ABC of Obstetric Fistula

It is the result of prolonged, obstructed labour. It leaves women incontinent, ashamed and often isolated from their communities. It is the occurrence of abnormal hole between the bladder or rectum and the vagina, characterised by the continuous and uncontrollable leakage of urine and/or faeces following childbirth. And it predominantly happens when women do not have access to quality emergency obstetric care services.

This is the story of obstetric fistula, a condition that the World Health Organisation, WHO, says, each year, affects 50,000 to 100,000 women worldwide. It is estimated that more than two million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa. And recently, Engender Health, a non-governmental organisation, revealed that Nigeria currently has 150,000 women suffering from obstetric fistula. According to the body, the huge number is waiting to be given surgical operation, with 12,000 new cases recorded annually.

There are numerous challenges associated with providing fistula repair services in developing countries, including a scarcity of available and motivated surgeons with specialised skills, operating rooms, equipment and funding from local or international donors to support both surgery and post-operative care. Obstetric fistula most commonly occurs among women who live in under-developed countries, who give birth without any access to medical help.

A woman with fistula is too often rejected by her husband and stigmatised due to foul smell.

In the meantime, approximately 80 to 95 per cent of vaginal fistula can be closed surgically. This, perhaps explain why, Ban Ki-moon, United Nations secretary-general recently said, “Fistula is fully preventable when all women and girls have access to high quality, comprehensive sexual and reproductive health services. Let us join forces to eliminate this global social injustice.”