Preventable obstetric fistula prevalent in Lesotho

LINEO MABEKEBEKE

MASERU – Obstetric fistula remains a significant health challenge, particularly in regions with limited access to timely medical care during childbirth. An obstetric fistula is a hole between the birth canal and bladder or rectum, caused by prolonged, obstructed labour without access to timely, high-quality medical treatment. In Lesotho, evidence shows that while facility delivery is high, estimated at 77 percent, the quality of care is suboptimal, exposing women to prolonged labour.

Globally, half a million women and girls in sub-Saharan Africa, Asia, the Arab States, Latin America, and the Caribbean are estimated to be living with fistula. Despite new cases developing every year, fistulas are almost entirely preventable. It leaves women and girls leaking urine, faeces, or both and often leads to chronic medical problems, depression, social isolation, and deepening poverty.

International Day to End Fistula is a day to raise awareness, intensify actions, strengthen partnerships, and mobilise support to finally end this preventable and treatable condition.The day is observed globally every year on May 23, and this year will be marked under the theme ‘Breaking the Cycle: Preventing Fistula Worldwide.’The theme underscores the critical importance of proactive measures to prevent obstetric fistulas and their far-reaching consequences.

It also calls for urgent action to address healthcare and societal gaps and inequalities that lead to prolonged obstructed labour, the direct cause of obstetric fistula. By focusing on prevention, the theme aims to draw the attention of governments, community stakeholders, development partners, policymakers, and decision-makers to break this harmful cycle and promote maternal health and well-being globally.

As the leader of the global Campaign to End Fistula, the United Nations Population Fund (UNFPA) provides strategic vision, technical guidance, support, medical supplies, training, capacity building, and funds for fistula prevention, treatment, social reintegration, and advocacy programmes. UNFPA also strengthens sexual and reproductive health care, including timely and quality emergency obstetric services, to prevent obstetric fistulas from occurring in the first place.

Evidence has shown that women and girls at risk of fistula are also at risk of maternal mortality, making advocacy and accelerated action towards ending fistula a matter of life and death. Globally, for every maternal death, 20 to 30 additional women experience childbirth injuries that significantly affect their quality of life and well-being. In Lesotho, the maternal mortality ratio is high, estimated at 566 per 100,000 live births.

Midwives are recognised as key allies in preventing obstetric fistulas, given their crucial role in providing maternal care. Investing in comprehensive maternal health services, including the training and deployment of skilled midwives, is essential for reducing the prevalence of fistulas and improving maternal health outcomes. UNFPA calls for strategic investments to ensure equitable access to quality maternal health services to prevent fistula cases and preventable deaths among women and girls.

“By prioritising prevention, timely intervention, and holistic support, Lesotho can safeguard the health and well-being of mothers and new-borns, ultimately eliminating childbirth-related injuries and illnesses. “Bold leadership, political will, and targeted investments are indispensable for realising the vision of eradicating obstetric fistulas and ensuring the rights and dignity of women and girls worldwide,” UNFPA concludes.