* Women with obstetric fistula are abandoned by their husbands due to the embarrassing incontinence

Staff Report

KARACHI: In Pakistan an overwhelming number of women are facing obstetric complications during pregnancy and only one in twenty women with complications have access to emergency care.

The country has one of the highest maternal mortality rates across the globe as three women die every hour in Pakistan from causes related to pregnancy and childbirth.

This was stated by gynaecologists at a seminar on 'Prevention and Treatment of post-partum complications (Fistula) in Pakistan' organized jointly by the United Nations Population Fund (UNFPA) in collaboration with the Pakistan National Forum on Women's Health (PNFWH) at PMA House on Thursday.

Presentations were made by Prof Majeed Memon, Hamdard Medical University, Dr. Shershah Syed, Dow University of Health Sciences and Civil Hospital, Dr. Riffat Sultana Qatar Hospital, Dr. Nighar Shah of Murshid Hospital, Dr. Samrina Hashmi, Noor Hospital, Dr. Shaheen Zafar of Liaquat National Hospital and Dr. Aziz Abdullah of LNH.

Dr. Riffat Sultana of Qatar Hospital said that if women are not cared for during pregnancy and have complications at the time of delivery they can be left physically disabled for life.

One of the acute disabilities is fistula, termed by some international agencies as the most devastating of all childbirth injuries. An obstetric fistula develops when blood supply to the tissues of the vagina and the bladder (and/or rectum) is cut off during prolonged obstructed labor. The tissues die and a hole forms through which urine and/or feces pass uncontrollably. Women who develop fistulas are often abandoned by their husbands, rejected by their communities, and forced to live an isolated existence.

Such women are sometimes abandoned by their family members, especially spouses, are rejected by their communities and forced to live an isolated existence. While accurate data is scarce, according to the UN, an estimated 4,000 to 5000 new cases of fistula occur in Pakistan each year. The problem appears to be particularly acute in the country's remote regions.

Ninety-nine percent of fistula cases were reported from rural areas because women didn't have access to prompt healthcare. All fistula cases are avoidable and more than 90 percent are treatable if pregnant women are well taken care by their family members and provided immediate medical treatment after experiencing labour pains. According to Dr. Nighat Shah of Murshid Hospital some women with fistula are forced to take up begging or prostitution.

According to the Fistula Foundation, more than two million women live with fistula. Eradicated in western countries at the end of the 19th century when the cesarean section became widely available, obstetric fistula continues to plague women throughout the developing world. It is estimated that there are 100,000 new fistula cases each year, but the international capacity to treat fistula remains at only 6,500 per year. The United Nations Population Fund (UNFPA) estimates the world's population of fistula sufferers at more than two million.

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