By Ndey Sowe
Obstetric Fistula is one of the most severe childbirth injuries affecting women globally, resulting from prolonged and obstructed labour without access to timely, high-quality medical treatment. It often leads to chronic medical problems, depression, social isolation and deepening poverty. The condition is also linked to harmful cultural practices such as Female Genital Mutilation (FGM) and Child Marriage.
It is in this regard that on the commemoration of the International Day to End Obstetric Fistula, the United Nations Population Fund (UNFPA launched a nationwide campaign on Monday 23rd May 2022, to eliminate the medical condition by 2030.
The launch of the campaign held at the Sir Dawda Kairaba Jawara International Conference Centre, was graced by Mrs. Fatoumatta Bah-Barrow, wife of President Adama Barrow, and the theme for this year’s commemoration was: “End Fistula Now; Invest in Quality Healthcare, Empower Communities.”
In her statement, Mrs. Bah-Barrow said fistula is one of the most severe forms of childbirth injuries which mainly affects the most vulnerable and poorest girls and women living in areas with limited access to quality health services.
“The fight for obstetric fistula is a fight for human dignity. Indeed, fistula unlike HIV / AIDS, can be easily prevented and treated if diagnosed properly,” Mrs. Bah-Barrow said. However, given the stigma and low awareness associated with this condition, most cases are not reported making it difficult to gather an accurate data on fistula.
Ndeye Rose Sarr, the UNFPA’s Gambia Representative said this year’s theme is a call for investment to improve the quality of care and place emphasis on the key role communities play in addressing social, cultural, political and economic determinants that impact maternal and sexual reproductive health, and rights.
“It is not enough to only remind ourselves of the devastating condition many women around the world live through with obstetric fistula but to commit to ensure they live dignified lives. As we reflect on this year’s theme, it is critical for Government and partners including the UN system, to redouble efforts so that health systems are strengthened for women to get access quality health care in health facilities nearest to their homes. We need to empower women so that the decision to seek health care especially antenatal care and reproductive health services, will be timely met,” Ms. Rose Sarr remarked.
Dr. Mustapha Bittaye, Director of Health Services who represented his Minister, said Gambia experiences high rates of early marriage (37% nationwide and 44% in rural areas), low literacy and education rates and lack of decision-making powers for women. He said these are all prevalent in the country as additional risks factors for obstetric fistula.
Fatou Kinteh, Minister of Gender, Children and Social Welfare added that the theme for this year’s commemoration is in line with the Government’s efforts to augment investment in order to improve maternal health by addressing sexual and reproductive health as well as maternal, new-born and children’s health.
“My Ministry in particular has been constantly contributing its quota in the fight against this menace under the theme of community empowerment. We have done this through the implementation of local programs and strategies aimed at tackling the complex circumstances and conditions that contribute to the development of obstetric fistula in our various communities,” Kinteh stated.
Other speakers include Dr. Abubacarr Jah, Urology Surgeon and Fatou Dumbuya, a fistula survivor who gave testimony on second chances at survival and dignity.
Despite the absence of a national representative data on the prevalence of fistula in The Gambia, prevalence estimations are drawn from proxy measures of maternal and perinatal Deaths rates, fistula treatment data as well as contextual data. These estimations according to a 2020 situational analysis, recorded a prevalence rate of 0.46 to 2.05 per 1,000 women. Based on these rates, the current national burden is estimated at between 335 to 1,052.