On Wednesday 21st of May the SafeBirth4All coalition hosted a conference in Dublin to advocate for the elimination of Obstetric Fistula (OF) and raise awareness of the realities for the millions of women across the world who live with the condition.
Keynote speakers at the conference were Dr. Shane Duffy MD, Consultant Obstetrician & Gynaecologist, Chelsea and Westminster Hospital, London and visiting Fistula Surgeon in Uganda; and Eva Kyeni, Fistula Awareness Advocate, Researcher and fistula survivor.
What is Obstetric Fistula?
Obstetric Fistula is a debilitating childbirth injury resulting from a prolonged or obstructed labour without access to emergency medical intervention. The injury causes an abnormal opening (fistula) between a woman’s genital tract and her urinary tract and/or rectum, and which leads to permanent incontinence. Some 2 million women and girls are estimated to be living with OF, mostly in sub-Saharan Africa and Asia, with an estimated 50,000-100,000 new cases annually, yet worldwide the treatment capacity is approximately 15,000 cases a year.
OF is a preventable condition and in developed countries like Ireland with established social and healthcare systems, OF is mostly eradicated.
The medical impact of OF is devastating but there are also the pyscho-social effects on a woman resulting from the stigma of incontinence, isolation from family and community, and economic hardship due to lack of access to work and livelihood opportunities.
Some women report living with OF for over 50 years. While many OF injuries can be repaired through surgery, there are few trained fistula repair surgeons, and the cost is prohibitive for most women in developing countries.
SafeBirth4All Campaign
The SafeBirth4All campaign is spearheaded by a coalition of organisations that include the Association of Leaders of Missionaries and Religious of Ireland (AMRI), the Medical Missionaries of Mary, Geneva for Human Rights and Misean Cara, and was launched by Sabina Higgins, in Dublin in May 2024.
The SafeBirth4All campaign emphasises the devastating medical and psycho-social impact of OF and supports key initiatives to ensure its prevention.on holistic and rights-based interventions, including access to quality healthcare, education, and advocacy. Early initiatives have included raising global awareness of OF, strengthening partnerships with traditional birth attendants and healthcare workers, and engaging local and national leaders to integrate OF prevention and treatment into policies.
Fr Edward Flynn CSSp, a founding member of the SafeBirth4All coalition, outlines that “The Safebirth4All campaign has at its heart, human rights, prevention and a holistic approach to reintegration and rehabilitation of women,” and goes on to stress that key to eradicating OF is education, awareness and advocacy, and access to quality healthcare.
Keynote Speakers
Eva Kyeni, an OF survivor, advocate and PhD student, spoke at the conference of how when in the hospital after her own OF repair surgery, she met voiceless women and felt the ‘need to speak out and let people know that these women [with OF] are suffering’.
These women have been described as 21st Century lepers, young girls and women, who have been ostracised and expelled by family, friends and communities due to the stigma of child loss and the stench of the constant leaking of urine and/or faeces caused by their fistula.
Dr. Shane Duffy spoke of his voluntary work training surgeons in fistula repair in Kitovu Hospital, Uganda:
“There are 50,000 new cases of Obstetric Fistula each year but worldwide only 15,000 patients have surgery, tragically 90% of babies die during obstructed labour.” Dr. Duffy called for a paradigm shift in OF prevention and care: “Taking action means saying no to indifference, it is a choice”. He called on governments, international organisations, civil and religious society and concerned individuals to do more to address the root causes of obstetric fistula; inadequate healthcare systems, poverty, lack of awareness and stigma.
Dr. Duffy commended the SafeBirth4All coalition, saying, “The strength of the SafeBirth4All coalition is that it is bringing together people with different strengths to address this issue.“
OF is a preventable condition and in developed countries like Ireland with established social and healthcare systems, OF is mostly eradicated (in 1895 the last fistula hospital in the United States closed). The SafeBirth4All coalition puts its focus on holistic and rights-based interventions, including access to quality healthcare, education, and advocacy. Early initiatives have included raising global awareness of OF, strengthening partnerships with traditional birth attendants and healthcare workers, and engaging local and national leaders to integrate OF prevention and treatment into policies.
To learn more: www.safebirth4all.com.
Hear Dr. Shane Duffy speak with Spirit Radio FM about the SafeBirth4All campaign and efforts to address obstetric fistula through medical interventions and advocacy. Click here.
