Last week the world celebrated International Day to End Obstetric Fistula.
It is unfortunate that while this condition is preventable and treatable, it is still very common today. The most affected are women and girls who are poor, with low level of education, got pregnant as teenagers and stay in rural settings. Poor access to skilled maternal health services does not help the situation.
Obstetric fistula is an abnormal hole between the urinary bladder and or rectum and vagina leading to incontinence of urine and or stool. This condition often results from prolonged obstructed labour among women with poor access to emergency caesarean section. It is a condition that leaves these women living in shame, depression and sometimes ostracised by society.
Ending obstetric fistula is critical to achieving the sustainable development goals and fundamental to improving maternal and newborn health. Its occurrence is a violation of human rights and a reminder of gross inequities.
Women and girls living with obstetric fistula face physical, psychosocial, and socioeconomic challenges.
Some of physical problems include bad odour because of the constant leakage of the urine and /or faeces, limited movement and irritation and wounds because of friction between thighs. They also face discrimination and are isolated in society and therefore tend to be powerless and face financial constraints.
Unfortunately, women and girls affected by obstetric fistula often do not know that treatment is possible, cannot afford it or cannot reach the facilities where it is available.
We have seen great progress on maternal and newborn health in recent years. However, a lot more needs to be done. Unfortunately, many women in Kenya continue to live with fistula.
More than one-third of births (37 per cent) take place at home, making the situation even worse. Amref Health Africa’s Obstetric Fistula programme was established in 1992. Since its inception, the programme has been involved in large scale surgical interventions targeting women and girls with obstetric fistula. The programme trains doctors, nurses and midwives in fistula awareness, prevention, surgical repair and post-operative care.
More than 13,000 women and girls have since received fistula repair. More than 1,000 healthcare workers trained on prevention and management of obstetric fistula with more than 100 surgical camps conducted across the country.
Amref in partnership with UNFPA and the Ministry of Health have developed and launched two policy documents on fistula — the Female Genital Fistula Trainer’s Manual and the National Strategic Framework on Female Genital Fistula in Kenya
They were launched by First Lady Margaret Kenyatta during a medical safari in West Pokot. These two documents will strengthen our resolve to eradicate the burden of female genital fistula in Kenya.
In 2003, UNFPA and its partners launched the global Campaign to End Fistula, which is now active in more than 55 countries, working to prevent and treat and rehabilitate fistula survivors.
In 2013, the UN commemorated the first International Day to End Obstetric Fistula, on May 23, to raise awareness of this issue and mobilise support around the globe. This day is observed annually around the world by partners committed to ending fistula.
The theme for this year was “Women's rights are human rights! End fistula now!” a critical step towards achieving SDGs and towards the fight for women’s rights, including the sexual and reproductive health.
While we have made great achievements in terms of how far we have come, we need to increase investment to achieve this historic goal to end fistula now!
John Kutna is the Family Planning and Maternal, Newborn and Child Health programme manager at Amref Health Africa in Kenya; Vayonda Ongaya is the Programme Assistant
