Suffering in silence: SHC questions funds availability to control fistula in province

Despite passage of national maternal health policies, around 5,000 women in the country develop fistula every year

KARACHI: The Sindh High Court (SHC) told on Tuesday the provincial health department and other authorities to submit reports regarding the status of the availability of funds to control fistula disease in the province.

A two judge bench, headed by Justice Munib Akhtar, asked them to furnish such details by November 6.

The bench was hearing a petition 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.

During Tuesday's proceedings, Dr Kishwar Khatri, the focal person for the provincial government, informed the judges that special courses for midwifery had already been successfully conducted to train them on dealing with the patients who had fistula related problems.



However, he said that the government was facing a dearth of funds to initiate special trainings for the gynaecologists in the affected areas.

The petitioners' lawyer, Sarah Malkani, said that despite the passage of national maternal health policies, around 5,000 women in the country developed fistula every year. The petitioners estimated that over 1,500 suffering from the disease 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.



The bench directed the focal person, the health secretary and other authorities concerned to submit reports regarding the provision of funds to control the disease.

The next hearing was fixed on November 6.