Responding to obstetric fistula amid COVID-19
“As a Senior Nursing Officer, I have worked with so many women and girls with obstetric fistula and I would not wish this condition on anyone.
It is a humiliating condition and those who suffer from it deserve our respect, empathy and help. My prayer is that everyone with obstetric fistula will be repaired and that we can clear the backlog of existing cases.”
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I also pray that people become aware of this condition and we all work hard to prevent it from happening in the first place, so that in the near future Ghana will no longer report cases of obstetric fistula. That is my desire, as we commemorate the International Day to End Obstetric Fistula, amid COVID-19.
These are the words of Ms Rose Mantey, a Senior Nursing Officer and a Nurse Midwife in charge of the Fistula Centre of Mercy Women’s Hospital in Mankessim in the Central Region.
A seasoned nurse, Ms Mantey is passionate about and dedicated to restoring the dignity of women and girls with obstetric fistula.
Devastating disease
Obstetric fistula is a devastating childbirth injury caused by prolonged, obstructed labour, which affects millions of people all over the world. This complication occurs most often among girls and women living in poverty and in regions of the world where there are inadequate medical services.
Globally, two to three million women in Sub-Saharan Africa and Asia develop obstetric fistula.
In Ghana, it is estimated that 1,350 new cases of obstetric fistula occur each year, amounting to an incidence rate of 1.8 per 1,000 deliveries.
International Fistula Day
The consequences of fistula go beyond the individual woman and affect spouses, relatives and the community at large.
To draw attention to this devastating condition, every year, May 23 is commemorated as the International Day to End Obstetric Fistula, to promote action towards the prevention and treatment of obstetric fistula.
The theme for this year is: “End gender inequality! End health inequities! End fistula now!”
Although a lot has been done over the past years to create awareness of fistula in Ghana, including media engagements and advocacy campaigns, there is still ignorance about this condition.
Against this backdrop, the United Nations Population Fund (UNFPA) is collaborating with the National Obstetric Fistula Taskforce Team, the Ghana Health Service and its partners in this year’s commemoration to sensitise the populace to the condition, taking into consideration the current COVID-19 pandemic.
According to the agency, it is essential to advocate and create awareness about the need to ensure the continuity of essential maternal health services and interventions, amid COVID-19, to prevent childbirth-related complications such as obstetric fistula.
Stigma and shame
In a statement, the Chairman of the National Obstetric Fistula Taskforce in Ghana, Prof. Anyetei T. Lassey, said the devastating condition had multiple impacts on its sufferers, including the indignity of constantly leaking urine or faeces or both through their birth canals.
“The associated stigma and shame are horrendous”, he stated.
Prof. Lassey indicated that as the world grappled with the coronavirus pandemic, the chances of focusing on it to the detriment of other essential health services, including sexual and reproductive health services, were real and high.
“Most pregnant women and girls are apprehensive about accessing maternal health services for fear of becoming infected with the coronavirus, increasing the probability of prolonged and/or undetected obstructed labour, which causes obstetric fistula. We need to encourage all pregnant women and girls to seek the services of a skilled birth attendant during this pandemic, Prof. Lassey stressed.
He observed that Ghana had made modest gains in preventing and managing fistula cases, adding that the country must enure the continuity of maternal health services in amid COVID-19 to reduce the incidence of obstetric fistula, “while the National Obstetric Fistula Task Team and the Ghana Health Service, continue to repair the backlog of unrepaired already existing fistula cases.”
Essential health services
In his statement, Dr Patrick Kuma-Aboagye noted that women and girls silently suffered indignity and shame simply because they had obstetric fistula.
“Their sufferings nudge us to continue to put measures in place to prevent others from developing this devastating childbirth-related complication, even as we tackle the coronavirus pandemic,” he said.
The Ghana Health Service, he stated, was committed to ensuring the continuity of essential health services, which included sexual and reproductive health services, for all amid the fight against COVID-19.
Dr Kuma-Aboagye indicated that healthcare providers had been provided with personal protective equipment to ensure that they were safeguarded as much as possible from the infection.
In turn, this would offer reassurances to patients as they access health services, along with their observation of the mandatory precautionary procedures of handwashing, using hand sanitisers, wearing face masks and observing physical distancing, he said.
He encouraged everyone to access maternal health services to ensure that complications such as obstetric fistula are prevented.