No, I’m not talking about Covid-19, which has invaded our shores and our minds for several weeks now. I’m thinking rather of Obstetric Fistula which is truly a horror for those women, mostly in South Asia and Africa who live with it. Some wait, for as many as 15, 30 or even 40 years before they have a repair operation.
It is truly a distressing and embarrassing condition to live with. It leads to shame and isolation, stigmatization and exclusion. For many it is a life sentence. Lives are shattered and ruined. Family units are fractured and broken. All dignity is gone. It is truly a modern-day leprosy. And those who are most affected are those women living in extreme poverty, far away from cities and where there are few medical services.
The Hamlin Hospital in Addis Ababa is world-famous for its Fistula repair and re-integration work. Towards the end of the 90s a submission was made by the ‘Terrace End in Palmerston North’ Rotary club in New Zealand that the hospital be granted the Rotary International Award for World Understanding. The submission opened with the following introduction:
“It is most unlikely that you will ever be injured in such a way that you have a permanent opening between your bladder and rectum (i.e, fistula) so that the urine and faeces trickle down your legs 24 hours a day! Add to this the difficulties of living in a remote village in a poor country, with an inadequate water supply and not enough money to busy rags and diapers. You would smell greatly and be totally ostracised”.
Most of the finance and effort that is spent by individuals, foundations, NGOs and Governments on this issue focusses on medical repair operations. I believe, that in addition to paying attention to necessary medical treatment it is time to focus now on the human rights dimensions of the problem, so that the present distressing situation – living with Obstetric Fistula – which young women endure can be addressed and eliminated. The emphasis needs to be on prevention.
“Obstetric fistula is a devastating but easily preventable childbirth injury caused by prolonged, obstructed labor. It can cause both urinary and fecal incontinence. It is a stark outcome of gender inequalities, the denial of human rights and poor access to reproductive health services. It is estimated, that more than 2 million young women live with untreated fistula”. 
I first heard of Obstetric Fistula when I was working in Pakistan in the 1980s and once had an opportunity to meet a doctor – Dr Shershah Syed – who was engaged in repair operations for women from rural Sindh and Balochistan. Last year when I returned from the Philippines, I again took an interest in this issue. I am now involved in advocacy work with NGOs in affected countries and the International Human Rights mechanisms in Geneva to prevent this horror of horrors.
In January I travelled to Kenya and Uganda to meet with people engaged in the work of advocacy for these women. Last month I worked with others in Geneva to prepare a statement about this issue, trying to raise awareness within the human rights council.
The last Fistula hospital in the USA closed in 1895.