Obstetric fist…what?

23 May 2014 –Never heard of fistula? No wonder. That’s probably because of three reasons: Firstly, the condition is virtually unheard of in developed countries. Secondly, it mostly affects poor people in rural areas, and lastly, it only affects women. In our modern world, full of medicines and technologies, 800 women a day still die from complications linked to childbirth. But that is only part of the tragedy. For every fatality, twenty more women suffer debilitating, life altering injuries, such as obstetric fistula.

Obstetric fistula, to put it simply, means a hole in the birth canal which is caused by prolonged, obstructed labour due to the lack of timely and adequate medical care. In most cases, the baby is either stillborn or dies within the first week of life, and the woman suffers a devastating injury—a fistula—that renders her incontinent. Many women and girls with fistula are shunned by their families and communities, deepening their poverty and magnifying their suffering. Fistula used to be prevalent in the U.S. and Europe, but was nearly eliminated in the latter part of the 19th century and early 20th century thanks to improved obstetric care in general and the use of C-sections in particular to relieve obstructed labor.

Living with fistula is a pure nightmare. Women suffering from the condition often have no other choice than wrapping their genitals in rags. When these rags are soaked and it is not possible to substitute them, women simply squeeze them and put them back on. Women with this condition often exhibit strong bodily odours and are ashamed of leaving the house.

To make matters worse, victims of obstetric fistula are usually among the hardest to reach, and are often illiterate and with limited access to health services, including maternal and reproductive health care.

Yet, there is hope. In most cases, obstetric fistula is treatable by surgery, the procedure is relatively simple and the cost is very low – only around $450.

However, the issue of women suffering from obstetric fistula has been largely neglected. Each year the number of women that join this miserable multitude dramatically increases. It is estimated that in developing countries a fistula case occurs 2 out of every 1,000 births. Over 2 million women in Africa and Asia are victims of fistula, and between 50- 100 000 new cases occur each year.

As we observe the International Day to End Obstetric Fistula, the UN seeks to raise awareness and catalyze the efforts of all the people of good will in order to prevent new cases and bring aid to those already suffering from the condition. On this day, UN Secretary-General Ban Ki-moon reminds the international community that, ”Registering and tracking each woman and girl with fistula can help ensure that more individuals receive treatment, survivors stay healthy and their future babies thrive."