International Day to End Obstetric Fistula

Twenty years on – progress but not enough.
Act now to end fistula by 2030.

Nature has given women the unique gift of bearing a child. Giving birth is an occasion to bring joy to the families. It can be devastating If bringing forth new life results in compromising one’s life. That is what happens when women go through obstetric fistula. Obstetric fistula is a condition arising out of prolonged, obstructed labour, resulting in a hole between the birth canal and the bladder or rectum. May 23 is the observation of the International Day to End Obstetric Fistula. It aims to raise awareness about obstetric fistula. 5 lakh women in more than 55 countries live with fistula. Thousands more occur every year.  Obstetric fistula is preventable and, importantly, is treatable. Spreading awareness is the need.

To have one’s life compromised to bring forth new life is a devastating fate.

Nature has given women the unique gift of bearing a child. Giving birth is an occasion to bring joy to the families. It can be devastating If bringing forth new life results in compromising one’s life. That is what happens when women go through obstetric fistula. Awareness about this condition is poor. Obstetric fistula is a condition arising out of prolonged, obstructed labour, resulting in a hole between the birth canal and the bladder or rectum. Obstetric fistula leads to chronic medical problems for the mother. May 23 is the observation of the International Day to End Obstetric Fistula. It aims to raise awareness about obstetric fistula. What started as a ‘Campaign to End Fistula’ in 2003 led to the UN declaring it an annual observation in 2013.   

While pregnancy and childbirth are generally safer than ever before, thousands of women still endure the devastating consequences of obstetric fistula. There are five variants of fistula. Sadly, the statistics indicate that 90% of pregnancies involving fistula end in stillbirth. The affected person experiences leakage of urine and faeces, associated with foul odour. Its occurrence is more prevalent in Sub-Saharan Africa, Asia, Latin America, the Caribbean, and the Arab regions. 5 lakh women in more than 55 countries live with fistula. Thousands more occur every year.  Obstetric fistula remains a significant challenge in India, particularly in rural areas. An estimate indicates the overall prevalence of obstetric fistula in India to be 2.2%. With quality healthcare systems becoming available, Obstetric fistula is not prevalent in rich countries. 

No woman deserves to live in misery, Especially when it is treatable.
A Victim who went through childhood pregnancy.

Some of the ancient Egyptian documents refer to papyri, which is an obstetric fistula. By the mid-19^th century, doctors had developed procedures to correct the fistula, and a report indicated that it was in Alabama, USA. Still, in many countries, Midwives provide the majority of first-line maternity care and are vital to preventing fistula and other childbirth injuries. However, there is a critical shortage of well-trained midwives globally. An estimate puts it at 900,000. More than half of them are needed in sub-Saharan Africa alone. Social taboos and belief systems are adding to the agony of the affected. In some societies, there is a belief that the condition is a divine punishment or a curse. Some believe that this is related to venereal diseases. All are making the lives of the affected miserable.   

Ending obstetric fistula requires the full involvement of midwives at the community, national, regional and global levels. 
The International Confederation of Midwives

Obstetric fistula is preventable. It is achieved by delaying the age of the first pregnancy, discontinuing harmful traditional practices, and ensuring timely access to obstetric care. Timely access to quality emergency obstetric and newborn care is an effective way of preventing this occurrence.    

Preventable maternal morbidity is a human rights concern, and preventable deaths and grievous injuries sustained by women and girls during pregnancy and childbirth are not inevitable events but rather a direct result of discriminatory laws and practices, harmful gender norms and practices, a lack of functioning health systems and services, and a lack of accountability.
UN Human Rights Council

It is possible to treat a fistula if it has happened. Up to 95% of fistulas can be closed with surgery. Unfortunately, care does not reach all, and the cost of the treatment makes it not easy for people with low incomes to avail themselves of it. Despite this, there is significant progress. More than 140000 fistula repairs have been made and supported by agencies like UNFPA. It leads to restoring health, hope, and dignity for survivors. However, more than 500,000 women require the treatment. The lack of trained professionals is another challenge in surgery for fistula patients. There is a need for ongoing systematic data collection mechanisms like a fistula registry that would facilitate coming out with effective prevention methods.

Fistula is largely preventable
and, importantly, is treatable.
Spreading awareness is the need.

Toons: Anusha
Logs: M Sai Baba
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