Sudan: UN aims to curb injuries suffered by women enduring prolonged labour

The United Nations Population Fund (UNFPA) is leading a global effort to end obstetric fistula – an abnormal hole in the birth canal caused by prolonged labour without speedy medical attention – in Sudan, where 5,000 new cases occur every year.

Obstetric fistula, which leaves women with chronic incontinence and in most cases a stillborn baby, is almost entirely preventable. However, there are only three health centres for fistula across in the vast country.

Occurring disproportionately among impoverished girls and women, it occurs when emergency obstetric care is not available to women developing complications during childbirth. Many Sudanese women live far from the reach of medical services.

In Southern Sudan – where reproductive health problems such as fistula are the leading cause of death and illness for women of childbearing age – there are only eight qualified midwives, and seven of the ten States have none. Further compounding the risk of developing obstetric fistula is the fact that there are fewer than 30 general practitioners in all of Southern Sudan.

The Campaign to End Fistula, which started in 2003 and currently operates in over 40 countries, aims to end fistula worldwide by 2015 to meet the Millennium Development Goals (MDGs), a series of targets to slash poverty and other ills.

The initiative trains doctors, nurses and other health workers in live-saving obstetric care, and focuses on the three crucial areas of prevention, treating affected women and supporting them after surgery.

“Prevention is at the heart of this Campaign,” Saira Stewart, UNFPA Media Officer, told the UN News Service. “In the long run, prevention also entails tackling underlying social and economic inequities through efforts aimed at empowering women and girls, enhancing their life opportunities and delaying marriage and childbirth.”

The Campaign also works to provide care for women already living with fistula. A simple surgical procedure – at an average cost of $300 – will repair the injury in most cases, with 90 per cent success rates among skilled surgeons. The UNFPA scheme channels funding for the provision of free surgery to women who need it.

“Fistula treatment goes far beyond the surgical repair,” Ms. Stewart noted. “Many patients, especially those who have lived with the condition for years, will need emotional, economic and social support to fully recover from their ordeal.”

Sudan was one of the first countries the Campaign reached out to, primarily because of the high rates of obstetric fistula occurring yearly.

The Campaign works in tandem with its partners on the ground in Sudan to bolster health services for fistula repair surgery and rehabilitation, providing “a much-needed boost to Sudan’s health system as a whole, particularly since it has one of the highest rates of maternal death in the world,” Ms. Stewart observed.

The Sudanese Ministry of Health has partnered with UNFPA to conduct a month-long training session for health care workers in the Upper Nile, Northern Bahr El Gazal, Lakes and Jongolei States, currently underway.

In addition, UNFPA experts based in New York are on a two-day visit to Juba as part of the Campaign, and will meet with health officials and health care providers to stress the importance of preventing obstetric fistula.

Last year, in Western Darfur, UNFPA helped open the region’s first comprehensive fistula centre, a 16-bed facility with the capacity to treat almost 1,300 women yearly.

In Pakistan, where like Sudan, approximately 5,000 new cases of obstetric fistula occur annually, UNFPA has since last year been aiding seven regional centres to treat women suffering from the condition. As of last month, around 375 women were operated on free of charge, and the agency predicts twice as many women to be treated in the next 12 months.

Although obstetric fistula has almost entirely been eliminated in countries where emergency care is widely available, it still affects at least 2 million women worldwide and between 50,000 to 100,000 new cases develop every year.

“We’ve made remarkable progress since 2003, but the needs are great,” Ms. Stewart said. “Ending fistula worldwide will demand political will, additional resources, and strengthened collaboration between governments, community groups, NGOs and health professionals.”