Ahead of the International Fistula Day on Wednesday, the Ministry of Health has said obstetric fistula still remains a major public health problem with about 75,000-100,000 (1% of women of reproductive age) women suffering from the condition and 1,900 new cases per year.
Obstetric fistula is defined as an abnormal opening between the birth canal and the bladder/ureter or rectum of a woman that results in constant leakage of urine and/or faeces through the birth canal. Most fistulas are as a result of difficult childbirth and obstructed labour lasting more than 24 hours.
The Ministry of Health says although, 2,000 repairs are carried out every year, a good proportion of women affected by obstetric fistula are not receiving the required treatment hence leaving a backlog in the communities.
“Women who give birth before age 20 are at greatest risk of fistula. Their bones surrounding the birth canal are not fully grown so their baby may not be able to pass through their birth canal. Poor nutrition during a girl’s childhood can also cause stunted growth and increase her risk for fistula,” a ministry statement released on Monday by Dr Olaro Charles, the Director Clinical and Community Services, reads in part.
Dr Olaro says the Ministry with support from partners says it has put in place a number of interventions to address the growing problem of obstetric fistula by commencing a multifaceted fistula management program aimed at prevention, treatment and rehabilitation of fistula clients, providing more skilled health personnel to perform fistula repairs and reintegrating those who have undergone repairs back into their communities.
The ministry says it has also trained community health extension workers to enhance community mobilization for skilled delivery attendance and built capacity for districts and health facilities across the country in emergency obstetrics care and management including use of partographs to detect deviation from normal Labour. It is also improving on the referral system at all levels, availing Family Planning services and information, recruitment of skilled service providers (midwives) and critical cadres in lower level health facilities, equipping facilities with lifesaving commodities and supplies – all of which are geared to improving maternal and new born survival at all levels and implementation of the sharpened plan and family planning costed plan aimed to improve and save dignity of women at all levels.
Through Government efforts in partnership with developmental partners like UNFPA, USAID/ Engender Health/fistula care Plus Project, AMREF, Terrewode, WAWI and other stake holders , treatment for fistula is available free of charge in the following Hospitals; Mulago, Mbarara, Mbale, Fort Portal, Arua, Jinja, Lira, Soroti, Masaka and Hoima referral hospitals. Others are Moroto Regional Referral, Kabale Regional Referral Hospital, Kagando, Kitovu, Kamuli, Lacor, Kisiizi, Virika and Kumi mission hospitals.
“We have procured fistula repair equipment for all the above facilities and training of teams for fistula repair i.e. Surgeons, anaesthetists and nurses on fistula repair, to work as a team in each of the referral hospitals. As a result of these interventions, the numbers of repairs have increased and thus resulted in progressive reductions in the prevalence of fistula,” the ministry statement adds.
As part of the activities to mark the International Fistula Day, Ministry of Health is conducting a week-long Fistula medical camp in Mbale Regional Referral Hospital which intends to treat at least 40 patients. The national celebrations to mark the day will take place at Kavule Primary School, Kirika Sub County, Kibuku District on Wednesday to be presided over by the Speaker of Parliament under the theme “End Fistula Now, Reach Every One”.
Globally, approximately 2 million women are living with fistula, with 50,000-100,000 new cases occurring annually, most of which are in Sub-Saharan Africa and Asia.