close
Tuesday March 19, 2024

Victims of obstetric fistula continue to suffer in silence

By Our Correspondent
May 24, 2018

Islamabad : Even though obstetric fistula is preventable and in most cases, can be surgically repaired, an estimated 3,000 to 5,000 new cases develop in Pakistan each year. Organisations working in this neglected domain have urged the government to improve access to victims of obstetric fistula, who are among the hardest to reach and are often illiterate and with limited access to health services including maternal and reproductive health care.

The demand comes on the occasion of the International Day to End Obstetric Fistula, which is observed on May 23 each year to highlight the misery of victims on the one hand, and to awaken governments to the need for corrective measures to improve access to victims, to hold relevant training for healthcare providers, to raise public awareness, and to enforce appropriate adaptations in the medical curriculum.

One of the most serious injuries of child birth, obstetric fistula is a hole in the birth canal caused by prolonged labour due to the lack of timely and adequate medical care. In most cases, the baby is either stillborn or dies within first week of life and women suffers a devastating injury—a fistula that renders her incontinent. Many women and girls with fistula are shunned by their families and communities, deepening their poverty and magnifying their sufferings.

For two decades, the international community campaigned to reduce maternal mortality and morbidity. While precise figures are lacking, it is generally accepted that at least 2 million women, or perhaps as many as 3.5 million, suffer from obstetric fistula. The World Health Organisation (WHO) estimates that each year approximately 50,000 to 100,000 women are affected. In 2008, for the first time, the General Assembly acknowledged obstetric fistula as a major issue in women health by adopting a resolution.

Victims of obstetric fistula are usually among the hardest to reach and are often illiterate and with limited access to health services including maternal and reproductive health care. The persistence of the problem reflects broader health inequities and health care system weakness as well as wider challenges facing women and girls such as gender and socio-economic inequality, lack of schooling, child marriage and early child bearing all of which impede the well-being of women and girls and their opportunities.

According to a joint press release issued by the Pakistan Institute of Medical Sciences, the Pakistan National Forum on Women Health and the Fistula Foundation, prevention, treatment, and the social integration of survivors should be at the heart of addressing this health challenge.

Over the last 8 years, UNFPA has provided treatment to 5,000 women, and from 2016, the Fistula Foundation and Islamic Development Bank has directly supported more than 10,000 women and girls to receive surgical treatment for Fistula in Pakistan through their eight regional centres in the country.

The PNFWH, which is implementing the project all over Pakistan, is providing surgical treatment, training for doctors and mid-level health care providers and raising awareness on the social issues related to Obstetric Fistula.

In Pakistan, recently very high number of Iatrogenic Fistula have been reported. The Pakistan Medical Association and the Society of Obstetricians and Gynaecologist of Pakistan have expressed great concerns over this serious issue and have been urging health authorities to use their all resources to stop such practices. “PMDC and CPSP have to redesign their policies for registration and trainings,” the press release flags.

The Regional Fistula Centre at the MCH Centre, PIMS, is one of the 8 Centers, where from April 27, 2007 more than 700 Fistula patients have been treated from allocated catchment areas, i.e., 4 districts of Punjab (Jhelum, Chakwal, Rawalpindi and Attock), Azad Jammu & Kashmir and Gilgit Baltistan(GB) with 100% success rate.

The MCH Centre has also trained more than 1,200 healthcare providers in the allocated catchment areas; these include doctors, gynaecologists, nurses, LHVs, LHWs, LHS, and community midwifes. Every month, two training workshops are arranged at different DHQ Hospitals or THQ Hospitals for healthcare provides.

The above efforts notwithstanding, the fact that the problem is discussed only once every year when the International Day to End Obstetric Fistula is observed, shows that Pakistan still has a long way to go before the sufferings of these silent victims can meaningfully and comprehensively be addressed.