INTERNATIONAL DAY TO END OBSTETRIC FISTULA
THEME 2021: “Women’s rights are human rights! End fistula now!”
Photo: International Federation of Gynecology and Obstetrics (FIGO) @ figo.org
May 23 is the United Nations (UN) International Day to End Obstetric Fistula, which promotes action towards treating and preventing obstetric fistula, a condition that affects many girls and women in developing countries.
According to the World Health Organization, each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula. The development of obstetric fistula is directly linked to one of the major causes of maternal mortality (Obstructed labor; labor due to small pelvic size, resulting from women’s youth and premature childbearing and/or irritation).
Obstetric fistula is one of the most serious and tragic injuries that can occur during childbirth. Women who experience obstetric fistula suffer constant incontinence, shame, social segregation, and health problems, sometimes even after treatment.
What is obstetric fistula?
Obstetric fistula is the presence of a hole between a woman’s genital tract and urinary tract (that is, vesicovaginal fistula) or between the genital tract and the intestine (that is, rectovaginal fistula). The vesicovaginal fistula is characterized by the leakage of urine through the vagina, and the rectovaginal fistula is characterized by the leakage of flatus and stool through the vagina. Both vesicovaginal and rectovaginal fistula are associated with a persistent odor leading to social stigma and ostracization of these affected women. Studies have shown that there are multiple factors associated with obstetric fistula (WHO, 2000; UNFPA, 2002).
Clinical features or Symptoms of obstetric fistula
The clinical features of Obstetric fistula are not limited to the following; Foul-smelling vaginal discharge, urinary tract infections, pain in the vagina or surrounding areas, pain during sexual activity, obstetric palsy, infertility, depression, low self-esteem, feelings of rejection, mental health dysfunctions, loss of dignity, loss of sexual pleasure, suicidal thoughts.
How can Obstetric Fistula be prevented?
Obstetric fistula is preventable and it can be largely avoided by:
- Delaying the age of first pregnancy,
- The cessation of harmful traditional practices and
- Timely access to Obstetric care
How can Obstetric fistula be treated?
In most cases, a reconstructive surgery by a trained expert (fistula surgeon), serves as the treatment. The success rates can be as high as 90% for less complex cases and the average cost of fistula treatment, including surgery, post-operative care, and rehabilitation support is around $300 per patient (United Nations, 2020).
Principles of fistula management;
- Preparation of the patient for surgery:
- Improved nutrition
- Treat infection
- Treat other existing complication
Predisposing factors of Obstetric fistula in Nigeria
- Early marriage/childbearing
- Harmful traditional/cultural practices
- Trained traditional birth attendants
Obstetric fistula is an ancient human affliction that has been successfully controlled in most parts of the world, save much of west Africa. Whereas the techniques developed in the 19th century remain the hallmark of its treatment here, minimal access and morbidly is the consideration of the contemporary treatment of the occasional cases encountered in advanced countries
Respect for women’s rights as human rights should be seen as an important strategy for all stakeholders to consider as an adoption when developing programs towards ending fistula.