More than 50,000 new cases of Obstetric Fistula develop each year, according to the Ministry of Health. It is said fistula affects an estimated two million women and girls in developing countries. Obstetric Fistula is a severe medical condition in women when the wall between the bladder and vagina is damaged and a fistula or hole develops. This means the woman constantly leaks urine and sometimes, if the rectal wall is affected, the ability to control faecal excretion is also lost. Such a hole can be on the bladder or the rectal wall, causing urine or stool to flow from the high pressure side (urinary tract or bowel) to the low pressure side (vagina). To tackle this preventable burden, effort contribution from everyone is needed for taking the lead to eliminate fistula in the country, according to Dr Anicet Nzabonimpa, the coordinator of Family Planning and HIV Integration Programme in the Ministry of Health. Speaking during the International Day to end Obstetric Fistula in Kigali, Dr Nzabonimpa said in past, fistula was a taboo in Rwandan community, adding that the people suffering from the condition could not dare to talk about it; others thought it could not be treated. On Friday, the world marked, for the second time, the International Day to End Obstetric Fistula. This day was designated by the United Nations General Assembly, in 2013. Fistula is said to affect an estimated two million women and girls in developing countries. This year also marks the 11th anniversary of the Campaign to End Fistula, which was launched by UNFPA, in collaboration with a range of partners. The theme of this year’s Day, is “Tracking Fistula – Transforming Lives,” which organisers say reflects an important step forward in eradicating the medical condition. Dr Babatunde Osotimehin, the UN Under-Secretary-General and executive director of UNFPA, said Obstetric Fistula highlights persistent global inequalities in access to health care and basic human rights. Most women who develop fistula–usually caused by prolonged, obstructed labour–remain untreated for their entire lives, and the condition can easily recur in women and girls whose fistula has been surgically treated but who receive little or no medical follow-up and then become pregnant again. “To treat fistula and provide women with follow-up medical care, we need to know more about how many women and girls are in need of services and also where they live. In most instances, stigma forces women living with the condition to remain hidden andisolates them from families and communities,” Dr Osotimehin said. “By systematically registering and tracking each woman and girl who has or had fistula, we can make enormous strides inimproving their wellbeing and increasing the chances of their babies’ survival in subsequent pregnancies.” The UNFPA chief said eliminating the health crisis requires scaling up countries’ capacities to provide access to equitable, high-quality sexual and reproductive health services, including family planning and maternity care, especially comprehensive emergency obstetric care. “Tracking and treating all fistula cases is crucial, but it is also necessary for countries to take steps to prevent fistulas by addressing underlying medical and socio-economic causes, eliminating gender-based social and economic inequities, preventing child marriage and early childbearing and promoting education, especially for girls,” he said. Health ministry’s Nzabonimpa said fistula is not an exceptional case in the country, adding that it is preventable and in most cases treatable and healed. He urged sufferers not to be shy and withdraw from the society, but seek help early enough. He added that effort to eliminate it, 11 health fistula sites have been scaled up across the country so that more patients can have easy access. He said in few years, the number of local medical professionals who can treat fistula will increase gradually. The country has largely been relying on international medical volunteers, especially the International Organisation for Women in Development, that sends volunteer surgeons and other medical professionals into the country four times a year to treat the disease. Jozef Maerien, the country representative of the United Nations Population Fund (UNFPA), said their target is to double efforts to put an end to this grave global burden. “Working together, we can end the shame, the isolation and fistula,” he said. However, Maerien said a lot has been achieved, but still have a lot more to be done. “Stigma forces women living with the condition to remain hidden while we need their steadily statistics to treat them and provide the follow-up medical care,” he insisted. Jozef Maerien added in collaboration with the government, they will continue to provide emotional, economic and social support to the fistula survivors to help them fully recover from their ordeal, and take up their rightful place in their communities again. Since 2003, more than 3,500 women have been repaired in the country.
