‘Let’s End Fistula’

Asst. Min. Tolbert Nyenswah_web.jpg

The Officer-in-Charge of the United Nations Population Fund (UNFPA) office in Liberia, Dr. Philderald Pratt, has called on everyone to do all they can to end fistula in Liberia.

According to Dr. Pratt, who is also the Deputy Resident Representative of the UNFPA, stakeholders should also do all to address things that try to prolong obstetric fistula, including poverty, lack of access to health care and child marriage.

Dr. Pratt made the call Friday, May 23 at celebrations marking the second International Day to End Obstetric Fistula, held at the Fair Ground in Buchanan, Grand Bassa County.

Fistula is a medical condition caused by a hole in the birth canal and this is usually the result of prolonged, obstructed labor, according to UNFPA. This condition can be repaired or surgically fixed but can recur easily in women and girls, even though treated, but receive little or no medical follow-up and then become pregnant again.

This Day was celebrated under the theme, “Tracking Fistula – Transforming Lives,” and kicked off with a street parade by women groups, students and stakeholders, followed by an indoor program.

The UNFPA Deputy Resident Rep. disclosed that as part of global Campaign to End Fistula, with support from UNFPA, 47,000 women and girls around the world, including 1,300 of them from Liberia, have undergone fistula repair surgery, which was performed by Dr. John Mulbah and team of doctors of the Liberia Fistula Project.

As he spoke about the treatment, he also stressed the need to do all to shun stigma and discrimination against survivors.

Dr. Pratt emphasized that in most instances, stigma forces women living with the condition to go in hiding and isolate themselves from families and communities as they become undesirable.

UNFPA Executive Director’s Message

Reading the Day’s Message from UNFPA Executive Director Dr. Babatunde Osotimehin, who is his boss, Dr. Pratt said Obstetric fistula, which is prevalent in Liberia, highlights persistent global inequalities in access to health care and basic human rights. “Most women, who develop fistula, a hole in the birth canal usually caused by prolonged, obstructed labour, remain untreated for their entire lives, and the condition can easily recur in women and girls whose fistula has been surgically treated but who receive little or no medical follow-up and then become pregnant again.

“To treat fistula and provide women with follow-up medical care, we need to know more about how many women and girls are in need of services and also where they live. In most instances, stigma forces women living with the condition to remain hidden and isolates them from families and communities. By systematically registering and tracking each woman and girl who has or had an obstetric fistula, we can make enormous strides in improving their well-being and increasing the chances of their babies’ survival in subsequent pregnancies.”

Dr. Osotimehin, whose International Day to End Fistula Message was being read by Dr. Pratt, stated: “Eliminating the health crisis of obstetric fistula requires scaling up countries’ capacities to provide access to equitable, high-quality sexual and reproductive health services, including family planning and maternity care, especially comprehensive emergency obstetric care. Tracking and treating all fistula cases is crucial, but it is also necessary for countries to take steps to prevent fistulas by addressing underlying medical and socio-economic causes, eliminating gender-based social and economic inequities, preventing child marriage and early childbearing and promoting education, especially for girls.

“To address the neglected health and human rights violation of obstetric fistula, UNFPA, the United Nations Population Fund, together with partners around the world, launched the global Campaign to End Fistula a decade ago. Much progress has been made. With support from UNFPA, 47,000 women and girls have undergone fistula repair surgery. Partner organizations have provided treatment to many more women and girls living with fistula. However, much remains to be done, and far more support and momentum are needed to enable the Campaign to expand its reach to all corners of the world where women suffering from fistula remain isolated and often unaware that treatment is available or even possible.”

UNFPA Executive Director, who is also Undersecretary of the UN Secretary General, assured Liberians: “We have the resources and know-how. What we need now is the political will to elevate the status of women and girls, rectify inequalities and protect the human rights of every woman and girl, so that fistula may never again undermine a person’s health, well-being, dignity and ability to participate in and contribute to their communities.”

During the ceremony, two fistula survivals narrated their ordeal and how they got assisted through the Liberia Fistula Project and UNFPA to reintegrate in their respective communities.

UN Secretary-General Message

Also on the day, the UN Secretary-General Ban Ki Moon issued his Message in which he told the world that it is an appalling fact that in our world of modern medical advances, nearly 800 women still die from pregnancy-related complications each day, and for every woman who dies, almost 20 more are injured or disabled with severe or life-shattering, long-term conditions such as obstetric fistula.

“This International Day to End Obstetric Fistula is an opportunity to sound the alarm on this tragedy so that we may galvanize action to end it. Progress is possible. Over the past dozen years, some 47,000 women and girls have received surgical treatment supported by the United Nations Population Fund (UNFPA),” he stated.

According to SG Ban, registering and tracking each woman and girl with fistula can help ensure that more individuals receive treatment, survivors stay healthy and their future babies thrive. He said “The Every Woman Every Child initiative” can help advance progress by mobilizing partners to support all those who need help.

“Addressing obstetric fistula is more than a matter of health; it is a human rights imperative. This condition is one of the most devastating consequences of neglected childbirth and a stark reflection of inequality at its worst.”

The UN SG said fistula is fully preventable when all women and girls have access to high-quality, comprehensive sexual and reproductive health services, especially family planning, maternal health care and emergency obstetric care.

He urged all the partners to support the UNFPA-led global Campaign to End Fistula, describing it as “global social injustice.”

Liberia’s Ministry of Health

For his part, Health and Social Welfare Minister for Preventative Services, Mr. Tolbert Nyenswah, told the audience that the Government of Liberia has attached seriousness to the disease, adding: “It is recognized as a national public health issue.”

Asst. Min. Nyenswah disclosed that in March of this year, another fistula center, run and managed by the St. Joseph Catholic Church in Congo Town, surgically fixed the condition of the at least 50 women and girls, thereby increasing the total number of women and girls, whose conditions have been surgically repaired.

While assuring UNFPA and other stakeholders of the political will that the UNFPA Executive Director, Dr. Babatunde Osotimehin had asked for in his Message, Asst. Min. Nyenswah quoted a famous saying from President Ellen Johnson Sirleaf: “The nation thrives when mothers live; we must strive to keep them alive.”


According to Zonta, a group, which has supported the Liberia Fistula Project through the UNFPA, in addition to the physical consequences, fistula can also have social and psychological effects on patients. “Often there is stigma associated with this condition, and those women suffering from fistula are abandoned by their families and marginalized by their communities. Traumatic fistula, as a result of rape, adds to the psychological trauma, fear and stigma that follow rape, including the risk of unwanted pregnancy, vulnerability to sexually transmitted infections (STIs), including HIV, and decreased chances for women to get married, work or participate in the larger community.”

Zonta said the average cost of fistula surgery and post -operative care is approximately US$675, while the cost of social rehabilitation for a fistula survivor (provision of skills training and psychosocial support) is on average US$1,300.

 About Liberia Fistula Project

The Liberia Fistula Project was started in 2006. Then it was to access the state of fistula in Liberia and to use the study to address the situation.

At least more than a 1000 women and girls have been surgically repaired and of that number, 276 girls have gone through the rehabilitation program.




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