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The call by the First Lady, Mrs. Rebecca Akufo-Addo, for concerted efforts to tackle the problem of obstetric fistula in Ghana to improve the lives of mothers and reproductive health is a pregnant one.
It is pregnant because it concerns the treatment and prevention of the condition, as well as public education about it, including the need to avoid stigmatising patients.
Generally speaking, a fistula is an abnormal connection that joins either two body cavities, like the anus and the female reproduction organ, or one of them to the skin.
A fistula is said to occur when the tissue wall or a barrier between two body parts has broken down, usually due to trauma, injury, or infection.
While the World Health Organization (WHO) says an obstetric fistula is a hole in the birth canal caused by obstructed labour, the United Nations Population Fund (UNFPA) states that it is a hole between the birth canal and bladder or the rectum caused by prolonged, obstructed labour without access to timely, high-quality medical treatment.
The UNFPA information says it leaves women and girls leaking urine, faeces, or both and often leads to chronic medical problems, depression, social isolation, and deepening poverty.
Other sources say it leads to urinary incontinence, pain, tenderness, or itching in the affected area, pus or foul-smelling discharge, fever, and nausea or vomiting.
It is sad to learn that fistulas mostly occur among women living in poverty, in cultures where a woman’s status and self-esteem may depend almost entirely on her marriage and ability to bear children.
Looking at the fact that the regions in which obstetric fistula mostly occurs include sub-Saharan Africa, where Ghana is located, and the devastation of the condition, the First Lady’s call must be given special importance.
The role of women, particularly mothers, in the family and the larger society should call for urgency for everything that affects them in a disenabling manner, particularly bad health and poverty.
Even though the condition is said to not usually heal on its own, proper medical care, such as surgery and wound care, can help treat it.
This means the country must have the relevant medical facilities and well-trained professionals to manage the condition once it occurs.
The government must take this point seriously because the WHO states that obstetric fistula still exists because healthcare systems (particularly in poor countries) fail to provide accessible, quality maternal health care, including family planning, skilled care at birth, basic and comprehensive emergency obstetric care, and affordable treatment.
Fortunately, the condition is preventable.
A holistic approach to preventing it is being advocated, and this includes engaging with traditional authorities to understand the causes emanating from some cultural practices like putting underage girls in the family.
Besides, all women should seek medical care regarding fistulas.
Then, the larger society must be educated about the condition.
We believe the country must have all the motivation to fight fistula.
After all, preventing and managing obstetric fistulas will contribute to improved maternal health and the achievement of Sustainable Development Goal 3.7, which seeks universal access to sexual and reproductive healthcare services, including family planning, information, and education, and the integration of reproductive health into national strategies and programmes.
Also, that will enhance the country’s image in healthcare globally.
