Persistence of obstetric fistula, echoes broader health inequalities - UNFPA Representative

Ms Erika Goldson, the Deputy Representative of the United Nations Population Fund (UNFPA), on Thursday, said the persistence of obstetric fistula echoed broader health inequalities and healthcare system constraints globally.

She said the condition, which affected two million women in 55 low income countries, involved tragic injuries to the birth canal of a women or girl after prolonged and obstructed labour, resulting in the leakage of urine or faeces or both through the vagina, and it leaves humiliating effects on its sufferers.

Ms Goldson said the factors accounting for this devastating conditions, included the lack of access to family planning, skilled attendance at birth and emergency obstetric care, in addition to the violation of the rights of women and girls with obstetric fistula.

The theme for the 2019 commemorations: “Fistula is a human rights violation – end it now!”

Ms Goldson who was speaking at a press briefing in Accra, to mark the International Day said the theme touched on the heart of the issue and called for urgent action by all to eliminate the suffering of affected persons

She said the condition affected a high population of females almost exclusively in resource-poor settings of Africa and South Asia, with an estimated 50,000 to 100,000 women globally diagnosed each year and were often subjected to isolation, shame and stigmatization.

“To end fistula, we must ensure universal access to quality sexual and reproductive health services; eliminate gender-based social and economic inequality; prevent child marriages and early childbearing.” “We must also promote education and broader human rights; foster community participation in finding solutions, such as the active involvement of men, adolescents and youth, as well as seeking the help of fistula survivors as advocates.”

She said the UNFPA together with its global partners had since 2003 been engaged in the long battle against obstetric fistula, and “we are devoted to addressing challenges in our health system, which affect women and girls, particularly those suffering from obstetric fistula”.

“These women do not have a voice in society. Many are unable to access antenatal cares and have a skilled midwife or birth attendant to take care of them, leading to obstetric fistula in the first place,” she added.

Ms Goldson said as the UNFPA celebrated its 50 years of existence, it would remain committed to supporting the fight to end these injustices to women and girls, and continue to support the mobilization of those affected to have surgical repairs and reintegration into their communities, post-surgery.

The UNFPA she said would also work with the National Obstetric Fistula Task Force Team, the Ghana Health Service (GHS), and all stakeholders in restoring the dignity, hopes and dreams of the many affected women and girls who had been deprived of their human rights.

Dr Patrick Kuma Aboagye, the Director of the Family Health Division, GHS, said the development of obstetric fistula was directly linked to one of the major causes of maternal and infant mortality, as majority of women often lose their babies.

He said obstetric fistula was just not preventable, but could be cured through surgery, which had over the years proven to have a 90 per cent success rate, but said the biggest challenge for many women and girls had been reaching a health facility that had a surgeon trained in fistula repair.

Professor Anyetei T. Lassey, the Chairman of the National Obstetric Fistula Task Force, said a study, carried out by the GHS in 2015, estimated that about 1,300 new cases of fistula occurred yearly and yet, less than 100 cases are repaired leaving 1, 200 cases without care.

The UNFPA together with the Taskforce and the GHS launched a National Obstetric Fistula Prevention and Management Strategy in 2017, and also the 100 in 100 initiative as part of the implementation strategy.

Again, the average cost of fistula treatment including surgery and post-operative care, was approximately GHC 3,200, which was way beyond the reach of most women, and appealed to institutions to support the initiative financially to repair more cases and put smiles back on the faces of the victims.

Prof. Lassey called for enhanced public education through the mass media, urging communities and families to encourage sufferers to report early to the nearest health facilities for the necessary assistance, saying; “no woman or girl should be deprived of her dignity, hopes and dreams”, as it was their right and society should not hide them or stigmatize against them since the stigma and shame alone could kill them.