Campaign launched to end fistula

The UN Population Fund (UNFPA) has launched a women's health campaign aimed at raising awareness of obstetric fistula in the Sudanese capital, Khartoum. "The campaign [entitled "We MUST Care"] recognises that fistula by its nature is inseparable from the issues that face women on a daily basis - poverty, malnutrition, lack of education, early pregnancy and inaccessibility of maternal health care," said Kate Ramsey of the UNFPA at the launch on Thursday. Fistula, once common worldwide, occurs mainly as a result of obstructed labour and primarily among young women in their first pregnancy. The prolonged pressure of the baby's head against the mother's pelvis cuts off the blood supply to the soft tissue surrounding the bladder, rectum and vagina, which can then rot away leaving a fistula, with the woman unable to control her bladder or bowels. Reconstructive surgery is straightforward, successful in up to 90 percent of cases, and costs between US $100 and $400. But many women are unaware that it is available or have no money to pay for it. Most of those who live with the condition are poor, illiterate, married off early, with no access to education, medical help or money. The numbers of Sudanese women living with fistula are unknown; 200 are currently awaiting surgery in the Fistula Centre in Khartoum Teaching Hospital. However, the maternal mortality rate in Sudan is 509 per 100,000, one of the highest in the world. One in 12 women risks dying of pregnancy related causes. "Each year between 50,000 and 100,000 women [worldwide] sustain an obstetric fistula in the act of trying to give life," commented Dr Nimal Hettiaratchy, the UNFPA representative in Sudan, noting that fistula was both preventable and treatable. About 2 million women remained untreated in developing countries, many of whom were ostracised by their families, abandoned by their husbands, thrown out of their homes and even disdained by health workers, who considered them "unclean", he said. "It is inhuman and cruel to allow women in this state to go through this form of torture, especially since there is an available cure through an operation," Andréa Reichlin, the Swiss charge d'affaires in Sudan, commented during the launch of the campaign. "It is even more intolerable since we know that there is a possibility to eradicate fistula in the whole of Sudan if its prevention efforts are widely addressed." "The means to eradicate fistula are without any doubt in the field of education," she said. "Especially girls, who sadly make up the bulk of the illiterate population, must be given access to primary education," she said. The campaign hopes to upgrade the Khartoum Fistula Centre, to establish other fistula centres in El Obeid (Al-Ubayyid), Al-Fashir, Port Sudan and Juba, raise awareness about the condition and its links with early marriage and female genital mutilation, upgrade the skills of midwives, and make transport available to women to seek urgent medical attention.