A Preventable Tragedy: How One Woman Survived Fistula and Is Now Changing Her Community

"We spent the first three years of our marriage without a child. Then I gave birth to four daughters in consecutive years. My husband and I still hoped for a son. That hope led me to become pregnant for the fifth time. Everything seemed normal until a sudden tragedy changed my life forever," said 32-year-old Shamsunnahar from Tahirpur, Sunamganj.

Shamsunnahar Begum lives in a remote village surrounded by water bodies near “Tanguar Haor”. She left school after the third grade and was married at just 16 to Ashraful, a local farmer.

"My life has been a story of endless struggle," she recalled. "When we had no children in the first three years, I had to endure harsh treatment from family members and neighbours, asking why I wasn't conceiving. When I had daughters, I was taunted again. Seeing one girl after another, everyone would say, "It's only girls!" Shamsunnahar said.

"The burden of my grief grew heavier when it was discovered that my two youngest daughters had a disability,” she continued. “I felt like I was losing my mind. Only the Almighty and I know the bone-breaking labour it took to manage so many children, including two with special needs."

Her voice trembled as she spoke of the agonizing memory of her fifth pregnancy. 

"What happened next was even more tragic. My fifth child was a boy, and we were so happy and waiting for his birth. But he was stillborn. Before I could even process that grief, I realized my body was no longer under my control. I only remembered being in labour for a very long time and waiting helplessly before the baby was finally delivered. A few days later, I noticed that I was leaking urine uncontrollably. My clothes would be completely soaked, and a foul odour emanated from me. During that difficult time, my loved ones began to distance themselves one by one. Only my daughters stayed by my side."

Like her previous births, Shamsunnahar initially attempted to deliver at home. She waited for two days in hopes of a normal delivery. However, her condition gradually turned critical. Due to the extremely poor communication system in the haor area and the lack of a nearby advanced hospital, it took more than three hours to reach Sunamganj Sadar Hospital. By then, it was too late. The baby had already died in the womb. 

Across various remote regions of Bangladesh, including Sunamganj, hundreds of women and adolescent girls still suffer from painful conditions like obstetric fistula caused by prolonged, obstructed labour without medical care. Child marriage, poverty, limited awareness and lack of access to skilled birth attendants all contribute to this suffering. 

Seven days after returning home, Shamsunnahar faced a terrifying new problem: uncontrolled urinary leakage. Despite local treatment funded by villagers' donations, her condition did not improve for nearly a year.

Through her mother-in-law, Shamsunnahar connected with a healthcare provider under the Government of Bangladesh’s National Programme to End Obstetric Fistula. This initiative is supported by UNFPA, implemented by the Centre for Injury Prevention and Research, Bangladesh (CIPRB), and funded by Global Affairs Canada and the Government of Sweden. She received counselling, and was referred for diagnosis at the district hospital where doctors confirmed obstetric fistula. She was later sent to a specialized hospital at Dhaka where she underwent successful surgery.

"I suffered immensely from this disease. But today, I am healthy again, and joy has returned to my family," Shamsunnahar said.

Her husband, Ashraful, now stands firmly by her side. Having lost his mother as a child, he said: "I was always afraid of losing her. Now my children have found their mother again and this is my peace."

With support from the programme, the family received social protection assistance. Disability allowance cards were secured for her two daughters, easing their daily care. Shamsunnahar herself received a Vulnerable Group Feeding card as part of the rehabilitation support.

Beyond temporary relief, effective steps were taken to make her permanently self-reliant. Shamsunnahar received a sewing machine, and with the income from her tailoring and her husband’s auto-rickshaw driving, the family has finally found solvency. By earning with confidence, she has restored dignity and peace to her household.

Shamsunnahar is a champion for maternal health. She goes door-to-door in her village advising mothers not to take the risk of home delivery. Through her efforts, 12 other fistula patients in her area have accessed treatment.

Timely treatment and social support can prevent and cure even a devastating condition like fistula that Shamsunnahar suffered from. Today, she balances her household by sewing and working as a laborer, and raising her four daughters. Despite the odds, she continues the education of two daughters. She dreams of a future where no woman suffers from such a tragic condition. She remains committed to working as a fistula advocate, raising awareness in communities about the importance of timely, quality maternal health care at health facilities and delivery assisted by skilled midwives, as part of the journey to end fistula in Bangladesh.