23 May 2024, Cairo, Egypt – Each year, globally, there are up to 100 000 new cases of obstetric fistula – a devastating but largely preventable health condition. Over 2 million girls and women worldwide are estimated to be living with untreated fistulas. In the WHO Eastern Mediterranean Region, numerous girls and women across several countries endure this severe childbirth injury.
Obstetric fistula is caused by obstructed labour that accounts for up to 6% of all maternal deaths globally. It is a hole between the birth canal and bladder or rectum. The injury results in constant urinary or faecal incontinence, which often leads to social stigma and exclusion, as well as skin infections and comorbidities including kidney disorders.
Yet it has remained a ‘hidden’ problem because it affects some of the most marginalized people – poor, young and often illiterate girls and women in remote parts of the world.
Accessible midwifery and obstetric care, and affordable and accessible treatment of fistula are essential to prevent and manage fistula. So too is the provision of a social safety net for girls and women in every part of the world, including the poorest areas.
Obstetric fistula still exists because health systems fail to provide accessible, quality maternal health care, including family planning and skilled birth attendance. Adolescent pregnancy, childbirth at an early age, obstructed labour, lack of access to health facilities and midwifery care, and maternal malnutrition are some of the causes of the condition. Poverty and illiteracy are contributing factors.
Fistula has begun to gain international attention in the last decade or so. The United Nations marked its first International Day to End Obstetric Fistula on 23 May 2013. Access to quality prenatal care – which prevents obstetric fistula – is a basic right and will contribute to the improved health and well-being of girls and women and the achievement of the Sustainable Development Goals.
But greater momentum is needed – both globally and regionally – to drastically reduce the incidence of obstetric fistula, treat existing cases, and make systemic changes to save more girls and women from unjustified and undignified suffering.
On International Day to End Obstetric Fistula 2024, all efforts should be targeted at ending fistula so that no girl or woman has to endure this heartbreaking condition which is both preventable and treatable.