LAHORE: The world is observing “International Day to End Fistula” on Friday, while an estimated two million women are forced to live with fistula in developing countries due to lack of quality reproductive healthcare services.

Holding a press conference at the Lahore Press Club under the banner of Pakistan National Forum on Women’s Health (PNFWH) here on Friday, the senior obstetrics and gynecology professors said that thousands of other women simply suffering from the condition in silence are unaware that they can seek medical assistance.

The condition is not limited to women only as men in many cases may develop fistula, mostly in anal area.

Speaking on the occasion, the experts said the fistula, among women, is a devastating childbirth injury, which is not only treatable but preventable.

Prof Amna Yousaf, who works in the obstetrics and gynecology department of Sir Ganga Ram Hospital, Lahore, said the United Nations Population Fund (UNFPA) and Fistula Foundation this year are observing the international day based on a theme “Her Health, Her Right, Shaping a Future without Fistula”.

Explaining that fistula, she said it was usually fatal to unborn babies (90 percent of cases end in stillbirth) and causes added suffering and isolation to at least two million poor and marginalised women and girls in developing countries.

She lamented that around 5,000 women and girls are still forced to live with fistula in Pakistan, adding that ending it by 2030 requires a paradigm shift in the community’s thinking.

Dr Saeeda Bano, an associate professor at obstetrics and gynecology department ofSahiwal Medical College, Sahiwal, stressed that promoting universal access to quality healthcare was essential for the prevention of maternal mortality and morbidity.

She said fistula could be prevented when women get timely maternity care, including skilled birth attendance, midwifery care and emergency obstetric care (as needed), with accessibility to family planning services.

Stressing that change starts with the community, she said, community empowerment and participation were key to successfully addressing the determinants of maternal mortality and morbidity and ensure the utilization of fistula prevention and treatment services by women, girls, their families, and communities.

Dr Bushra Haq, an assistant professor at obstetrics and gynaecology department at Services Hospital, said ensuring access to safe holistic fistula treatment (surgical repair and social reintegration) for all women and girls in need is a key strategy for eliminating it.

She said a sustainable scale-up of quality treatment and healthcare services, including the availability of adequate numbers of trained, competent fistula surgeons and midwives, is needed to significantly reduce maternal and newborn mortality and to eradicate obstetric fistula.

The experts said this year’s International Fistula Day called for investments to improve the quality of care for maternal health, fistula prevention, and treatment.

They stressed that the communities should play a key role in addressing social, cultural, political, and economic determinants that impact maternal, sexual and reproductive health, and reproductive rights, besides contributing to the occurrence of obstetric fistula.

They urged the communities to use the momentum of the sustainable development goals (SDGs) together with strong political leadership, accelerated investment and action, to achieve this goal.

The experts said the UN’s target to end maternal deaths by 2030 was also possible in Pakistan, if the government shows its commitment through its policies in line with SDGs targets 2030. This could be achieved through improving emergency service delivery, especially at the primary Health care level, with provision of a strong referral mechanism to avoid complications, they added.

Published in Dawn, May 24th, 2025