PRESS BRIEFING BY UNFPA EXECUTIVE DIRECTOR

At a Headquarters press briefing today, Executive Director of the United Nations Population Fund (UNFPA), Thoraya Obaid, sounded a global alarm to help women combat obstetric fistula, a debilitating pregnancy-related condition caused by prolonged obstructed labour.

Launching a new report titled “Obstetric Fistula Needs Assessment:  Findings from Nine African Countries”, she expressed hope that the report would inspire a global campaign to prevent and treat fistula as well as to draw the world’s attention to this vitally important but forgotten issue. 

According to the report, obstetric fistula was by far the most devastating disability that could happen to a woman who survived a difficult childbirth, she said.  Women became social outcasts, and many believed they had been cursed.  Without skills to earn a living, such women were forced to beg or turned to sex work for a living.

The report, the first ever to map obstetric fistula in sub-Saharan Africa, stated that current estimates, indicating that some 2 million women lived with fistula, were too low, with findings indicating that, in Nigeria alone, as many as 1 million women could be living with fistula.  Ms. Obaid said the UNFPA was making fistula a priority issue because all women had the right to live in dignity.  Most women living with fistula today suffered in silence unaware that a simple cure was available.  They deserved the international community’s immediate attention, she said. 

The report marked an important first step in a global campaign against fistula, she said.  It mapped fistula in the nine sub-Saharan Countries of Benin, Chad, Malawi, Mali, Mozambique, Niger, Nigeria, Uganda and Zambia.  It revealed how many doctors were treating women in each country and outlined specific needs of hospitals in terms of equipment, staff and supplies.  It provided the information needed to take action.

Ms. Obaid added that the UNFPA was committed to preventing further cases and treating women who needed help.  It was working with its partners like EngenderHealth, to eventually bring fistula under control in Africa and Asia, as it was in the United States and other industrial countries.  She pointed out that what needed to be done was well known:  delaying early pregnancy, increased access to child planning, education of women and provision of skilled medical care at childbirth.  Those were all ways to prevent fistula.

She noted that since surgical repair had a 90 per cent success rate, it could allow women to return to normal life and have more children.  Although the cost of surgery -- estimated to range from $100 to $400 -- was considered a small amount for some, it was “a fortune” for poor women.  The UNFPA was working with partners to bring needed funds and expertise to that issue and had already acted on the information in the report by providing grants to each country so they could begin addressing their specific needs.

The UNFPA was also working to map fistula in other African and some Asian countries and was conducting advocacy at both global and national levels.  She urged the international community to open its eyes to fistula, saying the international community not only knew how to prevent it, it also knew how to treat it.  “No young woman should suffer in silence unaware that a simple cure is available and available cheaply”, she said.  According to the reports’ findings, women living with fistula in sub-Saharan Africa were usually 20 years old, with some as young as 13, illiterate and poor.

Also present at the launch were Dr. Amy E. Pollack, President of EngenderHealth, an international non-profit agency dedicated to improving access to quality reproductive health care in 25 countries; Dr. Joseph Ruminjo, senior medical associate with the same agency; and Dr. France Donnay, Chief of the UNFPA’s Reproductive Health Branch.  Speaking at the launch, Dr. Pollack observed that women who developed fistula often attempted to deliver their babies at home without skilled medical care.

Dr. Donnay, an obstetrician/gynaecologist with long experience in practicing medicine in her native Belgium and other countries, said the actual figures of fistula sufferers were uncertain because many women never came to the hospitals, as they were unaware treatment was available, or because of the stigma associated with it.

Dr. Ruminjo, also an obstetrician/gynaecologist, observed that as a Kenyan doctor who had performed fistula surgery, it was particularly noteworthy that while each country surveyed in the report had different needs, there were many striking similarities.  He pointed to the pain, trauma and the desperation that many of the women had to go through; a situation he said was the norm, rather than the exception for the majority of them.  He also bemoaned the lack of adequate surgical supplies and equipment as well as locally trained doctors to handle fistula patients.  If those immediate needs were not addressed, it would not be possible to meet the demand for care, he said.

In response to a correspondent’s question, Dr. Donnay confirmed that there were many women in the same situation in Asia (Pakistan) and the Middle East.

Asked what inroads had been made with governments and their understanding and willingness to put the issue into their budgets, Dr. Donnay said the government response varied from country to country, although all of them had been approached, and many had responded positively, while still others were in fact already on board.  Dr. Ruminjo added that some governments were still at policy formulation level while others were quite advanced in their response to the problem.

Ms. Obaid said that, as part of the Fund’s ongoing campaign to raise awareness about fistula, she had recently appointed her predecessor, Dr. Nafik Sadik, as special ambassador envoy on fistula.  Her role was to talk to governments and keep the issue in the media in those respective countries.

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