Obstetric Fistula: Life Shattering but Preventable

By Beattie, Jessica Bankes | UN Chronicle, September-November 2005 | Go to article overview

Obstetric Fistula: Life Shattering but Preventable


Beattie, Jessica Bankes, UN Chronicle


Imagine a world without obstetric fistula. The result of an obstructed childbearing labour that sometimes lasts for days without access to timely medical attention, obstetric fistula has a devastating impact on the lives of women. During labour, the continuous pressure of the baby's head against the soft tissues of the mother's pelvis causes fistula or a hole between the woman's vagina and either her bladder or rectum, which leaves her chronically leaking urine, excrement or both.

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The consequences are life shattering; in most cases the baby dies. Unable to control the constant trickle of bodily fluids, the mother is abandoned by her husband and shunned by the community because of the terrible odor and stigma associated with her condition. Without treatment, her prospects for work and normal family life, including childbearing, are greatly diminished. Filled with shame, she is relegated literally to the outskirts of her community and left to live in isolation.

Virtually non-existent in industrialized countries, obstetric fistula occurs primarily in poor areas of Africa, Asia and some Arab States. The World Health Organization has estimated that there are more than 2 million women and girls, some as young as 12, in developing countries suffering from it, with 50,000 to 100,000 new cases occurring each year. Yet, the condition is completely preventable and reparable. According to the United Nations Population Fund (UNFPA), "the success rate of fistula repair for experienced surgeons can be as high as 90 per cent. After successful treatment, most women can resume full lives". Sadly, many living with the condition either are unable to afford or access treatment or do not realize that treatment is available.

In January 2004, American television personality Oprah Winfrey dedicated an entire hour of her show to this little known, devastating childbirth injury. Heidi Breeze-Harris of Seattle, Washington, was among millions who tuned in that day. Three months pregnant at the time, she was deeply shocked by what she saw and heard and was so moved that by the end of the hour she felt compelled to help. Learning that the cost of reparative treatment for one woman is $300, she thought: "I've got that! This is an astronomical sum of money for these women, but it's so little by our standards, especially relative to the absolute devastation for the women left untreated."

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Tired of quietly lamenting the fact that issues affecting women and children are often left for last, Ms. Breeze-Harris, a self-described "sled-dog" ("Hook me up, I like to work!"), in her quest to fight fistula has ended up charging uphill as the co-founder of a volunteer initiative called "One by One". She began by talking about obstetric fistula to everyone she knew, quickly learning that few people had even heard about it. A few months after viewing the Oprah show, she met Kathy Bushkin, Executive Vice President of the United Nations Foundation (UNF), who was familiar with the condition. This contact eventually led her to Emily Courey of the UNF Women and Population Division, and over many phone calls they exchanged strategies and ideas as they devised the best way to work together.

UNF supports the work of the United Nations by helping it to forge new partnerships. Ms. Courey contacted UNFPA, the UN agency that with other partners had launched the global Campaign to End Fistula in 2003. According to Allyson Ryan, Partnership Development Associate for the Campaign, the overall goal is to make obstetric fistula as rare in the developing world as it is in industrialized countries today. Three strategic interventions are used toward this goal: prevention, treatment and social reintegration. In a short time, a triangular partnership was created between One by One, UNF and UNFPA. One by One works to raise funds that support the efforts of the Campaign, while UNF, acting as One by One's fiduciary, makes it possible for all donations to be fully tax deductible. …

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