MANGWE DISTRICT, ZIMBABWE – Two years ago, deep in the rural Mangwe district along the border of Zimbabwe and Botswana, Sabina Moyo found herself wondering whether she would die after giving birth to her baby at home.
“People say every pregnancy is different and the labor pains will not be the same,” Moyo says. “But I knew something was wrong when after hours of excruciating pain, nothing had happened.”
Moyo says her husband loaded her into a donkey-drawn cart and took her to the local Plumtree Hospital more than 20 kilometers (12 miles) away.
Moyo gave birth to a stillborn baby at the hospital. Soon after, she discovered that she was leaking urine while in the hospital recuperating.
Nurses told her that her labor had led to an obstetric fistula, a medical condition in which a hole develops between the vagina and either the rectum or bladder. But the staff at the small, rural hospital told her they had no experience treating the problem. They could not do anything for her.
For two years, Moyo has suffered from constant incontinence from what’s known locally as the “urine curse.” She must wash herself, her clothes and her blankets continually. But says she can only go to the borehole to obtain water after sunset to avoid being seen.
“The amount of water I collect is only enough for basic use,” she says, which makes it difficult to maintain sanitary living conditions.
She says she was once a respected woman in her community, but now she survives on subsistence farming and handouts from well-wishers.
“When I discovered I had the curse, I could never have predicted the amount of prejudice I would have to deal with,” Moyo says. “I was suddenly a pariah. Friends stopped visiting, neighbors avoided me, and little children laughed at me and called me the smelly witch.”
She says she feels abandoned by her entire community, including her husband. She says he left her under the guise of looking for work in neighboring Botswana.
Maternal mortality has increased in Zimbabwe, especially in rural areas where trained maternal health care professionals are rare. As a result, complications from childbirth, such as obstetric fistula, are also on the rise in rural provinces. Last year, the government waived fees for women to deliver in public hospitals, but the policy does not extend to treatment for complications, leaving many without care.
Deputy Prime Minister Thokozani Khupe lamented in an April 2012 statement that the maternal mortality rate in Zimbabwe had increased from 725 deaths for every 100,000 live births in 2007 to 960 deaths for every 100,000 live births.
Dr. Rabson Dombo, an obstetrician based in Matebeleland South province, where Moyo lives, says her case highlights the challenges women face in rural Zimbabwe. Poor access to water and proper sanitation exacerbate weak maternal health care.
“These women travel distances of more than two kilometers (1.2 miles) carrying water buckets on their heads, some pregnant and some with babies strapped on their backs,” he