“Fistula is seen as a punishment,” said Jacques Milliez, a gynaecologist who travels to Mauritania twice a year as part of a treatment programme. “Tradition dictates that a woman who experiences problems in childbirth is suspected of all manner of wrongdoing, such as adultery.”
The causes of fistula are also tied to tradition, with girls marrying and becoming pregnant at a young age, said Thierno Ousmane Coulibaly, the UN Population Fund's (UNFPA) head of reproductive health in Mauritania. “These girls do not have a sufficiently developed pelvis to give birth.” He added, “It is difficult to fight these socio-cultural practices.”
