Prof Alison Fiander, Clinical Lead for the RCOG's Leading Safe Choices programme and Chair of RCOG Global Health Project Development Committee writes…
It has been over 10 years since the UNFPA and its partners, of which the RCOG is one, launched its global Campaign to End Fistula in 2003.
The campaign has drawn the attention of policymakers, health professionals, affected communities and individuals, as well as the general public, to the issue of obstetric fistula.
However, despite remarkable achievements, many thousands of women and girls continue to live with the pain, stigma and shame of fistula. Ending the curse of fistula will require political will, additional resources and strengthened collaboration between governments, partners and civil society. As an official global partner of the campaign, the RCOG is committed in fulfilling its responsibility through both advocacy and practice.
It is widely known that the three main causes of obstetric fistula and indeed maternal mortality and morbidity in general are; poor access to family planning, the absence of a skilled birth-attendant during labour and lack of access to emergency obstetric care, should anything go wrong.
This year to coincide with International Day to End Obstetric Fistula, alongside Dr Jac Saorsa’s art exhibition ‘Drawing Out Obstetric Fistula: Exploring the ramifications of maternal birth trauma through art,’ we are also launching our Emergency Obstetric Skills course, funded by the Tropical Health Education Trust (THET). The course is a 3-day train-the-trainer package of skills and drills for healthcare workers including midwives, nurses, clinical officers and junior doctors. It is designed to help front line workers deal with common obstetric emergencies that have devastating consequences in low-resource country settings.
By teaching essential emergency obstetric care many mothers’ and babies’ lives can be saved and many mothers spared devastating birth-related injuries. As such, an important focus of the course will be on methods to prevent obstetric fistula caused by prolonged obstructed labour.
The course will support and empower health workers to make timely decisions and referrals, to work together as a multidisciplinary ‘delivery team’, to develop high quality antenatal and intra-partum services and to take a human rights approach to the care they provide.
There are 10 courses planned for the next two years, which will take place at Kitovu Health Care Complex, Masaka region, Uganda. The first course will be taught by a UK multidisciplinary faculty and as the project progresses a 'train the trainer' approach will be adopted to build capacity and equip a Ugandan faculty of trainers to ensure sustainable skills transfer.
Over the last few years, raising awareness of obstetric fistula worldwide has led to advances in the management of fistula that has helped heal and transform the lives of thousands of women and girls living with this devastating condition. On 23 May, please visit the RCOG website, view and share Dr Saorsa’s art exhibition, which is dedicated to raising awareness of the problem of fistula and celebrating the resilience, dignity and courage of women with obstetric fistula and the healthcare workers who support them.
The RCOG pledges to continue to highlight the burden of obstetric fistula and the plight of those living with consequences of fistula in order to bring an end to obstetric fistula worldwide.