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Dr Natalia Kamen, the Executive Director of the United Nations Population Fund (UNFPA), has called for accelerated efforts towards ending obstetric fistula by 2030, which is the deadline for achieving the Sustainable Development Goals (SDGs).

The scourge of the novel Coronavirus, she cautioned, threatened to take a huge global toll on maternal and newborn health.

Dr Kamen said these in a statement issued, on Friday, to herald the commemoration of this year’s International Women’s Day to End Fistula, on Saturday, May 23.

She recounted how the world convened in Nairobi, Kenya, last November, to celebrate the tremendous gains of the past 25 years in advancing the health and rights of women and girls.

She said:“With a deep sense of urgency, purpose and hope, leaders from around the world – from presidents to the grassroots, from refugees to royalty, from youth activists to CEOs – committed to accelerating action to ensure sexual and reproductive health and rights for all.”

However, just six months later, she said, the commitment was being tested like never before as health systems struggled to respond to the COVID-19 pandemic.

Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. It could be between the vagina and the rectum; ureter, or bladder and can result in incontinence of urine, faeces or both.

Between 50,000 and 100,000 women develop the condition yearly.

Dr Kamen noted that the COVID-19 crisis was already compounding the economic, social and logistical barriers that women and girls faced in accessing sexual and reproductive health services.

She said even where these services were available and accessible, fear, misinformation and stigma related to COVID-19 were deterring some pregnant women from seeking obstetric care.

Therefore, this year’s celebration, which is on the theme: “End gender inequality! End health inequities! End fistula now!” seeks to re-echo the need for governments to stick to their commitments made at the Nairobi Summit, and remain focused in achieving the global ambition, she said.

In the end, she said, the response to the COVID-19 pandemic must ensure the delivery of essential sexual and reproductive health services, including midwifery services and emergency obstetric care.
The absence of timely medical treatment would likely spur a dramatic increase in obstetric fistula, a serious childbirth injury resulting from prolonged, obstructed labour, she said.

Poor women and girls in rural areas are especially at risk, while the disproportionate incidence of the debilitating and sometimes life-threatening condition, reflects the social and economic inequities, and of unequal enjoyment of the right to health, including sexual and reproductive health.

She cited some contributory factors towards such violations as the lack of access to skilled health personnel; child marriage and early childbearing.

The Executive Director said while fistula had been virtually eliminated in developed nations, hundreds of thousands of women and girls in the developing world still lived with it and they required reintegration programmes.

The Fund for their support has, since 2003, however, enabled more than 113,000 women to undergo obstetric fistula repair surgeries.

Dr Kamen stated: “On this International Day to End Fistula, the memory of the late Dr. Catherine Hamlin, who passed away in March this year, looms large.

“She dedicated most of her long life to treating women and girls with fistula, focusing not only on the physical injury itself, but also on the scars created by stigma and discrimination”.

She said her charitable organisation, Hamlin Fistula Ethiopia, had brought hope and healing to women and girls, raised global awareness of fistula and spurred innovative efforts to end it.

She, therefore, called for a united front globally, in working in Dr. Hamlin’s memory, towards fulfilling her lifelong dream and the long-held aspiration to eliminate the preventable condition, “and in doing so, help protect the health and human rights of the poorest and most vulnerable women and girls”.