A campaign to end obstetric fistula

Saturday, May 23 was recognised as the International Day to End Obstetric Fistula. Obstetric fistula is a devastating yet completely preventable and, in many cases, treatable injury of childbirth. It leaves women, and many girls, incontinent and often stigmatised, abused and isolated from families and communities. At least two million women and girls live with the condition, and 50,000 to 100,000 new cases occur every year. Below are statements from Dr Babatunde Osotimehin, United Nations Under-Secretary-General and Executive Director of the United Nations Population Fund (UNFPA) and UN Secretary General Ban Ki-moon.

Dr Babatunde Osotimehin

SIGNIFICANT gains have been made in improving sexual and reproductive health and advancing reproductive rights since the 1994 Cairo International Conference on Population and Development. But many people, especially the poor and vulnerable, still lack access to quality sexual and reproductive health services, including life-saving emergency obstetric care. Women and girls living with fistula are among the most marginalised and neglected, and the persistence of fistula is a grave illustration of serious inequalities and the denial of rights and dignity.

The theme of this year’s International Day to End Obstetric Fistula, “End fistula, restore women’s dignity”, is both timely and crucial. As the Millennium Development Goals draw to a close and the world shapes a new development agenda, we have a golden opportunity to put the rights and dignity of women and girls — including the invisible, disenfranchised, and voiceless — at the heart of a people-centred, equity-driven, rights-based agenda. Only then can we transform the vision of ending preventable maternal and newborn death and injuries into reality, and truly bring about the world we want.

The global Campaign to End Fistula, launched in 2003 by UNFPA and partners, has catalysed progress towards eliminating fistula and supporting fistula survivors through its three-pronged strategy of prevention, treatment and social reintegration. UNFPA has supported over 57,000 fistula repair surgeries for women and girls in need, and campaign partners have enabled many more to receive treatment.

More and more women also receive rehabilitation — women like Nasima Nizamuddin from southern Bangladesh, whose husband rejected her and their nine month-old son, Nayem, when she developed fistula during his birth. After a successful surgery, Nizamuddin came to the UNFPA-supported Fistula Patients Training and Rehabilitation Centre in Dhaka for her emotional recovery and to acquire skills to make a living for her and her son, and to live a life in dignity.

However, much more needs to be done. We estimate that at least two million women live with the condition and 50,000 to 100,000 new cases occur every year. Fortunately, with the right combination of political will and leadership, financial commitment and scaling up of evidence-based, cost-effective, quality interventions, ending forced marriage and ensuring girls education as well as voluntary family planning, we can end the needless suffering of millions of women and girls. We can also ensure that others do not suffer the same fate.

Let us decide, as a global community, that the world we want is one where fistula no longer exists. Let us, once and for all, put an end to this assault on women’s and girls’ health and human rights, which steals from them their very dignity and destroys the most fundamental of human qualities: hope. Much of the world has already virtually eliminated fistula. It is time to finish the job. Let us all work together to wipe fistula off the map.

Ban Ki-moon

THE fact that fistula persists primarily among the poorest and most marginalised women and girls in the world is an egregious outcome of social, economic and gender inequalities, the denial of human rights and inadequate access to quality reproductive health services, including maternal and newborn care. We can and must put an end to this needless suffering.

I call on world leaders to commit to ending the scourge of fistula in our lifetime. To achieve this goal, every fistula-affected nation needs to develop an inclusive, costed and time-bound national strategy and action plan. The international community must also significantly intensify support to nations with the greatest need.

To address the neglected health and human rights issues of fistula, UNFPA launched the global Campaign to End Fistula. In the 12 years since this effort began, much has been accomplished, including providing relief to more than 57,000 women and girls through fistula surgical repairs. However, much more needs to be done.

Echoing the December 2014 United Nations General Assembly resolution on ending fistula, I urge the international community to speed up its efforts to end this condition. This needs to be part of a far-reaching and inclusive sustainable development agenda to improve sexual and reproductive and newborn health, strengthen health systems, eliminate health inequities and increase levels and predictability of funding.

We have a moral obligation, as a global community, to complete the unfinished agenda of eradicating fistula. Together, let us keep our promises to support universal human rights and ensure the health and dignity of women and girls everywhere.