UN calls for $750m to treat 3.5m women with obstetric fistula
|UN Secretary-General Ban Ki-moon is calling for at least $750 million to treat some 3.5 million cases of obstetric fistula by 2015 in an effort to cure the debilitating injury caused by obstruction in giving birth. |
"Obstetric fistula is one of the most devastating consequences of neglect during childbirth and a stark example of health inequity in the world," he says in a report to the General Assembly released on 11 October, in which he calls for intensified investment in cost-effective interventions, including surgery, to address the problem that afflicts women with the leakage of bodily wastes.
"Although the condition has been eliminated in the developed world, obstetric fistula continues to afflict the most impoverished women and girls, most of whom live in rural and remote areas of the developing world."
Reconstructive surgery can repair fistula injury and most women can be treated and, with appropriate psychosocial care, reintegrated into their communities, but few health-care facilities are able to provide high-quality fistula treatment owing to the limited number of health-care professionals with the appropriate skills.
Apart from surgery, Mr. Ban stresses prevention, noting that the condition is almost entirely preventable when there is universal and equitable access to quality maternal and reproductive health services. The same interventions that prevent maternal mortality can also prevent maternal morbidity.
He notes that three interventions have the most important and immediate impact on maternal death and disability: family planning; attendance during childbirth by skilled health personnel, such as a midwife; and emergency obstetric care, in particular Caesarean sections. Early marriage is also an issue with adolescent girls particularly at risk for obstetric fistula at a much higher rate than women in their twenties.
The UN World Health Organization (WHO) estimates that each year some 50,000 to 100,000 women worldwide are affected by obstetric fistula, a figure that Mr. Ban says may be an underestimate, as it is based on facility data, and a significant number of impoverished women from rural and remote areas in developing countries who experience complicated labour are likely never to reach a hospital.
UN Population Fund (UNFPA) Executive Director Thoraya Ahmed Obaid welcomed the report. "Every year millions of women suffer from pregnancy and birth-related complications, as well as injuries," she said in a statement. "Through working together we can ensure that fistula is something of the past."
UNFPA leads the global Campaign to End Fistula with a wide range of partners. Since 2003 the agency provided support to 47 countries, resulting in fistula treatment and care for some 16,000 women and the training of thousands of health-care personnel in prevention and management.
"The funds required to provide quality fistula repair reflect the magnitude of the problem," Campaign coordinator Gillian Slinger said. "If we consider the backlog of fistula cases and the treatment costs of approximately $300 per repair, we can conclude that the figures mentioned by the report are a conservative estimate."
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