Freedom of expression and information are key to achieving human development goals. The availability and accessibility of information promotes transparency, ensures better governance and reduces inefficiency and corruption. Information gives people the opportunity to improve their own lives, participate in the decision-making processes that affect them and hold their leaders to account.
In Senegal, the high instance of obstetric fistula – and the scarcity of information about preventing and treating this devastating injury – strongly demonstrate why access to information is crucial to achieving the Millennium Development Goals.
An obstetric fistula is an injury to a woman’s bladder or rectum caused by a long and difficult delivery without proper medical care. Women who suffer from fistulas are often socially ostracised and forced to leave their families due to a lack of understanding about the injury.
A fistula can be caused by a variety of factors, including early marriage and pregnancy, poor medical care during delivery and female genital mutilation. However, the majority of the population, especially those living in rural and deprived areas, is not aware of these. Often, the most affected regions are those that are the most remote. These regions have a very high level of poverty, limited access to healthcare and harmful cultural practices often continue to be imposed on girls and women.
The Senegalese government, together with international and national organisations, has taken a number of actions to deal with obstetric fistulas, including free fistula reparation treatment across the country. Yet the problem remains. Each year, hundreds of women continue to suffer from this injury due to a lack of accurate information about prevention, treatment and rehabilitation.
Linking poor access to information to fistula
ARTICLE 19 investigated the link between the lack of information and incidences of obstetric fistulas in Tambacounda Province, the area with the highest number of incidences in the country.
According to a survey conducted by ARTICLE 19 in Tambacounda, many people have never heard of obstetric fistulas. Many of those who did know about the injury did not know that women can get free treatment. Of 290 people who were interviewed, including 190 women, only 32 had heard of the injury.
The survey confirmed that women do not know where to go or which procedures to follow in order to get treatment. The injury is still surrounded by mystery, taboos and false information about its origins. Going to medical facilities for information is not common practice in Senegal, especially in regions such as Tambacounda. “It is difficult to ask for information when you don’t know where to channel your request or what procedures are in place,” reported a survey participant.
The outcome: “Information is a right for all the world’s people”
Our experience in Senegal shows that medical programmes alone won’t be enough to solve maternal health issues. People must know about the programmes and more importantly, know where to ask. Access to information is the crucial link in empowering women to improve their lives.
ARTICLE 19’s work in Tambacounda, while ongoing, shows early promise in improving maternal health outcomes through better access to information. Our pilot program trained 58 community activists and volunteer health assistants about the causes and treatment of fistulas. As a result, women suffering from fistulas were identified and referred for medical treatment in hospital. More generally, women reported feeling empowered to ask for information from health centres. They also said that they felt able to share what they had learned about the causes and treatment with their communities.
“After the training, I got more information about the dangers of fistulas and this allowed me to share this information with my friends and the people in my neighbourhood. I even detected a woman with a fistula. Information is a right for all the world’s people, just like the right to eat, to dress, to be medically treated.” – Ngolo Tamega, Development counsellor in the Pont neighbourhood.