Obstetric fistula is a childbirth injury caused by
prolonged obstructed labor in which a hole develops between the bladder and
vagina and /or rectum and vagina, leading to permanent incontinence.
During a
prolonged obstructed labor, the constant pressure of the unborn child's head on
the birth canal cuts off the blood supply to the surrounding tissues. After
several days of obstructed labor, the affected tissues die off and an opening is
created between the bladder and vagina (vesico-vaginal
fistula, VVF) and/or rectum and vagina (recto-vaginal fistula, RVF). The result is permanent incontinence,
with a woman being unable to control the flow of her urine or feces.
In most
cases, the baby dies and the mother is left suffering with severe physical,
emotional and social consequences. Due to the constant leaking of urine and
feces, she is likely to feel constant pain and discomfort, develop ulcerations in
the vaginal tract and easily contract infections. She may become afflicted with
a condition known as “foot drop,” making it difficult or impossible to walk
because of extreme nerve damage to the lower limbs caused by prolonged squatting
during labor. She may also develop kidney disease or even failure due to her
limited intake of fluids in effort to minimize the incontinence. Because of her
shameful condition, she is likely to be abandoned by her husband, shunned by
her family and cast out from her community. She is often left to suffer the
loss of her baby, her severe medical condition and her psychological trauma in social
isolation.
The World
Health organization (WHO) estimates there are 2 million women worldwide
suffering from obstetric fistula, with up to 100,000 new cases each year. The
majority of these women live in Sub-Saharan Africa, Asia and some Arab regions.
They tend to be poor, live in remote areas, have little to no education, are
bound to cultural norms and, have no access to medical care. Many are teenage
girls whose pelvises are not yet fully developed for childbirth.
While the effects
of obstetric fistulas are traumatic, the condition is generally easily
treatable and has a 90% healing rate. The cost of one operation is approx USD$
300. Unfortunately, most affected women
do not know about the treatment or cannot afford it.
Obstetric
fistula is fully preventable and its incidence can be eliminated if only quality
maternal health care services such as family planning, skilled birth attendance,
and emergency obstetric care could be made available to all women, particularly
those in developing countries. Prevention also entails addressing social issues
that contribute to the problem, such as cultural practices (e.g. early marriage
and pregnancy), poverty, education and the empowerment of women.
In 2003,
UNFPA (United Nations Population Fund) spearheaded the global campaign to End
Fistula, a collaborative initiative to prevent fistula and restore the health
and dignity of those living with its consequences. In this short time, thanks
to partnerships with organizations such as UNICEF, the World Bank, WHO, and
funding from high profile humanitarians such as Bill & Melinda Gates, it
has succeeded in bringing fistula to the attention of the general public,
policy makers, health officials, and affected countries.
While significant
progress has been made, ending fistula worldwide still requires more political
will, additional resources, and strengthened collaboration between governments,
community groups, NGO’s and health professionals.
To learn
more about obstetric fistula and how you can help, please visit:
www.unfpa.orgUnited Nations Population Fund: general information, programs &
partnerships.
www.who.orgWorld Health Organization: principles for clinical management.
The
Fistula Foundation: US based non-profit organization founded by former Peace
Corps teacher, Richard Haas and daughter Shaleece with the purpose of
supporting the work of the Addis Ababa Fistula Hospital in Ethiopia, the
foremost medical center in the world devoted exclusively to fistula repair, founded
in 1974 by Drs. Reginald and Catherine Hamlin.
www.womenshope.chwomen’s
hope international (whi): Swiss based charity founded by Martin &
ClaudiaLeimgruber, husband & wife
/ doctor & midwife team, dedicated to fistula repair and prevention in Ethiopia,
Chad and Afghanistan; also affiliated with Addis Ababa Fistula Hospital.
International Charities 
