A congressional briefing yesterday examined the effects of obstetric fistula, a hole in the birth canal suffered by young women who lack emergency obstetric care during prolonged labor. Particularly in developing nations, women who endure obstetric fistula are often ostracized due to their incontinence, odor, infertility, and inability to perform the duties expected of them in their community. Approximately 130,000 new cases develop every year, Dr. Steve Arrowsmith, vice president for International Program Development at the Worldwide Fistula Fund, said during the briefing.
Obstetric fistula is a reflection of poverty and the lack of maternal health care and family planning in some of the poorest countries. Cases in the developed world are now virtually nonexistent because mothers are typically older and are attended by skilled medical professionals during the birthing process.
The condition can be surgically repaired. Access to the proper treatment facilities, however, is restricted, in part, by the “brain drain,” or the mass movement of skilled physicians to countries with higher pay and standards of living than their own. Efforts are currently underway not only to train, but also to retain, skilled surgeons in African countries. Additionally, facilities and healthcare providers in developing countries lack much-needed funding and resources. President Bush has withheld funding for the past five years from the United Nations Population Fund, a major player in the fight to eradicate fistula.
Speakers at the briefing included Arrowsmith; Dr. Lisa Thomas, director of EngenderHealth’s Safe Motherhood Program; Dr. Anders Seim, executive director of Health and Development International; and Dr. Arletty Pinel, head of the Reproductive Health Branch of the UNFPA. Maurice Middleberg, vice president for Public Policy at the Global Health Council, moderated the session.