OP-ED BY UNFPA West and Central Africa Regional Director, Dr Sennen Hounton
Adelia's story is one of quiet suffering and resilience. “My clothes were constantly wet from urine or faeces and gave off a bad smell. The father of my children could no longer stand my presence and I couldn’t run my business. I suffered for 10 years. I was ostracized and had to stay with my mother in the village…”. These poignant words from Adelia, a survivor of obstetric fistula, bring to light the harrowing reality faced by countless women and girls. On this International Day to End Obstetric Fistula, themed "Breaking the Cycle: Preventing Fistula Worldwide," we must recognize that survivors like Adelia from Cameroon are not mere statistics; they are individuals whose lives and dignity demand urgent action and investment. Thanks to UNFPA support, Adelia was able to undergo surgery and her fistula is now only a distant memory and she was able to rejoin her community and start up her business again.
Obstetric fistula, a preventable and treatable childbirth injury, afflicts nearly 500,000 women and girls worldwide, with thousands of new cases emerging each year. Sub-saharan Africa has 50% of the estimated global burden of obstetric fistula and West and Central Africa is one of the sub-regions with the highest rate. This debilitating condition results from prolonged, obstructed labor without timely medical intervention, leading to severe physical, emotional, and social consequences. Women with obstetric fistula often endure constant incontinence, infections, and chronic pain. As a consequence of their condition, they frequently face stigma, social isolation and deepening poverty, as Adelia’s experience painfully illustrates.
Over the past two decades, UNFPA has supported 140,000 fistula repair surgeries. In 2023 alone, in West and Central Africa, over 3,000 cases of fistula were repaired and 422 doctors (surgeons, gynecologists-obstetricians or urologists) were trained.
Allocating adequate resources to support holistic programmes that address prevention, treatment, rehabilitation, and social reintegration will help restore a dignified life for women survivors of obstetric fistula and avoid further women from suffering from this tragic yet avoidable childbirth injury. The prevalence of obstetric fistula across lower- and middle-income countries in sub-Saharan Africa, is a symptom of deep-rooted global inequalities and failure of health systems. In contrast, it is almost absent from high-income countries, highlighting the disparity in healthcare access and quality.
Women and girls at risk of fistula are also at risk of maternal mortality, which is why advocacy and accelerated action towards ending fistula is a matter of life and death.
Meaningful community engagement to end child marriage and promote girl education is crucial to addressing the sociocultural drivers of poor maternal health outcomes like fistula. These efforts also facilitate the social reintegration of survivors and improve the overall well-being of women and girls.
Adelia’s journey from suffering to a dignified life is a testament that eliminating fistula and addressing its devastating consequences is possible. It is also a call to action. We cannot allow more women to endure a degrading life due to obstetric fistula. As we observe this International Day to End Obstetric Fistula, let us commit to breaking the cycle of neglect and ensuring that every woman has the chance to give birth safely and continue her life with dignity. The health and future of countless women and girls depend on our collective resolve to end this preventable tragedy
On this International Day to End Obstetric Fistula, let us renew our commitment to eliminating this debilitating condition. We call on national and international partners to invest in equitable access to quality maternal health services. By doing so, we can prevent and ultimately end fistula cases, ensuring that women and girls like Adelia can live healthy, dignified lives.
