Razia Shamshad, Fistula Survivor with her daughter in Karachi, Pakistan.
Razia Shamshad delivered her baby after four days of excruciating labour without proper medical care. After suffering obstetric fistula, she recovered thanks to surgery. Now she wants to help other women who suffer from it. Photo: UNFPA Pakistan

Let's fight fistula, now more than ever

The fight to end obstetric fistula, one of the most serious and tragic injuries that can occur during childbirth, could be threatened by the current pandemic of COVID-19.

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 - countries in which health care systems, even before the coronavirus outbreak, failed to provide accessible, quality maternal health care.

Due to COVID-19, 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.

The pandemic is also expected to cause significant delays in programmes to end female genital mutilation (FGM) - something that could lead to a spike in FGM cases, according to UNFPA, which is a contributing factor for obstetric fistula.

As the virus advances in these countries, health services become overloaded, or provide a limited set of the services that women need. At the same time, many women and girls also skip important medical check-ups for fear of contracting the virus.

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.

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Our heroines' stories

There is still room for optimism. Obstetric fistula exists, but fortunately, it can be treatable. Watch, read and listen to the experiences of these brave women, who suffered in silence, but are now an example of hope.

Theme 2020: "End gender inequality! End health inequities! End Fistula now!"

This year's Observance speaks up a clear message: "End gender inequality! End health inequities! End Fistula now!". Women and girls at risk of living with fistula faced structural and systemic barriers to care before the pandemic. As health systems across the globe struggle to cope with the COVID-19 response, sexual and reproductive health services risk being sidelined. Denial or lack of access to sexual and reproductive health services is especially devastating for women and girls who are already dealing with economic, social, cultural and logistical barriers.

The pandemic is deepening pre-existing inequalities (including gender inequalities), exposing vulnerabilities in social and economic systems which are in turn amplifying the impacts of the pandemic.

As the battle against the COVID-19 pandemic rages on, efforts to end fistula should continue. Provision of universal quality maternal health care services, including an adequate numbers of competent midwives and fistula surgeons to attend the woman already affected, should be a priority. Fistula prevention, treatment and follow-up services should be given high attention during pandemics.

In response to the impact of COVID 19 on maternal health services (as health resources get diverted and maternity units shut down), UNFPA, the United Nations sexual and reproductive health agency, remains and will remain committed with its programs in protecting the maternal health workforce, providing safe and effective maternity care to women and their babies and maintaining and protecting the maternal health systems.



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 documents

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 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.