Obstetric Fibrosis Affects 500,000 Women, Yet Curable

Obstetric fistula is a completely treatable health condition. Yet it affects over 500,000 women worldwide.

Five days – that is how long it took Dah, a 14-year-old prospective mother from Côte d’Ivoire, to give birth. The child was stillborn, and she developed obstetric fistula.

Sixteen years – that is how long Dah had to live with the agonising condition, undergoing eight different surgical procedures before finally getting the fistula repaired.

In recognition of the over 500,000 women like Dah who are forced to endure what is a highly treatable condition, the International Day to End Obstetric Fistula is being observed on Friday.

Obstetric fistula is a medical condition that refers to the development of a small hole between the birth canal and the bladder or rectum, leading to leakage of urine or faeces.

This year’s theme, “Her Health, Her Right: Shaping a Future without Fistula,” seeks to promote progress toward the goal of eliminating fistula by 2030.

“Women’s bodies become battlegrounds — not only through sexual violence but through the deliberate denial of reproductive rights and health services,” said Sima Bahous, Executive Director of UN Women.

A Silent Crisis

Obstetric fistula is often brought on by prolonged or difficult childbirth. Most of the half a million women suffering from the condition live in the Global South.

Many women with fistula experience social isolation and exclusion due to leaking urine or faeces. This, in turn, can lead to depression and deepening poverty.

Kambiré, a small business owner who lives in Bouna, lived with obstetric fistula for 23 years. She even had another child before receiving medical assistance.

“I preferred to isolate myself because of the fistula,” she said. “I couldn't sit for long for fear of getting wet.”

She only learned that it was treatable after listening to a radio show, which inspired her to seek treatment at a hospital supported by the UN sexual and reproductive health agency (UNFPA). Now, she owns a small pot-making business.

Entirely Preventable and Treatable

UNFPA has set the goal of eliminating obstetric fistula by 2030 — a goal that appears achievable, given that the condition is both completely preventable and fully treatable.

Between 2003 and 2024, UNFPA supported nearly 150,000 surgical fistula repairs, including 4,400 in Côte d’Ivoire for women like Dah and Kambiré.

Catherine, a mother of two in Bouna, also received medical assistance from a UNFPA-supported hospital.

“Now that I’m healthy, I’m happy. I can run my business and spend time with my friends,” she said.

Nevertheless, obstetric fistula remains stubbornly persistent across the world due to disparities in global health systems.

UNFPA notes that midwives are key to preventing fistula and other childbirth injuries. However, there is a global shortage of over 900,000 midwives — 500,000 of whom are needed in Sub-Saharan Africa alone.

Reproductive health education and empowerment are similarly essential to addressing and preventing obstetric fistula.

“The most effective shield we can offer women and girls is their own power, voice, and leadership,” said Ms Bahous.

Networks of Solidarity

After receiving successful treatment, Dah — like Kambiré — started a seasonal food business through which she prepares and sells produce.

She has also joined with other fistula survivors in Bouna to raise community awareness and reduce stigma.

“When women lead, they protect not only themselves but their families and communities… The impact is transformative,” said Ms Bahous.