Today is International Day to End Obstetric Fistula. Obstetric fistula (OF) are debilitating complications of obstructed labor, which result in uncontrollable leaking of urine and/or faeces, leading to devastating, stigmatized and dehumanizing conditions for the affected women. It is sad to note that this condition mostly affects poor, marginalised women in the developing world. There are at least two million women living with fistula, primarily in sub-Saharan Africa and South Asia with 50,000 – 100,000 women and girls affected each year in Africa alone.
Fistula has a devastating social, emotional and economic impact on women. As a result of the continuous leakage of urine and faeces into the vagina, affected women often have an offensive odour, causing them to be ostracised by their husbands, families and community. Vaginal injuries can also result in sexual dysfunction and an inability to conceive, further jeopardising a woman’s relationship with her husband and her cultural loss of value.
Many women who develop obstetric fistulas are completely abandoned by their husbands and forced to live out the rest of their lives in poverty and isolation.
Treatment includes surgery to repair fistula, rehabilitation, and social reintegration. Psychological and emotional counselling, as well as skills building are also an important aspect of rehabilitation. Unfortunately though, fistula repair is expensive and usually out of reach of women living in poverty or in remote areas with little or no access to healthcare.
To further complicate the issue, many women are not even aware that fistula can be repaired. To reach them, Amref Health Africa works closely with communities in underserved areas to identify women suffering from fistula and ensure they get help. Through intense community mobilisation, we promote our fistula ‘camps’, where hundreds of women undergo operations in temporary surgical facilities. We also conduct surgical outreach to bring fistula repair to hard-to-reach communities. It is important to emphasise that fistula is preventable. This calls for ensuring women have access to quality maternal care, including regular antenatal visits and delivery with skilled birth attendants. Ending early marriages, eliminating female genital cutting and ensuring girls stay in school, as well as voluntary family planning, are also key measures in preventing fistula.
The theme of this year’s International Day to End Obstetric Fistula, “End fistula, restore women’s dignity”, resonates completely with women who recover from this debilitating condition. Not only are they physically sound again, but they are able to rediscover their dignity, regain their place in community and start life anew. For many years Amref Health Africa has implemented fistula repair programmes across East Africa, Malawi and other areas to promote safe motherhood and contribute to ending obstetric fistula. Amref Health Africa’s comprehensive prevention and management of fistula is improving women’s and communities’ health contributing to lasting health change in Africa.
On this International Day to End Fistula, Amref Health Africa renews its commitment to working with governments, development partners and civil society organisations to:
- Explore innovative ways of engaging communities to promote prevention and management of fistula
- Work hand-in-hand with relevant bodies and institutions to build skills of frontline health workers in preventing and managing fistula
- Increase health education among girls and women and the community at large to end fistula
- Implement quality programmes to end stigma surrounding fistula and restore the dignity of women who are suffering from fistula
Amref Health Africa realises that governments are solely responsible for ensuring the right to health for their citizens and commits to supporting the governments to meet this objective. To that extent, Amref Health Africa urges governments as well as their development partners to meet the following obligations for accelerating the abandonment of female genital cutting, one of the contributing factors to fistula:
- Replace female genital cutting by adopting alternative rites of passage
- Allocate adequate resources to support the empowerment of women and adolescents
- Ensure frontline workers are knowledgeable and skilled in the prevention and management of fistula
- Support the implementation of innovative programs to empower communities to promote maternal and newborn health
- Ensure adequate resources are in place to sustain youth-friendly health facilities and access to sexual health and reproductive rights education among youth