By Ms. Ndéye Rose Sarr
Pregnancy and childbirth are meant to be beautiful experiences filled with incomparable excitement and immense joy, for women who choose motherhood. Unfortunately, this journey is a source of horror, pain, and abandonment for some 500,000 women globally who live with Obstetric Fistula. Obstetric Fistula is one of the most severe childbirth injuries often resulting from prolonged and obstructed labour, and lack of access to timely and quality emergency obstetric care services before and during delivery.
Despite the absence of nationally representative data on the prevalence of Fistula in The Gambia, a 2020 Situational Analysis showed an estimated prevalence rate of between 0.46 to 2.05 per 1000 women. Based on these figures, the current national burden is estimated to be between 335 to 1052. However, being a condition, which relegates women to social isolation, abandonment by their spouses and families, mental health and psychosocial conditions and poverty, we are positive that the available data does not portray the complete picture of Obstetric Fistula existence in our communities. To give us all some food for thought, I would like to borrow the words of the renowned Gambian Urological Surgeon Dr. Abubacarr Jah, “a woman living with Obstetric Fistula today, represents someone who narrowly escaped maternal death.”
So really, what can we do collectively to make the eradication of Obstetric Fistula a reality in The Gambia by 2030 and ensure that every woman who chooses pregnancy and motherhood, is assured a healthy and safe birth?
We must challenge men in our communities to be fully engaged in the health and wellbeing of their families. They must be involved in ensuring the sexual and reproductive health of their spouses and we must collectively champion efforts to end the social stigma and discrimination perpetrated against women living with Obstetric Fistula.
We need to coordinate national interventions and guide efforts leading to the complete eradication of Obstetric Fistula in accordance with the 2018 resolution adopted by the Ministers of Health from the ECOWAS region. There is a need to develop and commit to the implementation of a National Strategy to Eliminate Obstetric Fistula in The Gambia. This strategy will be the blueprint for sustainable interventions to accelerate the realization of zero fistula cases in the Gambia by 2030.
We must also strengthen The Gambia’s health system to first give access to quality antenatal care, family planning and deliver when necessary unlimited and uninterrupted Comprehensive Emergency Obstetric and Neonatal Care (CEmONC). This should be coupled with the availability of adequate maternal lifesaving drugs and equipment in health facilities across the country. There is also a need to build the human capacity of health care workers particularly by investing in the training of adequate midwives and improving on the quality of care everywhere.
Finally, given that Obstetric Fistula has been linked to harmful cultural practices such as Female Genital Mutilation and Child Marriage, it is time to ask ourselves, why do we hold on to cultural practices which have proven to negatively impact the health and wellbeing of women and girls and set us back in our development endeavours? We must create an environment where the health, dignity and bodily autonomy of women and girls are guaranteed and where we nurture positive cultural practices and abandon what is deemed harmful.
One woman living with Obstetric Fistula is one woman too many. We can make The Gambia one of the first countries within the West and Central African Region to eradicate Obstetric Fistula, if we center the experiences and needs of women and girls in our interventions. It is possible!
UNFPA stands ready to support The Gambia in this endeavour. We are aiming for a Gambia, where every pregnancy is wanted, every childbirth safe and every young person’s potential is fulfilled.
About the author:
Ms. Ndéye Rose Sarr is UNFPA Country Representative in The Gambia
