The theme of this year’s International Day to End Obstetric Fistula, “Tracking Fistula – Transforming Lives,” reflects an important step forward in eradicating this preventable condition, which affects an estimated two million women and girls in developing countries.
Obstetric fistula highlights persistent global inequalities in access to health care and basic human rights. Most women who develop fistula, a hole in the birth canal usually caused by prolonged, obstructed labour, remain untreated for their entire lives, and the condition can easily recur in women and girls whose fistula has been surgically treated but who receive little or no medical follow-up and then become pregnant again.
To treat fistula and provide women with follow-up medical care, we need to know more about how many women and girls are in need of services and also where they live. In most instances, stigma forces women living with the condition to remain hidden and isolates them from families and communities. By systematically registering and tracking each woman and girl who has or had an obstetric fistula, we can make enormous strides in improving their well-being and increasing the chances of their babies’ survival in subsequent pregnancies.
Eliminating the health crisis of obstetric fistula requires scaling up countries’ capacities to provide access to equitable, high-quality sexual and reproductive health services, including family planning and maternity care, especially comprehensive emergency obstetric care. Tracking and treating all fistula cases is crucial, but it is also necessary for countries to take steps to prevent fistulas by addressing underlying medical and socio-economic causes, eliminating gender-based social and economic inequities, preventing child marriage and early childbearing and promoting education, especially for girls.
To address the neglected health and human rights violation of obstetric fistula, UNFPA, the United Nations Population Fund, together with partners around the world, launched the global Campaign to End Fistula a decade ago. Much progress has been made. With support from UNFPA, 47,000 women and girls have undergone fistula repair surgery. Partner organizations have provided treatment to many more women and girls living with fistula. However, much remains to be done, and far more support and momentum are needed to enable the Campaign to expand its reach to all corners of the world where women suffering from fistula remain isolated and often unaware that treatment is available or even possible.
The time has come to put an end to obstetric fistula and address the circumstances that perpetuate it, including poverty, lack of access to health care, child marriage and early childbearing. We have the resources and know-how. What we need now is the political will to elevate the status of women and girls, rectify inequalities and protect the human rights of every woman and girl, so that fistula may never again undermine a person’s health, well-being, dignity and ability to participate in and contribute to their communities.
