Reintegration and Trauma Counselling for Survivors of Obstetric Fistula
Votoka believes that all women who suffer from obstetric fistula need emotional healing as well as physical healing. Obstetric fistula. There can be so much loss involved in these two words.
The loss of a child. A stillborn birth from a harrowing situation.
The loss of a husband. Abandoned and despised because of incontinence.
The loss of family and friends. Not wanted. Not valued. Ridiculed.
The loss of church and community. Not welcome.
The loss of fertility.
The loss of income.
The loss of self worth.
Even the loss of self.
Many women we support have considered suicide rather than living this life. Some have tried. We do not know how many out there may have succeeded. It is part of our mission to show these women that they DO have value - whether their physical injury is cured or not. They are loved, they are valuable, they are worthy, and they have something to offer the world.
Our trauma and reintegration program is at the heart of what we do - it is incorporated into our own ways of interacting with the women we support, we teach about trauma to nurses and midwives, and we approach each woman in our care with love and compassion.
Many of the women in our team have suffered obstetric trauma - stillbirths, the loss of a toddler, infertility, near-death experiences during labour, obstetric fistula itself. We connect with the women we support because of our deep love and compassion, which is also borne of pain.
We are so proud of our reintegration team and the work they do, the heart and soul they give to the women we support. In 2026 they have already helped more than 700 obstetric fistula survivors. They are warriors working tirelessly to teach, to listen, to help and to love.
Every year we buy over 500kg of soy beans. These are meticulously sorted (to remove rocks and dirt), boiled, dried, and ground to make a nutritious soy powder. We prepare the soy drink for malnourished women who will receive repair operations, both before and after their surgery, helping them to recover more effectively.
Many women who go on to have a safe cesarean birth, come to visit us with their babies. It is such a joy to see a healthy mum and a healthy baby! We also go and visit some of our patients in their homes, to check on their emotional well-being. Not all women can be cured even if they do have access to surgery, so we work closely to support them.
We show the women love by being sisters or mothers to them. In Angola your mother or your sisters will braid your hair, do your nails, help remove burrowing fleas from your feet. Some of the women we support have not felt the kindness of human touch in years. God washed his disciples feet to show humility and grace, in the hope that they would show the same grace to others. We endeavour to live by this example.
And we TEACH! We teach the women about what obstetric fistula is and how it caused damage to their bodies. We teach the women about trauma - what it is and how it affects you and how you can release your trauma in healthy ways. We teach the women skills to grow their self esteem - hand sewing and basic literacy. We help them to feel proud and capable and worthy.
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