Combating fistula: Restoring ‘dignity’ to affected women

Divorced, abandoned and forced into isolation, women suffering from fistula undergo a heartrending experience.

ISLAMABAD: Divorced, abandoned by their families and forced into isolation, women suffering from fistula undergo a heartrending experience. Obstetric fistula is a significant public health problem in Pakistan, particularly effecting women living in rural and remote areas. Given the stigma and shame attached to this condition, most of these women remain hidden and untreated.

President of Pakistan National Forum on Women’s Health Dr Shershah Syed explained that obstetric fistula is a medical condition in which a passageway is formed between the bladder and the vagina or the rectum and the vagina. The condition is a result of inadequate medical care given to women during labour or childbirth.

On Wednesday, Dr Syed addressed the re-launching of the Regional Fistula Conference “Neglected No More , Dignity Restored” by the United Nations Population Fund (UNFPA) here at Islamabad Club.

The re-launch campaign aims to draw attention, commitment and resources to eliminate obstetric fistula and to make the government, doctors, donors and health professionals recognise the condition as a serious public health issue. Health experts on the occasion declared March 21 as Fistula Awareness Day in Pakistan.

“Given the high maternal mortality in the country, estimated 4,000 - 6,000 new cases of obstetric fistula occur every year in the country,” said Syed.

Unfortunately, as the issue remains neglected, the full extent of the problem has never been mapped and lacks accurate data, he added.

The greatest tragedy is that these cases can be largely avoided by delaying the age at first pregnancy and timely access to obstetric care. It is unfortunate that qualified gynaecologists in our country are incompetent and fail to take precautionary measures, which results in iatrogenic fistula, he said.

Around 5,000 women suffering from fistula have been treated in the country for the past five decades with surgeries lasting only around half an hour each, he added.

He urged that tertiary hospital in the country should provide treatment, counselling and prevention of fistula. He said the government needs to address the issue by initiating its own projects, instead of relying on projects by international agencies.

“Additional resources and strengthened collaboration between the government, community groups, international and national agencies and health professionals are needed to eliminate fistula from Pakistan,” said Director General Health Dr Asad Hafeez, while speaking on the occasion.

Treatment of fistula is currently being provided free of cost in seven regional centres established in major cities of the country, however, these services are not being provided in rural areas due to logistic problems. He said that a national task force will be established to train health professionals on prevention and treatment of the condition.

Published in The Express Tribune, March 3^rd, 2011.