Living with obstetric fistulaBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d2881 (Published 09 June 2011) Cite this as: BMJ 2011;342:d2881
All rapid responses
Mrs. Fatima Aliyu,
I was overwhelmed with indignation and resentment after reading your
birth diary, full of criminal medical malpractice and unethical
I hope you find a concluding cure, after all this time, and wish you
all the best.
It is unacceptable that millions of women get systematically
humiliated, disrespected and mutilated in thousands of labour ward
parodies, in developing Countries.
Prevention of vescicovaginal and rectovaginal fistulas is better,
easier and cheaper than their cure.
Basic obstetric skills are mandatory!
By writing basic, I mean a one page flow chart with instructions, hanging
to the labour ward wall, even an uneducated person can follow!
1) The woman in labour is in pain, she is not being lazy!
2) Urinating blood is bad!
3) Black water coming out from the vagina is bad!
4) Before accepting a woman in labour, make sure your "Hospital" can
support an emergency cesarean section.
5) A midwife can help in many other ways than repeating "push, push,
6) A woman in pain for more than 24 hours, but still not giving
birth, is bad!
7) Frequent vaginal examinations are bad!
Unfortunately, in Mrs. Aliyu's case, these simple rules were not
See also my rapid response here.
Competing interests: Dr Stavros Saripanidis is an active voluntary member of a non-profit organization that fights for women's rights.