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Pregnancy-Related Disability Causes African Women Physical, Social Pain - 2003-12-07

A report by the U.N. Population Fund shows that obstetric fistula, a devastating pregnancy-related disability, is widespread in sub-Saharan Africa. The report finds women who suffer from it tend to keep their condition hidden for fear of being shunned by their communities.

A young woman visiting a hospital in Benin seeking help for her fistula says it is her last hope. She explained she can no longer live in her village. She said her family no longer loves her. If the operation does not work, she said, she would prefer to kill herself than go on living with her condition.

Fistula can occur when a young, poor woman is in obstructed labor for several days without medical help, and cannot get a Caesarian section. The baby usually dies and the mother is left with extensive tissue damage to her birth canal. She also loses control over her bladder and bowels.

France Donnay heads the Reproductive Health Branch of the U.N. Population Fund. She says these women become outcasts in their villages. She says the physical, psychological and social pain they suffer is unnecessary, as the fistula is a condition that can be prevented and treated surgically.

"Once cured, once the operation has been performed and is successful, they can go back to their villages," said Ms. Donnay. "Often they get married again to the same husband or to another one. Sometimes, it is important for them to get to another life, because it is better for them that the community would not know that they had a fistula. But, they can claim their dignity and their life again."

The United Nations estimates at least two million women around the globe live with fistula. Almost all are in sub-Saharan Africa and south Asia. Between 100,000-200,000 new cases occur every year.

A World Health Organization pregnancy expert, Luc de Bernis, says reconstructive surgery to treat fistula has a 90 percent success rate and costs $200-400. He notes that poor women seeking help face a number of obstacles.

"We have a lack of people trained to address fistula," said Dr. de Bernis. "In many countries, we have one or two percent who are able to deal with fistula. It is very difficult for a number of women who are poor, living in rural areas, non-educated, to reach the places where the fistula can be treated. In addition to that, the cost is an important issue."

The U.N. Population Fund has launched a worldwide campaign to end obstetric fistula. The campaign aims to raise awareness of the condition and expand services for prevention and treatment in Africa and Asia. The fund says it needs $20 million to support projects during the next three years.