Suffering in silence: SHC seeks progress report to control fistula diseases

Health dept to submit report on measures taken to control deaths from diseases by August

KARACHI: The Sindh High Court (SHC) has called for a progress report from the health department on measures taken to control deaths from fistula diseases in the women of the province.

A two-judge bench, headed by Justice Munib Akhtar, passed this direction while hearing a petition seeking direction for the provincial authorities to take steps to control the diseases.

During Monday's proceedings, the focal person for the health department, Dr Kishwar Khatri, informed the court that gynaecologists were being given two-week trainings in the affected areas to control such diseases.



Filing a report, Khatri said special trainings of midwifery had already been held in the affected areas. Meetings are being held with stakeholders, including the representatives of international organisations and the petitioners, to devise a mechanism that will effectively control these diseases, he informed.

The bench directed the focal person to submit a progress report by August.

Case history

A petition was jointly filed by gynaecologist Dr Shershah Syed, non-governmental organisation Tehreek-i-Niswan and Kiran Sohail, a mother of six who had developed obstetric fistula after having her first child and was left untreated for over eight years.



The petitioners submitted that despite the passage of national maternal health policies, around 5,000 women in the country developed fistula every year. They estimated that over 1,500 suffering from the injury hailed from Sindh, where a majority of the government hospitals do not provide fistula repair surgery.

In the petition, they explained that obstetric fistula was a hole between the birth canal and the rectum or bladder that leads to continuous, uncontrollable flow of urine or faeces, or both. It is mainly caused by prolonged obstructed labour without timely emergency obstetric care but can be repaired through a surgical procedure, they added.

According to the petitioners, the country had, in 2006, introduced the National Maternal Newborn and Child Health Programme, which called for improvements in maternal and newborn child health services at all district levels, including 24-hour comprehensive emergency obstetric care, training of community midwives, access to comprehensive family planning services and general awareness of maternal health services.



While Sindh had developed a health sector strategy in 2012 to address maternal deaths and improve antenatal care, only four hospitals are staffed and equipped to repair fistulas in the province, the petitioners pointed out.

They pleaded that the provincial government be held accountable for the denial of timely and adequate treatment of obstetric fistula as violations of women's fundamental rights under the Constitution, including their rights to life and dignity.