United Nations International Day to End Obstetric Fistula 2020

“The quality of mercy is not strain’d, It droppeth as the gentle rain from heaven
Upon the place beneath: it is twice blest; It blesseth him that gives and him that

May 23rd is United Nations International Day to end obstetric fistula.

The theme for this year’s event: End gender inequality! End health inequities!
End Fistula now!”. Efforts to end fistula should continue.

We are living in extra ordinary times where even the haves” are squabbling to make ends meet amidst this rather loathsome COVID 19 pandemic. Talks of stimulus packages for individuals, businesses, etc. are some of the measures taken by governments to tackle this canker of a disease. Cliché as it sounds there is no gainsaying the impact of the COVID 19 disease and its corollary repel effect not only on the economy but all sectors.

The health sector has particularly been hit and the attention and resources being drawn to this pandemic have led to the seeming relegation of other similarly existential medical conditions to the background.

Of the many such condition is Obstetric Fistula. For the benefit of those of us with little knowledge of this disease, it is the disruption of or inadequate blood supply to the soft tissue between the vagina and the urinary tract or between the vagina and the rectum by compression of the fetal head during child birth. Mostly, this is borne out of the result of prolonged obstructed labour during child birth. The adverse effect of this condition include, leaking of urine and or feaces as a result of the compression which leaves a permanent anomalous opening in the perineum.

Generally this can happen to any woman during or after child birth but it is particularly prevalent in poor, rural areas of Africa and Asia. A woman with fistula faces devastating physical and psychological consequences. According to a report from the United Nation, “about 800 women die from pregnancy or childbirth-related complications around the world every day. For every woman who dies of maternal related causes, it is estimated that at least 20 experience maternal morbidity, one of the most severe forms of which is obstetric fistula”.

Women suffering from obstetric fistula are in all regions of Ghana, but the highest prevalence is in the Northern, Ashanti, Western, Central, & Upper Regions.

A study carried out by the Ghana Health Service in 2015 estimated that about 1,300 new cases occur every year. This study indicated that UNFPA & Ghana Health Service are only able to treat not more than 100 cases a year, leaving more than 1,000 women without care annually due to the difficulty in locating these women.

Women who develop obstetric fistula condition lose their confidence & self-esteem because of the unpleasant body odor, chronic skin diseases, blisters & sores they have to endure. Worse of all is the stigmatization & isolation in society, making them depressed & shy to come out to get help and treatment. Most relatives and husbands of these women believe they are being punished for having extra marital affairs. These women are tagged as cursed and ungodly and therefore outcasts in society.

The UNFPA has intimated “the persistence of obstetric fistula, one of the most serious injuries that can occur during childbirth, is a tragic sign of social injustice and inequity in developing countries. This failure of health systems could grow greater in times of COVID-19.”A powerful statement, that resoundingly buttresses the point that this condition has been relegated to the background for decades leaving already poor vulnerable women to suffer in solitude. Understandably, the recent trillions that have been dedicated to the COVID 19 pandemic is crucial to humanity but it is equally important we do not lose sight of other preventable or curable ailments that has been with us from time immemorial.

The United Nations in recent publications unequivocally stressed the unprecedented adverse effect on the condition during this pandemic. The August body posited that “due to COVID-19, it is expected that 13 million more child marriages could take place by 2030 than would have otherwise. Families are more likely to marry off daughters to alleviate the perceived burden of caring for them, especially in the anticipated economic fallout of the pandemic.

The pandemic is also expected to cause significant delays in programs to end female genital mutilation (FGM) – something that could lead to a spike in FGM cases, according to UNFPA, which is a contributing factor for obstetric fistula.

As the virus advances in these poor countries, health services become overloaded, or provide a limited set of the services that women need. At the
same time, many women and girls also skip important medical check-ups for fear of contracting the virus.”

To complement all ongoing efforts, we would want to seize today’s opportunity to urge benevolent individuals and cooperate organizations to support Essential
Relief International Foundation’s Adopt, Repair, Restore, Empower project(ARRE), Which means adopting women suffering from obstetric fistula, repair the condition through surgery, restore their dignity and empower them economically. COVID 19 pandemic has not stopped women from going into labour, rather this pandemic has worsen the case of women in these obstetric fistula prevalent areas as hospital visits decrease for fear of contracting the virus.

In conclusion, Essential Relief International believes that strong partnership is required to support Government’s efforts to prevent, repair & completely eliminate obstetric fistula. Together, we can end fistula in Ghana.

Thank you!