Obstetrisk fistula – et studie i ulighed

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En kvinde restituerer efter en fistula-operation på Hamlin Fistula Hospital i Addis Ababa, Ethiopia.
Foto: Australiens udenrigs- og handelsministerium
Laurits Holdt

NEW YORK, 22 May 2015 (UN NEWS): Obstetric fistula is a devastating yet completely preventable and, in many cases, treatable injury of childbirth, affecting at least two million women and girls worldwide and leaving them isolated from communities, the United Nations spotlighted ahead of the International Day to End Obstetric Fistula.

“The fact that fistula persists primarily among the poorest and most marginalized women and girls in the world is an egregious outcome of social, economic and gender inequalities, the denial of human rights and inadequate access to quality reproductive health services, including maternal and newborn care,” Secretary-General Ban Ki-moon said in his message on the Day, marked annually on 23 May.

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“We have a moral obligation, as a global community, to complete the unfinished agenda of eradicating fistula,” he added.

Alvorlig fødselsskade

Obstetric fistula is one of the most serious and tragic injuries that can occur during childbirth. It is a hole between the birth canal and the bladder or rectum caused by prolonged, obstructed labour without treatment.

Sufferers often endure depression, social isolation and deepening poverty. Many women live with the condition for years – or even decades – because they cannot afford to obtain treatment. And up to 100,000 new obstetric fistula cases occur every year.

International Day to End Obstetric Fistula, marked worldwide on 23 May and with this year’s theme, ‘End fistula, restore women’s dignity’ serves as an opportunity for world leaders to commit to ending the scourge of fistula in our lifetime.

Every fistula-affected nation needs to develop an inclusive and time-bound national strategy, Mr. Ban said, calling on the international community to significantly intensify support to nations with the greatest need.

50.000 – 100.000 nye tilfælde hvert år

An estimated 2 million women in sub-Saharan Africa, Asia, the Arab region, and Latin America and the Caribbean are living with this injury, and some 50,000 to 100,000 new cases develop each year. Yet fistula is almost entirely preventable. Its persistence is a sign that health systems are failing to meet women’s essential needs.

Eradicating the scourge needs to be part of a far-reaching and inclusive sustainable development agenda to improve sexual and reproductive and newborn health, strengthen health systems, eliminate health inequities and increase levels and predictability of funding.

The United Nations Population Fund (UNFPA) and its partners launched the global Campaign to End Fistula in 2003. In the 12 years since the effort began, UNFPA has supported over 57,000 fistula repair surgeries for women and girls in need, and Campaign partners have enabled many more to receive treatment.

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Går ud over de svageste og mest udsatte

Speaking on the ahead of the Day, UNFPA Executive Director Dr. Babatunde Osotimehin said that while significant gains have been made, many people, especially the poor and vulnerable, still lack access to quality sexual and reproductive health services, including life-saving emergency obstetric care.

“Women and girls living with fistula are among the most marginalized and neglected, and the persistence of fistula is a grave illustration of serious inequalities and the denial of rights and dignity,” he said.

As the world shapes a new development agenda, a new opportunity has presented itself to put the rights and dignity of women and girls – including the invisible, disenfranchised, and voiceless – at the heart of a people-centred and rights-based agenda, he said.

Dr. Osotimehin said that with the right combination of political will and leadership, financial commitment and scaling up of evidence-based, cost-effective, quality interventions, ending forced marriage and ensuring girls education as well as voluntary family planning, it is possible to end the needless suffering of millions of women and girls.

“Let us decide, as a global community, that the world we want is one where fistula no longer exists,” he said, adding:

“Let us, once and for all, put an end to this assault on women’s and girls’ health and human rights, which steals from them their very dignity and destroys the most fundamental of human qualities: hope.”