Dr Hani Fawzi, RCOG Vice President for Global Health, writes…
Obstetric fistula is one of the most serious and tragic injuries that can happen to a woman during childbirth. It occurs when prolonged obstructed labour without medical intervention causes a hole between the vagina and rectum or bladder. In 90% of obstetric fistula cases, the baby is stillborn, while obstructed labour accounts for 6% of all global maternal mortality. This devastating condition affects more than two million women worldwide, with up to 100,000 new cases occurring each year, yet is largely preventable.
For women who survive, obstetric fistula often takes a severe toll on their lives. They may suffer chronic incontinence, infection, and in the worst untreated circumstances, death. Aside from the immeasurable physical and psychological pain, those in developing countries are often ostracized by their community due to the stigma and shame attached to the condition. While surgical treatment can repair up to 90% of cases, access to affordable surgery is not available to the vast majority of women suffering the condition.
The RCOG has long advocated to eradicate obstetric fistula. Its Centre for Women’s Global Health has teamed up with the Kitovu Health Care Complex in Uganda to roll out its Excellence in: Obstetric Skills programme, a train-the-trainer teaching initiative. Since then, nearly 300 local health workers have been trained to manage obstetric emergencies, with an emphasis on how to prevent and manage obstructed labour. They’ve also been taught about thea psychological harm obstetric fistula can cause by hearing from local women. This has strengthened their resolve to do all in their power to prevent women suffering needlessly in the future.
Today (23 May) marks International Day to End Obstetric Fistula, which is part of a campaign by the United Nations Population Fund to end obstetric fistula. The RCOG is proud to be an official partner of this initiative to raise awareness of this issue and mobilize support around the world. This year’s theme is ‘hope, healing and dignity for all’.
This year, the College will mark the day by showcasing those involved in work to end fistula and its consequences. In these videos, UK and Uaganda based clinicians, midwives and physiotherapists explain their motivation for working to end fistula, highlight the importance of a multidisciplinary team in treating women, and call for a holistic approach that looks to repair both the physical and psychosocial effects of fistula. Last year, the College released a film to show the impact its Excellence in: Obstetric Skills programme was having in Uganda. Recently, a second film, Returning to Uganda: Funding a trainee Fellowship, featured RCOG Fellow Marcus Filshie who has established a fellowship to fund trainee doctors to deliver training and carry out monitoring and evaluation exercises for the project.
The RCOG is actively calling for women to have access to the quality care they deserve. Obstetric fistula can be prevented. Part of the solution involves enabling and supporting health workers to provide quality management at an early stage of labour. In addition, societies must also address the significant burden of disability suffered by women and demand that governments put greater emphasis upon women achieving their basic human right to be free from needless physical and mental trauma. We want to end the suffering of women from obstetric fistula within a generation.
For more information, please see:
To get involved in the conversation, use the hashtag #IDEOF2017 and #EndFistula