The fistula usually develops when prolonged labour presses the unborn child so tightly in the birth canal that blood flow is cut off to the surrounding tissues, thus causing them to rot away. Another significant cause of obstetric fistula is sexual abuse/ rape, especially within conflict/post-conflict areas.
Towards the end of last year, 85 refugees visited a rehabilitation and reintegration centre for fistula victims near the Ethiopian capital, Addis Ababa. The refugees were from the Democratic Republic of Congo, Djibouti, Eritrea, Somalia and Sudan, countries which have known conflict in recent years.
"Sexual violence is not only a major cause of forced displacement among refugee women, but is also a significant problem women encounter both during flight from their home countries, as well as upon arrival in their new host communities", JRS Eastern Africa Communications Officer, Angelika Mendes, said.
"These trips are part of JRS projects in Ethiopia as teams seek to build awareness about human rights to help refugees protect themselves, their families and the societies they live in", added Ms Mendes.
During the trip to the Desta Mender centre, about 15km west of Addis, refugees learned about the causes and consequences of fistulas. The centre mainly accommodates young girls forced to marry and give birth at a premature age. Since they had no access to an obstetrician they developed fistulas.
"Once the girls' husbands, families or friends learn about the fistulas, they reject and abandon them. Our centre also facilitates income generating activities to help the women become economically independent", the vice director of the centre, Ms Zuriyash Belay, explained.
Refugees had a chance to learn about the various activities offered at the centre, including poultry and vegetable farming, and midwifery training. The centre also offers adult literacy courses.
"Today, I came to know the consequence of early marriage and the suffering of our sisters. We have to stand against the culture of early marriage," said a refugee from Eritrea.
"We now see the extreme need to protect women from dehumanising acts and to stand for their rights," said another refugee. "We will make sure that we will protect women's rights every day. To protect women means to protect society," he added.
All the refugees who participated in the trip have completed JRS-certificated courses in English, computer and IT skills at the Refugee Community Centre in Addis.