Obstetric Fistula is a childbirth injury caused by prolonged, obstructed labour without timely intervention, typically, a Caesarean section. The result is a constant leaking of urine and/or faeces through the vagina. This makes it a sensitive condition that relegates women to social exclusion and isolation, adverse discrimination, and low self-esteem. Globally, about two million women remain untreated in developing countries and between 50,000 and 100,000 new cases occur each year, the majority of whom live in Sub-Saharan Africa.
In The Gambia, the United Nations Population Fund (UNFPA) works with the Ministry of Health and other partners to provide fistula repair surgery and rehabilitation for women suffering from the condition, while strengthening the Ministry of Health’s capacity to integrate quality Fistula Case Management in the healthcare delivery system. Since 2018, over 60 women have received free fistula repair surgery as part of this programme.
The Director of Health Services, Dr. Mustapha Bittaye, says “The Ministry of Health is highly committed to reducing fistula as that is indirectly reducing maternal morbidity and mortality in The Gambia. We will continue to work with partners and stakeholders to fight against obstetric fistula.”
UNFPA’s Country Representative, Ms. Ndeye Rose Sarr says: “UNFPA is proud to have worked with the Ministry of Health and other partners to provide free fistula surgery to women in The Gambia. But we know that there are more women with fistula who are not aware that help is available. This may be because of the sensitivity of the condition and the social stigma attached to it. If you, or anyone you know, is living with Obstetric Fistula, we urge you to call 1025 for information about free repair surgery.”
Reconstructive surgery can, in most cases, mend the injury. Two weeks or more of post-operative care are needed to ensure a successful outcome. Counselling and support are also important to address emotional damage and facilitate social reintegration. As with any surgery, fistula repair does carry some risk. Possible complications after a fistula surgery include infection, urinary problems, and breakdown of repair, most of which can be effectively managed. Only in rare cases do patients die.
UNFPA Gambia is part of the initiators of the Global Coalition on the eradication of Obstetric Fistula. Led by Belgium, this coalition is aimed at bringing together diverse stakeholders, foster collaboration, and coordinate efforts to prevent new cases of obstetric fistula, provide comprehensive treatment and care to affected women, and ultimately eliminate this devastating condition worldwide. This is in line with the Government of The Gambia’s commitment to end Obstetric Fistula by 2030.
