A woman with a mask
Beatriz Sebastião, 28, a fistula patient at the District hospital of Mocuba, Zambezia province, Mozambique, November 18, 2020.
Photo: UNFPA Mozambique.

Women's rights are human rights! End fistula now!

Obstetric fistula is one of the most serious and tragic childbirth injuries. A hole between the birth canal and bladder and/or rectum, it is caused by prolonged, obstructed labour without access to timely, high-quality medical treatment. It leaves women with incontinence problems, and often leads to chronic medical problems, depression, social isolation and deepening poverty.

This problem is preventable with the correct medical assistance and its occurrence is a violation of human rights and a reminder of gross inequities.

The theme for this year is “Women's rights are human rights! End fistula now!” We must put an end to the obstetric fistula as a critical step towards achieving the Sustainable Development Goals (SDGs) and realizing the promise of the Beijing Declaration and Platform for Action as well as the Programme of Action of the International Conference on Population and Development. Both plans are oriented to fight for women’s rights, including the sexual and reproductive health.

In order to reach this goal, the UN Population Fund has launched an updated manual that serves as a crucial resource and a guiding light on the path to achieving health, gender equality and human rights for all.

Cover of the UNFPA publication title: Obstetric Fistula & other forms of female genital fistula

Obstetric fistula & other forms of female genital fistula: Guiding principles for clinical management and programme development.

The so-called “orange manual” has long been the only authoritative, gold-standard guide to the holistic, comprehensive and “bigger picture” aspects of eliminating obstetric fistula (including programming, policy, prevention, treatment, social reintegration and more). The original (2006) version of the manual has now been updated with the latest evidence, strategies, tools and resources.

Ending obstetric fistula by 2030

2020 marked the count-down towards the goal of ending the problem of obstetric fistula by 2030, according to the last report of the Secretary General.  

Obstetric fistula is preventable; it can largely be avoided by delaying the age of first pregnancy; the cessation of harmful traditional practices; and timely access to obstetric care.

Unfortunately, the current pandemic affects all these preventive measures in developing countries where obstetric fistula still exists. More women and girls will be at risk of obstetric fistula due to overburdened health systems. In addition, fistula repairs have widely been suspended as they are deemed to be non-urgent and hospitals have diverted resources to care for patients with COVID-19.

Besides, it is expected that 13 million more child marriages could take place by 2030 than would have otherwise. Families are more likely to marry off daughters to alleviate the perceived burden of caring for them, especially in the anticipated economic fallout of the pandemic.

Due to all these reasons an increase in cases might occur and new strategies will be required in the post-COVID-19 recovery period to address the expected backlog of cases.

With this possible future scenario of preventive measures in danger, now more than ever, it is important to call on the international community to use the International Day to End Obstetric Fistula to significantly raise awareness and intensify actions towards ending obstetric fistula, as well as urging post-surgery follow-up and tracking of fistula patients.

Did you know?

  • Hundreds of thousands of women and girls in sub-Saharan Africa, Asia, the Arab region, and Latin America and the Caribbean are living with this injury.
  • Women who experience this preventable condition suffer constant urinary incontinence, which often leads to social isolation, skin infections, kidney disorders and even death if left untreated.
  • A surgery can repair the injury with success rates as high as 90% for less complex cases.
  • The average cost of this treatment, which includes surgery, post-operative, care and rehabilitation support, is $600 per patient.

Related links

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The UN Population Fund and its partners launched the global Campaign to End Fistula, which is now active in more than 55 countries, working to prevent and treat fistula, and to rehabilitate and empower fistula survivors. So far UNFPA has supported more than 113,000 surgical repairs for women and girls since 2013, and partner agencies have supported thousands more. 

Midwife checking a pregnant woman

Are pregnant women at increased risk? Is the epidemic affecting women disproportionately? Are rates of domestic violence rising? Learn more about the COVID-19 pandemic and how it affects women, pregnancy, family planning care and medical care. 

A crowd of women sitting and laughing

International days and weeks are occasions to educate the public on issues of concern, to mobilize political will and resources to address global problems, and to celebrate and reinforce achievements of humanity. The existence of international days predates the establishment of the United Nations, but the UN has embraced them as a powerful advocacy tool. We also mark other UN observances.