{"id":20132796,"date":"2026-05-23T12:26:33","date_gmt":"2026-05-23T10:26:33","guid":{"rendered":"https:\/\/www.dabangasudan.org\/?p=20132796"},"modified":"2026-05-23T12:46:32","modified_gmt":"2026-05-23T10:46:32","slug":"fistula-in-sudan-a-wound-the-world-refuses-to-look-at","status":"publish","type":"post","link":"https:\/\/www.dabangasudan.org\/en\/all-news\/article\/fistula-in-sudan-a-wound-the-world-refuses-to-look-at","title":{"rendered":"Fistula in Sudan, a wound the world refuses to look at"},"content":{"rendered":"\n

By Rana S. for Radio Dabanga<\/a><\/span><\/ins><\/em><\/strong><\/p>\n\n\n\n

As the United Nations marks the International Day to End Obstetric Fistula today, May 23, experts and aid workers on the ground in Sudan warn that the global conversation is missing a graver and more urgent dimension: the traumatic fistulas inflicted by the epidemic of sexual violence accompanying Sudan\u2019s war.<\/strong><\/p>\n\n\n\n

Obstetric fistula<\/a> is among the most debilitating (and preventable) injuries a woman can sustain during childbirth. It occurs when obstructed labour is not managed in time: a baby\u2019s head becomes lodged in the pelvis, cutting off blood circulation to surrounding tissue. The resulting damage can open a hole in the wall separating the birth canal from the bladder or rectum, leaving a woman incontinent and, without surgery, permanently so.<\/p>\n\n\n\n

In the Tina area on the Chad-Sudan border, hundreds of women are currently waiting for fistula surgery. According to Prof Eric Reeves<\/a> \u2014 a Sudan scholar and founder of Team Zamzam<\/a>, the community support programme coordinating their care \u2014 not one of them has an obstetric fistula. Every case, he told Radio Dabanga, is traumatic.<\/p>\n\n\n\n

While obstetric fistula and traumatic fistula share a similar presentation and require similar surgical treatment, they differ fundamentally in cause and severity. Traumatic fistula<\/a> is caused by sexual violence, including rape and penetration with objects. The women who sustain traumatic fistula are also, by the nature of conflict, far less likely to be anywhere near a functioning medical facility. \u201cThose who are suffering from traumatic fistula are in places like Zamzam where there was nothing, or in rural villages that have been overrun where there\u2019s no medical attention,\u201d Reeves said.<\/p>\n\n\n\n

Beyond the physical injury, fistula \u2014 obstetric or traumatic \u2014 carries a devastating psychosocial weight. \u201cGiven the cultural taboo associated with rape, women are reluctant to report it to the few medical workers present in refugee camps, which can lead to further medical complications of injuries they may have sustained during the rape,\u201d a 2004 Amnesty International<\/a> report noted.<\/p>\n\n\n\n

Many are shunned or abandoned by family and community due to the physical realities of constant incontinence. \u201cMost women will suffer serious psychological problems, having to bear and raise an unwanted child and suffering from social stigma and a lack of community support,\u201d the report said.<\/p>\n\n\n\n

 Reeves emphasized that these psychosocial consequences are routinely underestimated precisely because the material needs in conflict zones are so overwhelming. \u201cThere\u2019s so much violence, there\u2019s so much brute physical injury, that what may be just as debilitating and damaging goes untreated.\u201d<\/p>\n\n\n\n

A pattern two decades in the making <\/strong><\/p>\n\n\n\n

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\u201cThere is a reluctance to come to terms with the reality of rape in Darfur and elsewhere in Sudan with the expansion of the war by the RSF. To treat traumatic fistula is to come face-to-face with the consequences of a demonic violence.\u201d<\/em> – Eric Reeves<\/p>\n<\/blockquote>\n\n\n\n

Sexual violence as a weapon of war<\/a> is not a new phenomenon in Sudan. The country had once developed specialized networks for fistula care<\/a>, including Dr. Abbo\u2019s renowned fistula centre in Khartoum, a UNFPA-supported hub in Zalingei, and dedicated facilities in El Fasher.<\/p>\n\n\n\n

Now, that map has been completely erased. In 2024, the Rapid Support Forces (RSF) bombed El Dayat Maternity Hospital<\/a> for Obstetrics and Gynecology in Omdurman, Sudan\u2019s largest maternity hospital, shutting down life-saving surgeries. The fall of El Fasher in late 2025, which was accompanied by mass rape<\/a>, saw the Saudi Maternity Hospital in El Fasher sustain a brutal attack by the RSF. Approximately 460 people were killed<\/a> inside, many of them patients.The broader healthcare infrastructure has been thoroughly gutted<\/a> by staff displacement, critical supply shortages, and direct attacks<\/a> on medical facilities, forcing a significant portion of the country’s hospitals to close entirely.<\/p>\n\n\n\n

\u201cThat was one of the most shocking episodes of the war to date,\u201d Reeves said. \u201cThere is a reluctance to come to terms with the reality of rape in Darfur and elsewhere in Sudan with the expansion of the war by the RSF. To treat traumatic fistula is to come face-to-face with the consequences of a demonic violence.\u201d<\/p>\n\n\n\n

\u2018They just give their tears and their thanks\u2019<\/strong><\/p>\n\n\n\n

Since its founding, Team Zamzam has facilitated more than 90 fistula surgeries. Reeves describes the process as intensely labour-intensive. Staff must psychologically prepare women who have never undergone surgery for what lies ahead, support them through catheterisation \u2014 \u201cwhich is very, very hard\u201d \u2014 accompany them to and from the operating site, and monitor their recovery closely.<\/p>\n\n\n\n

\u201cThe suffering was unspeakable,\u201d Reeves said. \u201cBut it was one of the things I\u2019m proudest of in what we\u2019ve been able to do.\u201d<\/p>\n\n\n\n

The logistics of providing this care are becoming increasingly perilous. The roads connecting Tina to potential surgical sites are difficult to navigate, and, with the heavy rainy season fast approaching \u2014 Reeves expects it to be heavy this year \u2014 those roads risk being cut off entirely. Security is another constant threat: the RSF has crossed into Chad on multiple occasions, and Tina itself has been struck by drone attacks.<\/p>\n\n\n\n

But what stays with Reeves, he told Radio Dabanga, is not the scale of the suffering but the moments of relief. Parents of women the programme has helped come to the counsellors overwhelmed with emotion. \u201cThey don\u2019t know how to express it. They don\u2019t have anything they can give; they just give their tears and their thanks,\u201d Reeves said. \u201cThe idea of seeing one\u2019s daughter suffer in this way is just excruciating beyond anything I can say.\u201d<\/p>\n\n\n\n

The bigger picture<\/strong><\/p>\n\n\n\n

The broader humanitarian picture offers little reason for optimism. The UN reported last month that only 16 percent<\/a> of Sudan\u2019s humanitarian funding needs for the year have been met. The shortfall has forced a \u201cstrict prioritization exercise<\/a>,\u201d a downsizing of aid to bare-minimum survival packages that leaves specialized programs, like medical care for sexual violence survivors, severely strained.<\/p>\n\n\n\n

The dismantling of USAID has compounded the shortfall, Reeves said, adding that the UN Refugee Agency<\/a> has cut programmes along the northern stretch of the Chad-Darfur border. \u201cThings are getting worse, not better, in terms of humanitarian resources,\u201d Reeves said. \u201cWe\u2019re just trying to get through it month to month.\u201d<\/p>\n\n\n\n

For the women near Zamzam waiting for fistula surgery, that is the reality of what the International Day to End Obstetric Fistula looks like this year.<\/p>\n\n\n\n

#EndFistula<\/p>\n