life of an unborn baby!

Our suggestions for church actions include:

• teaching congregations about obstetric fistula

• encouraging pregnant women to have prenatal care

• encouraging pregnant women to have at least 1 ultrasound for each pregnancy

• identifying women at higher risk of obstetric fistula -- first birth, adolescent, short height (1.5m and under)

• supporting women at higher risk or who live far from hospitals with emergency obstetric conditions to relocate closer to a hospital in the last month of pregnancy

• establishing church "waiting houses"

• promoting marriage and pregnancy at the right age (after 20 years)

• promoting family planning in the religious context

• teaching couples and families about a "birth plan" and how to prepare in case of an emergency

• encouraging families to focus on the nutrition of children so they grow well

  • consumption of soy, peanuts and beans

  • consumption of green leaves and fruits

  • exclusive breastfeeding for the first 6 months

• promoting a woman's right to have a safe birth

We are very proud of everyone involved in preparing the event and hope that this conference opens the national conversation about Obstetric Fistula Prevention. We are very grateful to CICA for their complete commitment to the event, and to our donors for their support and trust!