KARACHI: Experts representing the United Nations Population Fund (UNPF) announced on Monday at a press conference that the organisation could no longer provide support to the fistula project currently being run across the country on account of serious resource shortage.

They were speaking at a press conference organised at the Karachi Press Club to mark International Day to End Obstetric Fistula.

Sharing their concerns over lack of government efforts regarding prevention and treatment of fistula, the experts including representatives of Pakistan Medical Association and Pakistan National Forum on Women’s Health said the government needed to take responsibility of and compensate the women who developed obstetric fistula due to state’s failure in providing obstetric emergency services at its health facilities.

“The UNFP has been funding initiatives for fistula treatment since 2005, though the memorandum of understanding signed with the relevant [Pakistani] ministry was only for five years and under the agreement the government was supposed to take over the project. It’s time that the Pakistan government owned these efforts and made them part of its health programmes,” said country manager of UNFP fistula project in Pakistan Dr Sajjad Ahmed Siddiqui, adding that the organisation was facing serious resource constraints and further support was no longer possible.

“We want the government to take over the 13 centres we have established at public sector hospitals in the country,” he said.UNFP provincial representative Shrutidhar Tripathi said obstetric fistula was a neglected health crisis and very much a human rights issue.

He noted that developed countries didn’t report the incidence of fistula, as they had made obstetric emergency services available to all segments of their population while evidences from low-income countries also showed similar results, indicating that prevention of the health complication was possible if the government provided resources to tackle it.

“Obstetric fistula is the manifestation of our society struggling with issues like lack of education, violence against women and early marriages. It also highlights the great need for making quality midwifery services available to women,” Mr Tripathi observed.

He requested the federal and provincial governments to come up with a strong commitment to provide obstetric care to all women.

Explaining obstetric fistula, noted physician Dr Shershah Syed said it was a hole between the vagina and rectum or bladder that was caused by prolonged obstructed labour, leaving a woman incontinent of urine or faeces or both.

Around 5000 women fell victim to fistula every year in Pakistan.

He cited the case of an 11-year-old girl, resident of Mithi, Tharparkar, who suffered from obstetric fistula for 14 years before she was finally operated upon. “She had a stillbirth and was left by her husband soon afterwards. Doctors were shocked to see the burnt skin of her abdomen and thighs and when they asked her family members about it, they said she was under ‘treatment’ by a faith-healer as they suspected that she was a victim of some kind of evil spirits,” said Dr Shershah, adding that the girl had a simple 20-minute surgery involving little cost at the Mithi hospital and left for her village the very next day.

With the assistance of UNFP, training was being provided to doctors and centres had been set up in major cities of the country to provide free treatment for fistula, he said in reply to a question. “But it’s the state responsibility to provide quality healthcare and the government must do its job.”

Pakistan Medical Association representative Dr Mirza Ali Azhar and artist Sheema Kermani urged the media to highlight public health issues and create awareness on subjects directly affecting poor communities.

Published in Dawn, May 24th, 2016