Sherpur, Bangladesh - Banessa Bibi, a senior resident of Purbo Samuchura village in Sherpur, is now in her nineties. The exact count of how many children she brought into this world has grown hazy with time. She only remembers that five survived, three daughters and two sons. Since those early days, Banessa has witnessed an unyielding truth: in her village, childbirth meant a dark corner of a room and the hands of an unskilled traditional birth attendant called Dai Ma.
However, the magnitude of the harm home delivery carries is best evidenced by her two daughters, Jamena and Jamila.
The life story of Jamila Khatun, 45, is steeped in tragedy. Twenty-six years ago, during the home delivery of her second child, Saddam, severe complications changed her life forever. She developed obstetric fistula, a devastating childbirth injury caused by prolonged and obstructed labour.
The condition did not only leave Jamila physically traumatized. It isolated her from society, her family, and even from herself. A constant foul odor emanated from her body. Out of shame and humiliation, Jamila withdrew from public life for two decades. Even her own granddaughter refused to go near her. Jamila still shudders recalling those years of despair.
“For so many years, I was trapped in shame and isolation. But after finally learning that my fistula could be cured, I was referred to the doctors at Dhaka Medical College Hospital , who gave me my life back through two free surgeries. At first, I was scared of what would happen to me. But their kindness, counseling, and stories of other recovered women gave me strength,” Jamila said.
After an unsuccessful surgery in 2025, a second procedure in 2026 finally succeeded. For the first time in nearly a quarter of a century, Jamila could breathe freely, sit comfortably beside others, and live with dignity again.
Jamila’s elder sister, Jamena Khatun, 55, carried a remarkably similar story of suffering. She developed fistula during the birth of her first child and went on to give birth to seven more children while living with the condition. Driven by poverty, Jamena worked as a domestic helper in Dhaka, but she never revealed her illness to anyone. She feared that if her condition became known, she would lose her job. In 2025, while visiting home, she heard about her younger sister’s surgery and recovery. For the first time, she allowed herself to believe that healing might also be possible for her.
With the support of a fistula coordinator, Jamena sought treatment. A single surgery ended decades of her suffering. Today, both sisters are healthy. They can laugh, work, socialize, and move through their community without fear or shame.
For years, women living with fistula in Sherpur had little access to specialized care, while pregnant mothers remained at risk due to gaps in maternal healthcare services. To help change this reality, UNFPA, with funding from Global Affairs Canada (GAC), strategically deployed midwives to Rajnagar Mother and Child Welfare Centre and Noyabil Union Health and Family Health Centre to strengthen maternal healthcare, prevent new fistula cases, and ensure comprehensive follow-up support for survivors. These midwives now conduct weekly outreach every Tuesday, bringing maternal healthcare directly to local community clinics and reaching women who might otherwise never seek care.
At the same time, the Upazila Health Complex has strengthened its maternal health services through UNFPA-supported structured training and mentoring for healthcare workers. Together, these efforts are helping dismantle long-standing barriers to care, improving service delivery, and ensuring more women can access life-saving maternal healthcare before complications become life-threatening.
A deep-rooted belief still persists among village women that home births are more cost effective and less "troublesome" than going to a hospital. Their knowledge regarding prenatal, delivery, and postnatal care remains in the dark. The situation is steadily changing as the Government of Bangladesh and UNFPA continue increasing public awareness on fistula, identifying new patients, strengthening diagnosis and referral, and increasing coordination among service providers to treat nearly 20,000 obstetric fistula patients in the country. Ensuring institutional delivery is vital to preventing new cases. For Banessa Bibi, the suffering of her daughters reflects a painful reality shared by generations of women in her village. But today, for the first time in decades, that cycle is beginning to change.
