Editorial

Fight obstetric fistula with all steam!!

The call by the First Lady, Mrs Rebecca Akufo-Ad­do, for concerted efforts to tackle the problem of obstet­ric fistula in Ghana to improve the lives of mothers and repro­ductive health is a pregnant one.

It is pregnant because it concerns the treatment and prevention of the condition, as well as public education about it, including the need to avoid stigmatising patients.

Generally speaking, a fistula is an abnormal connection that joins either two body cavities like the anus and the female reproduction organ or one of them to the skin.

A fistula is said to occur when the tissue wall or a barrier between two body parts has broken down, usually due to trauma, injury, or infection.

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While the World Health Or­ganisation (WHO) says obstetric fistula is a hole in the birth canal caused by obstructed labour, the United Nations Population Fund (UNFPA) states that it is a hole between the birth canal and bladder and or the rectum caused by prolonged, obstructed labour without access to timely, high-quality medical treatment.

The UNFPA information says it leaves women and girls leaking urine, faeces or both, and often leads to chronic medical prob­lems, depression, social isolation and deepening poverty.

Other sources say it leads to urinary incontinence, pain, tenderness, or itching in the affected area, pus or foul-smell­ing discharge, fever and nausea or vomiting.

It is sad to learn that fistulas mostly occurs among women living in poverty, in cultures where a woman’s status and self-esteem may depend almost entirely on her marriage and ability to bear children.

Looking at the fact that the regions in which obstetric fistula mostly occurs include sub-Sa­haran Africa, where Ghana is located, and the devastation of the condition, the First Lady’s call must be given special impor­tance.

The role of women, partic­ularly mothers, in the family and the larger society should call for urgency for everything that affects them in disenabling manner, particularly bad health and poverty.

Even though the condition is said to not usually heal on its own, proper medical care, being surgery and wound care, help treat it.

This means the country must have the relevant medical fa­cilities and well-trained profes­sionals to manage the condition once it occurs.

The Government must take this point seriously because the WHO states that obstetric fistu­la still exists because health care systems (particularly in poor countries) fail to provide accessi­ble, quality maternal health care, including family planning, skilled care at birth, basic and com­prehensive emergency obstetric care, and affordable treatment.

Fortunately, the condition is preventable.

Holistic approach to prevent­ing it is being advocated and this includes engaging with tradition­al authorities to understand the causes emanating from some cultural practices like putting under-age girls in the family way.

Besides, all women should seek medical care regarding fistulas.

Then, the larger society must be educated about the condition.

We believe the country must have all the motivation to fight fistula.

After all, preventing and managing obstetric fistula will contribute to improved maternal health and the achievement of the Sustainable Development Goal 3.7 which seeks universal access to sexual and repro­ductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.

Also, that will enhance the country’s image in healthcare globally.

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