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Resources by Geographic Keywords

This list of resources is organized by geographic areas and individual countries. Click on a specific keyword to go to a list of items with that keyword. (This list is also available organized by programmatic keywords.)

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Individual Countries

Asia

  • Fact Sheet. Bangladesh: Phase III
    UNFPA. Fact Sheet. Bangladesh: Phase III. Last updated August 2005
    Download PDF
    Keywords: Overview, Asia, Assessment
     
  • Obstetric Fistula and Stigma
    Bangser, M. (2006). Obstetric Fistula and Stigma. The Lancet, 367(9509), 535-536
    Fistula is highly stigmatizing for those who live with it. Women who have a fistula are often divorced or abandoned. Yet many continue to show great resilience and strength. Due to the stigma associated with fistula, the WHO estimate of 2 million cases of fistula among girls and women is quite possibly a serious underestimate. Data collection has the possibility of further stigmatizing or marginalizing women with fistulae. Different kinds of engagement are necessary to prevent and manage stigmatizing conditions. Action-oriented research is needed so that there is a greater understanding of the conditions associated with living with fistulae. Broad partnerships of people and institutions committed to equity are also needed. Finally, underlying policies that create and perpetuate stigmatizing conditions and poverty must be challenged.
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    Keywords: Programs, Obstetric Fistula, Eastern and Southern Africa, Asia
     
  • Urinary fistulae in gynecological practice in North West Frontier Province.
    Ahmad, S. (Unpublished). (1988). Urinary fistulae in gynecological practice in North West Frontier Province. Paper presented in Lahore, 14p
    Link to Source
    Keywords: Clinical Information, Asia, Pakistan
     
  • Fistulae in obstetric practice
    Bhasker Rao, K. (Unpublished). (1988). Fistulae in obstetric practice. Madres, 13
    Link to Source
    Keywords: Programs, India, Asia
     
  • Genital fistulae
    Bhasker Rao., K. (1975). Genital fistulae. Journal of Obstetrics and Gynaecology of India, 25, 58-65
    Link to Source
    Keywords: Overview, India, Asia
     
  • Vesicovaginal fistula – a study of 269 cases
    Bhasker Rao, K. (1972). Vesicovaginal fistula – a study of 269 cases. Journal of Obstetrics and Gynaecology of India, 22(5), 536-541.
    Link to Source
    Keywords: Statistics, Asia, India
     
  • Self-reported symptoms of gynecological morbidity and their treatment in south India
    Bhatia, J.C., & Cleland, J. (1995). Self-reported symptoms of gynecological morbidity and their treatment in south India. Studies in Family Planning, 26(4), 203-216
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    Keywords: Maternal Health, Asia, Obstetric Fistula, India
     
  • Vesico-vaginal fistula--more than obstetric problem
    Bhutta, S.Z. (1996). Vesico-vaginal fistula--more than obstetric problem. Journal of Pakistan Medical Association, 46(6), 135-136
    Link to Source
    Keywords: Overview, Obstetric Fistula, Asia, Pakistan
     
  • Genital Fistula- Our experience
    Biswas, A., et al. (2007). Genital Fistula- Our experience. Journal of the Indian Medical Association, 105(3), 123-126
    Link to Source
    Keywords: Statistics, Asia, India
     
  • Poverty, poor health services condemn women to disability
    Ebrahim, Z. (2004, February 10). Poverty, poor health services condemn women to disability. Inter Press Service News Agency. Retrieved March 2, 2005 from http://www.ipsnews.net/.
    Experts say that obstetric fistula, a devastating disability resulting from obstructed labour, affects tens of thousands of women per year in Pakistan and the rest of South Asia. Jannat, a 23-year old woman who suffered an obstetric fistula, constantly leaks urine and feces through her vagina. She does not want to live anymore. Despite her mother’s constant care, Jannat still reeks of excrement. Another fistula sufferer, Farida, laments that she had to take her 11 year old out of school when during labour she lost one of two twins, and suffered a fistula. She was unable to take care of her baby and keep herself clean without the help of her older child. Women like Jannat and Farida also suffer social isolation due to their unpleasant condition. Dr. Shershah Syed, who heads the gynecology department at Karachi’s Qatar General Hospital, received training at the Addis Ababa Fistula Hospital and now runs an annual fistula camp in Sindh province’s rural interior, to perform fistula repair surgeries free of charge. Dr. Syed says that fistula does not receive enough attention in Pakistan because it is a problem that afflicts mainly the poor.
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    Keywords: News, Obstetric Fistula, Asia, Pakistan
     
  • Epidemic of Cesarean Section at the General, Private and University Hospitals in Thailand
    Chanrachakul, B., Herabutya, Y., Udomsubpayakul, U. (October, 2000). Epidemic of Cesarean Section at the General, Private and University Hospitals in Thailand. Journal of Obstetrics and Gynaecology Research, 26(5), 357-361
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    Keywords: Maternal Health, Asia, Prevention, Thailand
     
  • Maternal mortality and morbidity in the developing countries like India
    Coyaji, B.J. (1991). Maternal mortality and morbidity in the developing countries like India. Indian Journal of Maternal and Child Health, 2(1), 3-9
    Link to Source
    Keywords: Statistics, Asia, Obstetric Fistula, India
     
  • Eliminating obstetric fistula: progress in partnerships
    Donnay, F., & Ramsey, K. (2006). Eliminating obstetric fistula: progress in partnerships. International Journal of Gynaecology and Obstetrics, 94(3), 254-261.
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    Keywords: Programs, Prevention, Obstetric Fistula, Asia, Pakistan
     
  • Profile and repair success of vesico-vaginal fistula in Lahore
    Hafeez, M., Asif, S., Hanif, H. (2005). Profile and repair success of vesico-vaginal fistula in Lahore. Journal of the College of Physicians and Surgeons Pakistan, 15(3), 142-144.
    The purpose of the study was to describe the patient profiles with vesico-vaginal fistula and the success rate of the surgical repairs from two hospitals in Lahore, Pakistan, the Sir Ganga Ram Hospital and the Ghurki Trust Hospital, and covered the period of 1998-2002. Out of a total of 2570 women admitted to the gynaecological wards at both hospitals, 14 of those patients had VVF. The mean age was 34.8, the median parity 4. The mean age and median parity was significantly higher compared to patients from African countries. 71.4% of the cases were due to obstetric causes (28% due to obstructed labor). There was an 85.7% successful closure rate, though 37% had residual urinary incontinence.
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    Keywords: Statistics, Asia, Pakistan
     
  • Surgical Management of Genitourinary Fistula
    Hanif, M., Saeed, K., Sheikh, M. (2005). Surgical Management of Genitourinary Fistula. Journal of the Pakistan Medical Association, 55(7), 280-284.
    Twenty-two patients were operated on, 14 with a VVF, and 8 with an ureterovaginal fistula (UVF). The mean age of the patients was 35 (range 21-50). 71.4% of the VVF cases were due to obstetric causes, while 37.5% of the UVF cases were due to obstetric causes. The range of time since development of fistula was 7 months to 26 years. 78.6% of the VVF cases were repaired in the first attempt. In the rest of the VVF cases, a urinary diversion was planned.
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    Keywords: Asia, clinical information, Pakistan
     
  • Fistula: agonies and aftermath
    Haq, N. (2004, December 26). Fistula: agonies and aftermath. The Daily Star. Retrieved March 20, 2006, from http://www.thedailystar.net/2004/12/26/d412266101110.htm.
    Kazol Rekha, a young girl of 15 years, suffered injuries during childbirth over a year ago, and since then has returned to her parent’s home, at the insistence of her husband and in-laws. The tear between Rekha’s vagina and bladder, termed an obstetric fistula, resulted in the constant leakage of urine, and in her case, nerve damage to her legs as well. In most cases of obstetric fistula, the mother loses her baby and faces a number of devastating physical and social consequences. Although fistula is both preventable and treatable, a large number of Bangladeshi women and girls (estimated at 71,000) suffer from this condition, as a result of a number of factors including poverty, early marriage, and poor maternal health services. In rural Bangladesh, early marriage between the ages of 12 and 15 is common, as are adolescent pregnancies. These factors, the lack of antenatal care, and the fact that 92% of deliveries occur at home, all contribute to the incidence of fistula in Bangladesh. UNFPA undertook the first analysis of fistula in Bangladesh in 2003, and is helping to set up a National Fistula Centre at Dhaka Medical College Hospital (DMCH). Dr. Syeba at DMCH commented that in addition to fistula repair, awareness raising and increased access to emergency obstetric care are also crucial. She also noted that the women who suffer from fistula show extraordinary courage, and although all cannot be cured, repair surgery is highly successful and can help to restore the dignity of many women. While 123 successful surgeries have been completed so far, many more women, including Kazol Rekha, are waiting for their chance for a new life.
    Download PDF
    Keywords: News, Bangladesh, Asia, Obstetric Fistula
     
  • Consequences of Birth Policies and Practices in Post-Reform China
    Harris, A., Gao, Y., Barclay, L., Belton, S., Yue. Z. W., Min, H., Auqun, X., Hua, L., Yun, Z. (Nov, 2007). Consequences of Birth Policies and Practices in Post-Reform China. Reproductive Health Matters, 114-124.
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    Keywords: Maternal Health, Asia, Obstetric Fistula, China
     
  • Vesico-vaginal fistula: a review. Bangladesh
    Hussain, M.A. (1986). Vesico-vaginal fistula: a review. Bangladesh. Journal of Obstetrics and Gynaecology, 1(1), 21-32
    Link to Source
    Keywords: Clinical Information, Asia, Bangladesh
     
  • Obstetric fistulas in rural Pakistan
    Jokhio, A.H., and Kelly, J. (2006). Obstetric fistulas in rural Pakistan. International Journal of Gynaecology and Obsterics, 95(3), 288-289.
    Download PDF
    Keywords: Overview, Obstetric Fistula, Asia, Pakistan
     
  • Urinary fistulae in Government Rajaji Hospital, Madurai
    Logambal, A. and Poongodi, R. (Unpublished). (1989). Urinary fistulae in Government Rajaji Hospital, Madurai
    Link to Source
    Keywords: Statistics, Asia, India
     
  • Uterine rupture: preventable obstetric tragedies?
    Mishra, S.A., Morris, N., Uprety, D.K. (2006). Uterine rupture: preventable obstetric tragedies? Australian and New Zealand Journal of Obstetrics and Gynaecology, 46(6), 541-545
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    Keywords: Clinical Information, Obstetric Fistula, Asia, Nepal
     
  • Management of vesicovaginal fistulae in urological context
    Mubeen, R.M., Naheed, F., Anwar, K. (2007). Management of vesicovaginal fistulae in urological context. Journal of the College of Physicians and Surgeons-Pakistan, 17(1), 28-31.
    Link to Source
    Keywords: Clinical Information, Asia, Pakistan
     
  • Surgical Repair of genital fistulae
    Naru, T., Rizvi, J.H., & Talati, J. (2004). Surgical Repair of genital fistulae. Journal of Obstetrics and Gynaecology Research, 30(4), 293-296
    The authors detail their experience on managing genital fistule at the Aga khan University Hospital in Karachi Pakistan. Between January 1988 and December 2002, there were a total of 87 with genital fistulae. Sixty-eight cases were urogenital and 19 were rectovaginal fistulae. Three women had concomitant urogenital and rectovaginal fistulae. 54 of the patients were repaired successfully on the first attempt while three patients were cured at second repair. A success rate of 83.8% was achieved. All of the 19 rectovaginal fistulae (100%) closed after single repair.
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    Keywords: Statistics, Obstetric Fistula, Asia, Pakistan
     
  • Genitourinary fistulas of obstetric origin
    Rafique. M. (2002). Genitourinary fistulas of obstetric origin. International Urology and Nephrology, 34, 489493
    The objective of the study was to review 42 cases of genitourinary fistulas of obstetric origin from the Dept. of Urology at the Nishtar Hospital in Multan, Pakistan. From December 1999 to the 31st of May 2002, there were 36 VVFs, 2 vesicouterine fistulas, 1 ureterovaginal fistula and 3 urethrovaginal fistulas. 38% were due to obstructed labor. The author notes that while another 38% developed a fistula after a C-Section was performed for obstructed labor, and it was likely the labor and not the surgery that caused the fistula. All repairs were done at least 3 months after the formation of the fistula. Overall success rates were 85.7%. Median time from formation of injury was 5 months, with a range of 6 weeks to 20 years. Average size of fistula was 2.5 cm, with a range of .5-4 cm. 24% were nulliparous.
    Link to Source
    Keywords: Statistics, Obstetric Fistula, Asia, Pakistan
     
  • Vesical fistulae – an experience from a developing country
    Raut, V & Bhattacharya, M. (1993). Vesical fistulae – an experience from a developing country. Journal of Postgraduate Medicine, 39, 20-21
    This study looked at the records 62 cases of vesicovaginal fistula from 1981-1990 at a teaching and refferal hospital in Bombay. 57 of the cases were due to obstructed labor, and of those 57 patients, 44 of had delivered from home. 57 of the patients underwent surgery to repair their fistulae. Repair was succesful in 53 of the cases (87%). The other 4 that were failures were also repeat repairs. One patient died during the repair due to haemorrhage
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    Keywords: Statistics, Obstetric Fistula, Asia, India
     
  • Sexual trauma-an unusual cause of a vesicovaginal fistula
    Roy, K. et al. (2002). Sexual trauma-an unusual cause of a vesicovaginal fistula. European Journal of Obstetrics and Gynaecology and Reproductive Biology, 101, 89-90.
    A 20-year old nullipara developed a two vesicovaginal fistulas after her first sexual intercourse. She had two unsuccessful attempts at repair; the third was successful. She did not develop amenorrhea and she had abstained from sexual intercourse.
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    Keywords: Statistics, Asia, Traumatic Fistula
     
  • Enquiry on the epidemiology and surgical repair of obstetric related fistula in South-East Asia.
    Shah, K.P. (Unpublished). (1989). Enquiry on the epidemiology and surgical repair of obstetric related fistula in South-East Asia. Paper prepared for a Technical Working Group. Geneva: WHO, 11 p
    Link to Source
    Keywords: Clinical Information, Asia, Obstetric Fistula
     
  • National Fistula Centre set up at DMCH
    Star Health Desk. (2003, October 5). National Fistula Centre set up at DMCH. The Daily Star Retrieved March 2, 2005 from http://www.thedailystar.net/2003/10/05/d31005610191.htm.
    annually. The Government of Bangladesh, with 1,800,000 lakhs assistance from UNFPA, is going to set up a National Fistula Centre at Dhaka Medical College Hospital. The Centre will have an operation theatre, an adjacent ward (20 beds), and separate rehabilitation centre (80 person capacity). A Client Data Recording System (CDRS) will also be in place, Government officials and professionals attended an orientation workshop where they received information on the objectives, activities and guidelines of the National Obstetric Fistula Health Programme. Young age at marriage and high prevalence of childbirth at home (in the absence of skilled attendance) contribute to a high rate of maternal morbidity and mortality in Bangladesh. Obstetric fistula is a severe chronic injury that can occur during prolonged obstructed labour, in the absence of access to a cesarean section. Women with obstetric fistula leak urine and/or feces constantly, but surgical repair is possible. The fistula centre in Bangladesh is envisioned as an eventual ‘centre of excellence’ where services as well as training will be available. Given the higher social status of men in Bangladesh, UNFPA representative Suneeta Mukherjee feels that male involvement in the fistula programme is key.
    Download PDF
    Keywords: News, Obstetric Fistula, Asia, Bangladesh
     
  • Analysis of genito urinary fistulae
    Swarajylaxmi, K. (1986). Analysis of genito urinary fistulae. Journal of Obstetrics and Gynaecology of India, 36, 1042-1043
    Link to Source
    Keywords: Statistics, Asia, India
     
  • The obstetric fistula awareness and treatment program: bringing much needed relief to the women of Bangladesh
    The obstetric fistula awareness and treatment program: bringing much needed relief to the women of Bangladesh. (2004) O&G, 6(2), 139-140.
    In Bangladesh, 92 percent of women deliver at home. The 2002 estimated maternal mortality ratio was 320 per 100,000 live births – a value which is considerably higher among young women. The average age for marriage is 15. Though prevalence data for fistula is limited, an increasing awareness of this condition has developed in Bangladesh. Poverty and lack of supervised delivery and emergency obstetric care, as well as socioeconomic and cultural reasons such as lack of education, pregnancy at an early age and poor nutrition, all contribute to the incidence of obstetric fistula. UNFPA has partnered with Dhaka Medial College Hospital (DMCH) to develop programs to create awareness of fistula and develop skills to aid prevention and treatment of fistula. This has involved orientation and ‘operating room’ training workshops, the latter provided by fistula surgeons from Ethiopia, as well as Dr. Judith Goh and Dr. Hannah Krause, from Australia. Dr. Goh stresses that in addition to the usual physical leakage and social stigmatization experienced by fistula sufferers, other complications of obstructed labor occur, even after fistula repair surgery. As many of these are not addressed, women continue to suffer from pelvic floor dysfunction, sexual and reproductive dysfunction and psychological illness. On a second visit to DMCH, Dr. Goh and Dr. Krause were joined by their colleague Kate Sloane, a continence nurse advisor. These ‘skills transfer’ sessions included pelvic floor education and urodynamic assessments for women with ongoing incontinence. Dr. Krause also emphasized the importance of the many issues such as infertility, footdrop, psychological illness, chronic pain, dyspareunia, and post-fistula closure incontinence that must be addressed before a woman is able to reintegrate in society. She added that research is necessary to determine effective treatments for the problems of these women, and strategies to prevent fistula also need to be developed within communities in Bangladesh.
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    Keywords: Asia, Programs
     
  • Obstetric fistula is common in South Asia, UNFPA says
    UN News Service. (2003). Obstetric fistula is common in South Asia, UNFPA says. Retrieved March 2, 2005 from http://www.un.org/News/
    Obstetric fistula, a hole which results in leakage of urine or feces, is often a consequence of prolonged, obstructed labour. This condition affects hundreds of thousands of girls and women in South Asia, said the UNFPA. Affecting young and poor victims in the region, this issue demands higher priority on health policy agendas. In Bangladesh, 400,000 women are estimated to have this condition. The Government of Bangladesh announced that it will establish a centre of excellence for the region of South Asia, to address prevention and treatment of fistula.
    Download PDF
    Keywords: News, Asia, Obstetric Fistula, Bangladesh
     
  • UN official spotlights success of Bangladesh centre treating childbirth injuries
    UN News Service. (2006). UN official spotlights success of Bangladesh centre treating childbirth injuries. UN News Service. Retrieved July 28, 2006 from www.un.org/apps/news/printnewsAr.asp?nid=1852
    Executive Director of UNFPA, Thoraya Ahmed Obaid, visited the Fistula Centre in the Dhaka Medical College Hospital as part of the global Campaign to End Fistula. Ms. Obaid was deeply moved by stories by young girls who were abandoned and left infertile from obstetric fistula, as well as by stories of success from girls who have undergone fistula repair surgery at the hospital. Since opening in 2003, this health facility has treated more than 500 women and girls, and trained 50 doctors and 36 nurses in other locations. UNFPA reports plans to make this facility a centre of excellence for both fistula treatment and training; this would be of benefit to neighboring South Asian countries where tens of thousands of women suffer from fistula. In addition to fistula treatment, the hospital also offers rehabilitation and vocational training to help better facilitate reintegration into a life and community that had shunned them and their condition. In Bangladesh, where 13% of births are attended by skilled medical workers, and he average age of marriage is 15 for girls, the government has dedicated itself to programs and policies that will improve schooling for girls and improve reproductive health services. Already positive results are being reported by UNFPA in both areas.
    Download PDF
    Keywords: News, Asia, Obstetric Fistula, Bangladesh
     
  • Vesicovaginal fistula at tertiary care center in eastern Nepal
    Uprety, D.K., et al. (2008). Vesicovaginal fistula at tertiary care center in eastern Nepal. Journal of the Nepal Medical Association, 47(171), 120-122
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    Keywords: Clinical Information, Asia, Nepal
     
  • Bublocavernosus muscle flap in the repair of complicated vesicovaginal fistula
    Xu, Z., & Fu, Q. (2005). Bublocavernosus muscle flap in the repair of complicated vesicovaginal fistula. International Journal of Urology, 12, 1037-1040.
    Aim: To investigate the transposition of the bulbocavernosus muscle flap for repairing complicated vesicovaginal fistulas. Methods: Vesicovaginal fistulas were repaired via combined abdominal and perineal approaches. Through an abdominal approach, the fistula and surrounding scar tissue were excised thoroughly. A perineal incision was made between the orifices of the urethra and the vagina, dissecting until the fistula. The vaginal defect was closed through either the abdominal or the perineal approach depending upon its position. Through the abdominal approach, the bladder defect was closed in two layers with the suture lines vertical to each other. The bulbocavernosus muscle was freed through an incision between the labium majus pudendi and the labium minus pudenda, without damaging the pudendal vascular supply. The bulbocavernosus muscle flap was tunneled beneath the labium minus pudendi, and was sutured in place on the bladder wall over the fistula repair site. Results: Nine patients with complicated vesicovaginal fistulas were treated using this technique. After surgery, no symptoms of vagina leakage, urinary incontinence, or urethral stricture were reported by any of the patients, and they reported normal sexual function. Conclusions: Transposition of the bulbocavernosus muscle flap is an excellent technique with low morbidity and high success rate for repairing complicated vesicovaginal fistulas.
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    Keywords: Clinical Information, Asia, China
     
  • A Study to identify the occurrence of Obstetric Fistula in India
    UNFPA, A Study to identify the occurrence of Obstetric Fistula in India
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    Keywords: Programs, Asia, Obstetric Fistula, India
     
  • Report on The 2nd Asia and Pacific Regional Workshop on Strengthening Fistula Elimination in the Context of Maternal Health. Islamabad, Pakistan
    UNFPA. (April 2006). Report on The 2nd Asia and Pacific Regional Workshop on Strengthening Fistula Elimination in the Context of Maternal Health. Islamabad, Pakistan
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    Keywords: Overview, Asia, Obstetric Fistula, maternal health
     
  • South Asia conference for the prevention and treatment of obstetric fistula. Dhaka, Bangladesh
    UNFPA. (December 2003). South Asia conference for the prevention and treatment of obstetric fistula. Dhaka, Bangladesh
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    Keywords: Programs, Asia, Obstetric Fistula, Prevention
     

Eastern and Southern Africa

West Africa

Bangladesh

  • Vesico-vaginal fistula: surgical management of 100 cases
    Begum, A. (1989). Vesico-vaginal fistula: surgical management of 100 cases. Journal of Bangladesh College of Physicians and Surgeons, 6(2), 29-32
    Link to Source
    Keywords: Clinical Information, Bangladesh
     
  • Repair of vesico-vaginal fistula
    Ali, S.E. (Unpublished). (1989). Repair of vesico-vaginal fistula. Dhaka, 1989. 6 p
    Link to Source
    Keywords: Clinical Information, Bangladesh
     
  • Mental health screening in women with genital tract fistulae
    Goh, J., Sloane, K.M., Krause, H.G., Browning, A., & Akhter, S. (2005). Mental health screening in women with genital tract fistulae. British Journal of Urology, 112, 1328-133 0
    At this time there is very little information about the mental health status of women with genital tract fistulae. The objective of the study was to see if women with genital tract fistula screened positive for mental health dysfunction. The authors chose 68 patients overall from two hospitals, the Dhaka Medical College Hospital in Bangladesh (12/03-06/04) and the Addis Ababa Fistula Hospital in Ethiopia (06/04-07/04). The patients were screened using the General Health Questionnaire (GHQ-28) prior to their fistula repair. The authors used the 28 female staff members as controls. 66 of the 68 patients screened positive for mental dysfunction(97%), while 9 out of the 28 (32%)of the controls screen positive. Due to the high rates among the patients, the authors suggest that the management of women with genital tract fistula must include a psychological or psychiatric assessment and treatment component.
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    Keywords: Clinical Information, Bangladesh, Ethiopia
     
  • Fistula: agonies and aftermath
    Haq, N. (2004, December 26). Fistula: agonies and aftermath. The Daily Star. Retrieved March 20, 2006, from http://www.thedailystar.net/2004/12/26/d412266101110.htm.
    Kazol Rekha, a young girl of 15 years, suffered injuries during childbirth over a year ago, and since then has returned to her parent’s home, at the insistence of her husband and in-laws. The tear between Rekha’s vagina and bladder, termed an obstetric fistula, resulted in the constant leakage of urine, and in her case, nerve damage to her legs as well. In most cases of obstetric fistula, the mother loses her baby and faces a number of devastating physical and social consequences. Although fistula is both preventable and treatable, a large number of Bangladeshi women and girls (estimated at 71,000) suffer from this condition, as a result of a number of factors including poverty, early marriage, and poor maternal health services. In rural Bangladesh, early marriage between the ages of 12 and 15 is common, as are adolescent pregnancies. These factors, the lack of antenatal care, and the fact that 92% of deliveries occur at home, all contribute to the incidence of fistula in Bangladesh. UNFPA undertook the first analysis of fistula in Bangladesh in 2003, and is helping to set up a National Fistula Centre at Dhaka Medical College Hospital (DMCH). Dr. Syeba at DMCH commented that in addition to fistula repair, awareness raising and increased access to emergency obstetric care are also crucial. She also noted that the women who suffer from fistula show extraordinary courage, and although all cannot be cured, repair surgery is highly successful and can help to restore the dignity of many women. While 123 successful surgeries have been completed so far, many more women, including Kazol Rekha, are waiting for their chance for a new life.
    Download PDF
    Keywords: News, Bangladesh, Asia, Obstetric Fistula
     
  • Vesico-vaginal fistula: a review. Bangladesh
    Hussain, M.A. (1986). Vesico-vaginal fistula: a review. Bangladesh. Journal of Obstetrics and Gynaecology, 1(1), 21-32
    Link to Source
    Keywords: Clinical Information, Asia, Bangladesh
     
  • National Fistula Centre set up at DMCH
    Star Health Desk. (2003, October 5). National Fistula Centre set up at DMCH. The Daily Star Retrieved March 2, 2005 from http://www.thedailystar.net/2003/10/05/d31005610191.htm.
    annually. The Government of Bangladesh, with 1,800,000 lakhs assistance from UNFPA, is going to set up a National Fistula Centre at Dhaka Medical College Hospital. The Centre will have an operation theatre, an adjacent ward (20 beds), and separate rehabilitation centre (80 person capacity). A Client Data Recording System (CDRS) will also be in place, Government officials and professionals attended an orientation workshop where they received information on the objectives, activities and guidelines of the National Obstetric Fistula Health Programme. Young age at marriage and high prevalence of childbirth at home (in the absence of skilled attendance) contribute to a high rate of maternal morbidity and mortality in Bangladesh. Obstetric fistula is a severe chronic injury that can occur during prolonged obstructed labour, in the absence of access to a cesarean section. Women with obstetric fistula leak urine and/or feces constantly, but surgical repair is possible. The fistula centre in Bangladesh is envisioned as an eventual ‘centre of excellence’ where services as well as training will be available. Given the higher social status of men in Bangladesh, UNFPA representative Suneeta Mukherjee feels that male involvement in the fistula programme is key.
    Download PDF
    Keywords: News, Obstetric Fistula, Asia, Bangladesh
     
  • Obstetric fistula is common in South Asia, UNFPA says
    UN News Service. (2003). Obstetric fistula is common in South Asia, UNFPA says. Retrieved March 2, 2005 from http://www.un.org/News/
    Obstetric fistula, a hole which results in leakage of urine or feces, is often a consequence of prolonged, obstructed labour. This condition affects hundreds of thousands of girls and women in South Asia, said the UNFPA. Affecting young and poor victims in the region, this issue demands higher priority on health policy agendas. In Bangladesh, 400,000 women are estimated to have this condition. The Government of Bangladesh announced that it will establish a centre of excellence for the region of South Asia, to address prevention and treatment of fistula.
    Download PDF
    Keywords: News, Asia, Obstetric Fistula, Bangladesh
     
  • UN official spotlights success of Bangladesh centre treating childbirth injuries
    UN News Service. (2006). UN official spotlights success of Bangladesh centre treating childbirth injuries. UN News Service. Retrieved July 28, 2006 from www.un.org/apps/news/printnewsAr.asp?nid=1852
    Executive Director of UNFPA, Thoraya Ahmed Obaid, visited the Fistula Centre in the Dhaka Medical College Hospital as part of the global Campaign to End Fistula. Ms. Obaid was deeply moved by stories by young girls who were abandoned and left infertile from obstetric fistula, as well as by stories of success from girls who have undergone fistula repair surgery at the hospital. Since opening in 2003, this health facility has treated more than 500 women and girls, and trained 50 doctors and 36 nurses in other locations. UNFPA reports plans to make this facility a centre of excellence for both fistula treatment and training; this would be of benefit to neighboring South Asian countries where tens of thousands of women suffer from fistula. In addition to fistula treatment, the hospital also offers rehabilitation and vocational training to help better facilitate reintegration into a life and community that had shunned them and their condition. In Bangladesh, where 13% of births are attended by skilled medical workers, and he average age of marriage is 15 for girls, the government has dedicated itself to programs and policies that will improve schooling for girls and improve reproductive health services. Already positive results are being reported by UNFPA in both areas.
    Download PDF
    Keywords: News, Asia, Obstetric Fistula, Bangladesh
     

Belgium

Benin

  • Obstetric fistulae in West Africa: patient perspectives
    Nathan, L.M., et al. (2009). Obstetric fistulae in West Africa: patient perspectives. American Journal of Obstetrics and Gynecology, 200(5), e40-42. Epublished December 27, 2008
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    Keywords: Overview, West Africa, Obstetric Fistula, Benin
     
  • A randomized controlled trial of antibiotic prophylaxis for vesico-vaginal fistula repair
    Tomlinson, A.J., & Thornton, J.G. (1998). A randomized controlled trial of antibiotic prophylaxis for vesico-vaginal fistula repair. British Journal of Obstetrics and Gynaecology, 105, 397-399
    The authors’ hypothesis was that intravenous antibiotics given intra-operatively reduce the failure rate of vesico-vaginal fistula repair. They designed a single blind, randomized controlled trial at Hopital Evangelique, a district hospital in Benin. 81 women underwent repair of an obstetric vesico-vaginal fistula (2 of which were repeat repairs); a single surgeon did all of the surgeries. The 41 participants in the treatment group received ampicillin 500 mg intra-operatively while the 40 participants in the Control group received no prophylactic antibiotics. Antibiotic prophylaxis did not reduce the odds of failed repair or incontinence. The women in the antibiotic prophylaxis group received less post-operative antibiotics and had less urinary infections at day 10. The authors concluded that due to the high costs of prophylactic antibiotics, they should not be used in vesico-vaginal fistulae repair in the developing world outside randomized controlled trials.
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    Keywords: Clinical Information, Benin
     

Britain

Burkina Faso

Cameroon

Chad

China

  • Consequences of Birth Policies and Practices in Post-Reform China
    Harris, A., Gao, Y., Barclay, L., Belton, S., Yue. Z. W., Min, H., Auqun, X., Hua, L., Yun, Z. (Nov, 2007). Consequences of Birth Policies and Practices in Post-Reform China. Reproductive Health Matters, 114-124.
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    Keywords: Maternal Health, Asia, Obstetric Fistula, China
     
  • Bublocavernosus muscle flap in the repair of complicated vesicovaginal fistula
    Xu, Z., & Fu, Q. (2005). Bublocavernosus muscle flap in the repair of complicated vesicovaginal fistula. International Journal of Urology, 12, 1037-1040.
    Aim: To investigate the transposition of the bulbocavernosus muscle flap for repairing complicated vesicovaginal fistulas. Methods: Vesicovaginal fistulas were repaired via combined abdominal and perineal approaches. Through an abdominal approach, the fistula and surrounding scar tissue were excised thoroughly. A perineal incision was made between the orifices of the urethra and the vagina, dissecting until the fistula. The vaginal defect was closed through either the abdominal or the perineal approach depending upon its position. Through the abdominal approach, the bladder defect was closed in two layers with the suture lines vertical to each other. The bulbocavernosus muscle was freed through an incision between the labium majus pudendi and the labium minus pudenda, without damaging the pudendal vascular supply. The bulbocavernosus muscle flap was tunneled beneath the labium minus pudendi, and was sutured in place on the bladder wall over the fistula repair site. Results: Nine patients with complicated vesicovaginal fistulas were treated using this technique. After surgery, no symptoms of vagina leakage, urinary incontinence, or urethral stricture were reported by any of the patients, and they reported normal sexual function. Conclusions: Transposition of the bulbocavernosus muscle flap is an excellent technique with low morbidity and high success rate for repairing complicated vesicovaginal fistulas.
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    Keywords: Clinical Information, Asia, China
     

Congo

Cote d'Ivoire

Democratic Republic of the Congo

Ecuador

Egypt

Eritrea

  • Eritrean Women’s Health Project
    Eritrean Women’s Health Project(2002).Stanford University. Retrieved March 21,2005 from http://obgyn.stanford.edu/gynonc/eritrean.html.
    Dr. Mary Lake Polan, chair of the Stanford University Department of Obstetrics & Gynecology is the founder of the Eritrean Women’s Health Project, a health initiative for fistula repair. The rural nature of Eritrea, with poor communication and transportation infrastructure results in 80% of deliveries occurring without a physician or trained midwife. In September 2002, four gynecologists and one gyn-oncologist spent two weeks at the Mikane Hiwot Hospital in Asmara operating on 37 women with vesicovaginal and rectovaginal fistulas. They also taught Eritrean physicians how to do fistula repairs. They plan to return in early 2004 to continue their work.
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    Keywords: Programs, Eritrea, Eastern and Southern Africa
     
  • Advocates battle obstetric fistula in Eritrea.
    Hindery, R. (2004, August 8). Advocates battle obstetric fistula in Eritrea. Women’s ENews. Retrieved March 10, 2005 from http://www.womensenews.org/article.cfm/dyn/aid/1942/context/archive
    While in the United States, obstetric fistula has gone the way of tuberculosis and polio, it is widespread in countries such as Eritrea. Caused by protracted labour, a fistula is an opening usually between the bladder and the vagina, which leads to constant leakage of urine (and/or feces) through a woman’s vagina. Nurse Maureen Snider went to Eritrea with a team from Stanford University’s Eritrean Women’s Project. The team, led by Dr. Mary Lake Polan, performed 50 free fistula repair surgeries and plans to return to Eritrea to perform more surgeries. According to Snider, repair surgery usually takes about 15 minutes. An estimated 2 million women worldwide are believed to suffer from fistula, with 50,000 to 100,000 new cases each year. Women with fistula are often ostracized from their communities, due to this terrible condition that is easily treatable. The problem of obstetric fistula exists beyond the borders of Eritrea and has received international recognition. It is being addressed by organizations such as UNFPA and EngenderHealth. To increase awareness of this problem, independent filmmaker Lisa Russell recently directed a film called “Love, Labor, Loss” which follows a group of women in Niger who have arrived at a hospital in Niamey for fistula repair surgery. In July 2004, the Bush administration announced that for the third consecutive year, it will block the congressionally- approved $34 million due to the UNFPA. Russell hopes that despite this funding controversy, fistula will emerge as a unifying reproductive health issue, rather than a divisive one.
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    Keywords: News, Eastern and Southern Africa, Obstetric Fistula, Eritrea
     
  • Eritrean women's project response to Wall paper: 'Hard questions concerning fistula surgery in Third World countries.'
    Husain, A., et al. (2007). Eritrean women's project response to Wall paper: 'Hard questions concerning fistula surgery in Third World countries.' Journal of Women’s Health, 16(2), 281-282
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    Keywords: Programs, Eritrea, Eastern and Southern Africa
     
  • Surgical Management of Complex Obstetric Fistula in Eritrea
    Husain, A. et al. MD. (2005). Surgical Management of Complex Obstetric Fistula in Eritrea. Journal of Women’s Health, 14(9), 839-844.
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    Keywords: Eastern and Southern Africa, Statistics, Clinical Information, Obstetric Fistula, Eritrea
     
  • Mending Torn Lives: A series of open conversations with women suffering from obstetric fistula in Eritrea
    Krijgh, E., Campbell, B., Abraha, T. (2003). Mending Torn Lives: A series of open conversations with women suffering from obstetric fistula in Eritrea. UNFPA & Ministry of Health of Eritrea. Retrieved on February 23, 2005 from http://www.endfistula.org/download/mendingtornlives.pdf.
    Obstetric fistula is a wound caused by protracted labour. Its victims are mostly very young and very poor – girls or women without access to emergency obstetric care. After enduring the agony of unrelieved labour and the death of an unborn child, these women face the prospect of lifelong incontinence, infertility, shame, social isolation and poor health. UNFPA in Eritrea has focused its Reproductive Health Sub-programme on a number of issues related to obstetric fistula, including awareness-raising in the community, advocacy for emergency obstetric care, training and fund-raising for obstetric fistula repairs, and partnering with other groups. In Eritrea, skilled attendance at delivery is low (28%) and maternal morbidity and mortality are high. Socio-economic and cultural factors contribute to the development of obstetric fistula, including lack of education, heavy workloads, poor nutrition, young age at childbirth, unplanned pregnancy and limited health services. Female genital cutting, varying in severity, and highly prevalent among Eritrean women, is also a contributing factor. Traditional healers are often the most accessible health care provider for Eritrean women. The factors that impede fistula repair include lack of resources and lack of trained surgeons. In 2002, UNFPA and the MoH supported a team from the USA who performed fistula surgeries for three weeks. Of the 37 women who came for this surgery, 13 shared their personal stories, and gave ‘real-life’ insights into the problem of obstetric fistula in Eritrea. Women came from different ethnic groups. They were asked for some general information, and then were asked a number of simple open-ended questions. Summaries of the case studies cannot do justice to these moving accounts from the women of Eritrea. These are women who have endured labour for up to 3 or 4 days, and have often encountered additional complications during labour due to female genital circumcision and ‘sewing up’ of their genital area. Often socially isolated once they suffer fistula, many of these women have come for fistula surgery with great hopes - hopes of healthy children and a normal life.
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    Keywords: News, Eastern and Southern Africa, Obstetric Fistula, Eritrea
     
  • Experiences of women seeking medical care for obstetric fistula in Eritrea: implications for prevention, treatment, and social reintegration.
    Turan, J.M., et al. (2007). Experiences of women seeking medical care for obstetric fistula in Eritrea: implications for prevention, treatment, and social reintegration. Global Public Health, 2(1), 64-77
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula, Prevention, Reintegration, Eritrea
     

Ethiopia

  • New trends in the operative management of urinary fistulae
    Abbo, A.H., & Mukhtar, M. (1976). New trends in the operative management of urinary fistulae. Sudan Medical Journal, 13(4), 126-132
    Link to Source
    Keywords: Programs, Ethiopia, Sudan
     
  • The vesico-vaginal and allied fistulae – a report on 40 cases
    Bal, J.S. (1975). The vesico-vaginal and allied fistulae – a report on 40 cases. Medical Journal of Zambia, 9(3), 69-71
    Link to Source
    Keywords: Statistics, Ethiopia
     
  • A new technique for the surgical management of urinary incontinence after obstetric fistula repair
    Browning, A. (2006). A new technique for the surgical management of urinary incontinence after obstetric fistula repair. British Journal of Obstetrics and Gynaecology, 113, 475-478
    This study outlines a new surgical technique that is both simple and cheap. This procedure was performed on 12 women from February-July 2005 who had already had their fistulas repaired but were still incontinent, to varying degrees. The operation was performed by the vaginal route and involved using autologous tissues. Only 2 women had no improvement while 8 were completely cured. The other two women had improved but were not completely cured.
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Lack of value of the Martius fibrofatty graft in obstetric fistula repair
    Browning, A. (2006). Lack of value of the Martius fibrofatty graft in obstetric fistula repair. International Journal of Gynaecology and Obstetrics, 93(1), 33-37
    Objective: To ascertain if the Martius graft is of benefit to successful surgical outcome in obstetric fistula repair. Method: A retrospective analysis of 440 consecutive obstetric fistula repairs performed by the author in the Addis Ababa Fistula Hospital, Ethiopia or the Barhirdar Hamlin Fistula Center, Ethiopia, with or without the Martius fibrofatty graft. These were further divided into 13 subgroups of vesicovaginal fistula and all groups compared against two outcomes; fistula closure and presence of residual urethral incontinence following repair. Results were statistically analyzed with the Fisher's exact or Chi-squared test. Results: There was no statistical difference between groups with regards to breakdown of repair but a higher rate of residual incontinence in 3 subgroups with the Martius graft. Conclusion: The Martius graft can be safely omitted from obstetric fistula repair if the surgeon is experienced, and performs the same type of repair as used in this analysis.
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Obstetric fistula: Clinical considerations in the creation a new urethra and the management of a subsequent pregnancy
    Browning, A. (2007). Obstetric fistula: Clinical considerations in the creation a new urethra and the management of a subsequent pregnancy. International Journal of Gynaecology and Obstetrics, 99(1), S94-S97
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    Keywords: Clinical Information, Obstetric Fistula, Ethiopia, Eastern and Southern Africa
     
  • Obstetric fistula: Current practicalities and future concerns
    Browning, A. (2008). Obstetric fistula: Current practicalities and future concerns. International Urogynecology Journal and Pelvic Floor Dysfunction, 19(3), 333-334., A. (2008).
    Link to Source
    Keywords: Overview, Obstetric Fistula, Ethiopia, Eastern and Southern Africa
     
  • Pregnancy following obstetric fistula repair, the management of delivery
    Browning, A. (2009). Pregnancy following obstetric fistula repair, the management of delivery. International Journal of Obstetrics and Gynaecology, epublished May 8, 2009
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    Keywords: Statistics, Obstetric Fistula, eastern-and-western-africa, Ethiopia
     
  • Prevention of residual urinary incontinence following successful repair of obstetric vesico-vaginal fistula using a fibro-muscular sling
    Browning, A. (2004). Prevention of residual urinary incontinence following successful repair of obstetric vesico-vaginal fistula using a fibro-muscular sling. British Journal of Obstetrics and Gynaecology, 111, 357-361
    This article describes a new and simple surgical procedure, which, when employed at the time of fistula closure, seems to reduce the incidence of post-operative urinary incontinence. 32 patients were operated on at the Addis Ababa Fistula Hospital by the author, 20 whose fistulae were classified as simple and 12 as complex. The results were encouraging with both the simple and complex, though not with those who had markedly reduced bladder volume.
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    Keywords: Clinical Information, Obstetric Fistula, Prevention, Eastern and Southern Africa, Ethiopia
     
  • Risk factors for developing residual urinary incontinence after obstetric fistula repair
    Browning, A. (2006). Risk factors for developing residual urinary incontinence after obstetric fistula repair. British Journal of Obstetrics and Gynaecology, 113, 482-485
    The author notes that residual incontinence has been found between 8 and 33% of cases after a fistula repair. 530 patient records from 3 hospitals in Ethiopia were reviewed. 32% suffered residual incontinence. Statistically significant associations were : if the injury had affected the urethra, if there had been a repeat repair, if the fistula was large, if the bladder was described as small, if there was severe scarring which requied a vaginoplasty or flamp vaginal reconstruction or if a rectovaginal fistual was present. By identifying the risks before the surgery, more appropriate surgical techniques may be used.
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • The circumferential obstetric fistula: characteristics, management and outcomes
    Browning, A. (2007). The circumferential obstetric fistula: characteristics, management and outcomes. International Journal of Obstetrics and Gynaecology, 114(9), 1172-1176
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Women with obstetric fistula in Ethiopia: A 6-month follow up after surgical treatment
    Browning, A., & Menber, B. (2008). Women with obstetric fistula in Ethiopia: A 6-month follow up after surgical treatment. An International Journal of Obstetrics and Gynaecology, 115(12), 1564-9
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • FIGO initiative for the prevention and treatment of vaginal fistula.
    Browning, A., & Patel, T.L. (2004). FIGO initiative for the prevention and treatment of vaginal fistula. International Journal of Gynaecology and Obstetrics, 36(2), 317-322
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    Keywords: Overview, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • The impact of surgical treatment on the mental health of women with obstetric fistula
    Browning, A., et al. (2007). The impact of surgical treatment on the mental health of women with obstetric fistula. International Journal of Obstetrics and Gynaecology, 114(11), 1439-1441
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    Keywords: Statistics, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Stress urinary incontinence after delayed primary closure of genitourinary fistula: A technique for surgical management
    Carey, MP. et al. (2002). Stress urinary incontinence after delayed primary closure of genitourinary fistula: A technique for surgical management. American Journal of Obstetrics and Gynaecology, 186(5), 948-953
    The purpose of their study was to evaluate the anatomic pathology of severe incontinence after fistula closure and determine a surgical technique for correction. 22 women with severe urinary incontinence after fistula closure from the Addis Ababa Fistula Hospital were identified. An assessment of there incontinence was undertaken: 9 had severe GSI with normal compliance, 3 had GSI and poor compliance, 9 had GSI and detrusor instability and 1 had voiding dysfunction with overflow incontinence. Only patients with pure GSI underwent the surgery. The technique used combined retropubic urethrolysis, pubovaginal sling and omental graft. Outcome was assessed at 4 weeks and 14 months. The out come was 78% successful at 4 weeks and 67% at 14 months. This technique is seen as promising due to low morbidity and improved continence rates from other procedures.
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    Keywords: Clinical Information, Eastern and Southern Africa, Ethiopia
     
  • Obstetric Fistula: the international response
    Donnay, F., & Weil, L. (2004). Obstetric Fistula: the international response. Lancet, 363(9402), 71-72.
    While obstetric fistula has been eradicated from industrialized countries, its existence in developing countries is the result of a lack of quality maternal care. In 1989, WHO estimated that there were 2 million women and girls who suffered from obstetric fistula. However, obtaining reliable data is difficult due to the neglect of the issue and practical difficulties. Awareness of fistula should be included in delayed marriage programmes and safe motherhood programmes, both at the national and community levels. Emergency obstetric care must also be part of a prevention program, including increasing safe caesarean sections and symphysiotomies where caesarean are unavailable. Increasing the quality and availability of fistula repairs is also necessary.
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    Keywords: Programs, Obstetric Fistula, Ethiopia, Eastern and Southern Africa
     
  • Obstructed labour in Adigrat Zonal Hospital Tigray Region, Ethiopia
    Gessessew, A., & Mesfin, M. (2003). Obstructed labour in Adigrat Zonal Hospital Tigray Region, Ethiopia. Ethiopian Journal of Health Development, 17(3), 175-180
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Finding a balance in the treatment and prevention of obstetric fistula
    Glauser, W. (2008). Finding a balance in the treatment and prevention of obstetric fistula. Canadian Medical Association Journal, 178(12), 1527-1529
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    Keywords: Programs, Prevention, Ethiopia, Eastern and Southern Africa
     
  • Use of urethral plugs for urinary incontinence following fistula repair
    Goh, J., & Browning, A. (2005). Use of urethral plugs for urinary incontinence following fistula repair. Australian and New Zealand Journal of Obstetrics and Gynaecology, 45, 237-238
    The authors describe the use of urethral plugs in two cases of women whose fistulas were closed through surgical repair at the Addis Ababa Fistula Hospital but remained incontinent. The first case was a 26-year-old woman who had developed a fistula at the age of 16 following 4 days of labor. Her fistula was closed approximately 6 months later but she remained incontinent. A Femsoft urethral plug was used to manage her incontinence. With the plug, the woman noted that she only had occasional urinary leakage. She did not complain of any pain, dysuria or haematuria. The second case was of a 23 year old woman who developed her fistula at age 18 after prolonged labor. Her fistula was repaired 4 months later but she suffered from continuous urinary loss. After the woman was taught to insert a Femsoft plug, she did not have any leakage of urine. She initially complained of slight dysuria. The authors note that the urethral plug is a minimally invasive method of treating postfistula repair urinary incontinence.
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    Keywords: Clinical Information, Ethiopia, Eastern and Southern Africa
     
  • Mental health screening in women with genital tract fistulae
    Goh, J., Sloane, K.M., Krause, H.G., Browning, A., & Akhter, S. (2005). Mental health screening in women with genital tract fistulae. British Journal of Urology, 112, 1328-133 0
    At this time there is very little information about the mental health status of women with genital tract fistulae. The objective of the study was to see if women with genital tract fistula screened positive for mental health dysfunction. The authors chose 68 patients overall from two hospitals, the Dhaka Medical College Hospital in Bangladesh (12/03-06/04) and the Addis Ababa Fistula Hospital in Ethiopia (06/04-07/04). The patients were screened using the General Health Questionnaire (GHQ-28) prior to their fistula repair. The authors used the 28 female staff members as controls. 66 of the 68 patients screened positive for mental dysfunction(97%), while 9 out of the 28 (32%)of the controls screen positive. Due to the high rates among the patients, the authors suggest that the management of women with genital tract fistula must include a psychological or psychiatric assessment and treatment component.
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    Keywords: Clinical Information, Bangladesh, Ethiopia
     
  • Analysis of admission to Gondar Hospital in North-Western Ethiopia, 1971-1972
    Habte-Gabr, E. et al. (1976).Analysis of admission to Gondar Hospital in North-Western Ethiopia, 1971-1972. Ethiopian Medical Journal, 14, 49-59.
    Link to Source
    Keywords: Statistics, Eastern and Southern Africa, Ethiopia
     
  • Fistula – a socio-medical problem
    Haile, A. (1983). Fistula – a socio-medical problem. Ethiopian Medical Journal, 21(2), 71-78.
    Link to Source
    Keywords: Overview, Ethiopia, Eastern and Southern Africa
     
  • Fistula makes social outcasts of child brides
    Inbaraj, S. (2004, February 4). Fistula makes social outcasts of child brides. Inter Press Service News Agency. Retrieved March 2, 2005 from http://www.ipsnews.net/.
    Thirteen-year-old Meseret survived six days of grueling labour, and was left with a stillborn baby and an obstetric fistula. This injury left her leaking urine and feces constantly. She finally found her way to the Addis Ababa Fistula Hospital, where 1,200 women and girls like her, with obstetric fistula, are treated annually. Most fistulas can be corrected surgically, and the cost of the surgery is covered by the hospital, via funds from donors. While the prevalence is uncertain, UNFPA estimates that between 50,000 and 100,000 women in Africa may be affected each year. UNFPA’s work in addressing fistula was affected by President Bush’s withholding of 34 million from their annual budget in 2002. The girls and women who suffer from fistula are often poor, illiterate, unaware of their rights, and highly stigmatized in their societies. Prevention efforts to educate women on the dangers of early marriage and early childbirth prove difficult in the cultural climate of Ethiopia.
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    Keywords: News, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Married as children, women with obstetric fistulas have no future
    Inbaraj, S. (2004, March). Married as children, women with obstetric fistulas have no future. Population Reference Bureau. Retrieved February 16, 2005 from http://www.prb.org
    Wobete Falaga, a 13 year old girl in Ethiopia’s Amhara region, suffered from holes (or fistulas) between her vagina and bladder, and vagina and rectum. Constantly leaking feces and urine, Wobete made it to the Addis Ababa Fistula Hospital (AAFH) for repair surgery. Wobete is not alone; worldwide obstetric fistula affects up to 50,000 to 100,000 women each year. The condition is a result of prolonged obstructed labor, and the absence of a necessary cesarean section. A number of organizations, including UNFPA, WHO, EngenderHealth, Columbia University’s Averting Maternal Death and Disability Program, and the International Federation of Gynecology and Obstetrics (FIGO) are leading efforts to prevent and treat this condition worldwide. Most patients in Ethiopia come from the Amhara region, where girls marry very young. While most fistulas can be repaired surgically, some women may still suffer from stress incontinence, and a very small percentage of cases are incurable. AAFH provides literacy training, teaches patients their rights, and helps them reintegrate into their villages after they are repaired. The hospital also plans outreach centers to raise awareness of the dangers of early childbirth and the need of hospital delivery in case of complications. These centers are critical to ending the problem of obstetric fistula. Centers in Bahir Dar (the Amhara region) and the Tigray region will open soon, and plans for Yirragalem and Harar are underway.
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    Keywords: News, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Ethiopia: An epidemiological study of vesico-vaginal fistula in Addis Ababa
    Kelly, J. (1995). Ethiopia: An epidemiological study of vesico-vaginal fistula in Addis Ababa. World Health Statistics Quarterly, 48(1), 15-17
    Link to Source
    Keywords: Clinical Information, Eastern and Southern Africa, Ethiopia
     

  • Kelly, J. (Unpublished). (1978/1988). Fistulae which failed to heal, Addis Ababa, Ethiopia
    Link to Source
    Keywords: Overview, Eastern and Southern Africa, Ethiopia
     
  • Vesico-vaginal and recto-vaginal fistulae.
    Kelly, J. (1992). Vesico-vaginal and recto-vaginal fistulae. Journal of the Royal Society of Medicine, 85, 257-258.
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    Keywords: Statistics, Ethiopia, Eastern and Southern Africa, Britain, Iatrogenic Fistula
     
  • Vesico-vaginal fistulae
    Kelly, J. (1979). Vesico-vaginal fistulae. British Journal of Urology, 51, 208-210.
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    Keywords: Clinical Information, Obstetric Fistula, Iatrogenic Fistula, Britain, Eastern and Southern Africa, Ethiopia
     
  • Epidemiologic study of vesicovaginal fistulas in Ethiopia
    Kelly, J., & Kwast, B.E. (1993). Epidemiologic study of vesicovaginal fistulas in Ethiopia. International Urogynaecology Journal, 4, 278-281
    Three hundred and nine treated at the Addis Ababa Fistula Hospital during the years 1983 to 1988 were studied for biosocial factors, obstetric history, previous attempts at repair, the condition of the patient and the extent of injury to the genitourinary tract, as well as treatment and results. The mean age of the patients was 22.4 (range 9-45). 65% were under 25 years and 42% were under 20 years. The cause of the fistula was obstructed labor in 97.4%; in 62.7% it was the patients first labor; the outcome for the baby was a stillbirth in 92.7%. The fistula was complicated in 69.4%; a Martius graft was used in 73.6%; 88% were cured; 5.8% of repairs failed and in 6.2% the patient had stress incontinence. Obstetric fistulas in Ethiopia result from obstructed labor, mostly in a first pregnancy in young women, and it is rare for the baby to survive.
    Link to Source
    Keywords: Statistics, Eastern and Southern Africa, Ethiopia
     
  • Obstetric vesicovaginal fistulas: Evaluation of failed repairs
    Kelly, J., & Kwast, B.E. (1993). Obstetric vesicovaginal fistulas: Evaluation of failed repairs. International Urogynecology Journal, 4(5), 271-273.
    This study looks at 71 patients who had an unsuccessful repair at first attempt at the Addis Ababa Fistula Hospital. All fistulas were the result of obstructed labor and in 17.1% of the cases, the uterus had also ruptured. All of the fistula were classified as complicated. 18.3% of the cases had at least one unsuccessful attempt at repair. Spontaneous cure was seen in 3 patients, 41 were cured after a further operation. Associated factors for a failed repair were: a history of ruptured uterus, previous unsuccessful attempts at repair, patients whose general condition was poor and whose fistula was complicated.
    Link to Source
    Keywords: Clinical Information, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Alone and ashamed
    Kristof, N.D. (2003, May 16). Alone and ashamed. The New York Times
    In this Op-Ed column, the author describes the efforts of Catherine Hamlin, the Australian gynecologist who has dedicated her life to helping Ethiopian women overcome obstetric fistulas, a birth injury that results in incontinence and often nerve damage. One young 13 year old sufferer delivered a dead baby alone in the bush, but made it to Dr. Hamlin’s hospital for treatment, and now works in the hospital. When President Bush cut off 34 million is US funds to UNFPA, programs to address fistula were affected. At the same time, people like Catherine Hamlin are leading heroic efforts to help the stigmatized fistula sufferers.
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    Keywords: News, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Obstetric fistula in developing countries: a review article
    Muleta, M. (2006). Obstetric fistula in developing countries: a review article. Journal of Obstetrics and Gynaecology Canada, 28(11), 962-6
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    Keywords: Overview, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Obstetric fistulae: A retrospective study of 1210 cases at the Addis Ababa Fistula Hospital
    Muleta, M. (1997). Obstetric fistulae: A retrospective study of 1210 cases at the Addis Ababa Fistula Hospital. Journal of Obstetrics & Gynaecology, 17(1), 68-70.
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Socio-demographic profile and obstetric experience of fistula patients managed at the Addis Ababa Fistula Hospital
    Muleta, M. (2004). Socio-demographic profile and obstetric experience of fistula patients managed at the Addis Ababa Fistula Hospital. Ethiopian Medical Journal, 44, 9-1
    A study was conducted to characterize the obstetric experience, clinical and socioeconomic characteristics, and reasons for preference of place of delivery of 639 fistula patients admitted to the Addis Ababa Fistula Hospital, Ethiopia, between May 1999 and February 2000. About 94% of fistula patients were married and 83.6% had a delivery that caused the fistula before the age of 20. The mean ages at the first marriage and at the causative delivery were 14.7 (SD=2.6) and 17.8 (SD=3.2) years respectively. The mean height of fistula patients was 149 cms (SD=8). About 64% were primiparous, 279 (44%) delivered at home, and labor lasted for 3.8 days on average.
    Link to Source
    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Postcoital injuries treated at the Addis Ababa Fistula Hospital, 1991-1997
    Muleta, M., & Williams G. (1999). Postcoital injuries treated at the Addis Ababa Fistula Hospital, 1991-1997. The Lancet, 354(9195), 2051-2052
    This article describes 91 cases of girls and women who were treated for Rectovaginal Fistula at the Addis Ababa Fistula Hospital from 1991-1997. All of the cases of fistula were sustained through sexual abuse. 78 had been abused by their husbands, 9 were kidnapped (with the intention of marriage), raped, and discarded, 4 were kidnapped and raped. There were 18 cases of girls ages 6-10; 12 of the girls had sustained their injuries through marriage, 6 through rape. 57 cases of girls aged 11-15; 51 of the girls had sustained their injuries through marriage, 6 through rape. All of the women were underwent successful surgery to repair their fistula.
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    Keywords: Statistics, Eastern and Southern Africa, Traumatic Fistula, Ethiopia
     
  • Health and social problems encounters by treated and untreated obstetric fistula patients in rural Ethiopia
    Muleta, M. et al. (2008). Health and social problems encounters by treated and untreated obstetric fistula patients in rural Ethiopia. Journal of Obstetrics and Gynaecology Canada, 30(1), 44-50.
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula, Reintegration, Ethiopia
     
  • Obstetric Fistula in rural Ethiopia
    Muleta, M., et al. (2007). Obstetric Fistula in rural Ethiopia. East African Medical Journal, 84(11), 525-33
    Link to Source
    Keywords: Statistics, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Urinary and faecal incontinence following delayed primary repair of obstetric genital fistula
    Murray, C. et al. (2002). Urinary and faecal incontinence following delayed primary repair of obstetric genital fistula. British Journal of Obstetrics and Gynaecology, 109, 828-832.
    55 women who had received repair of an obstetric genitourinary fistula were interviewed during a 5-week period in 1999 at the AAFH. All of the women had received repair between 4 weeks and 3 months ago. The women were still at the hospital for multiple reasons, including waiting for relatives and continuing therapy. The mean age was 23 years (range 16-45). 38 developed fistulas after the first delivery, 17 followed the second to the fifth delivery, and 7 after the sixth or more delivery. 44 had a VVF, 11 had a VVF and RVF. The mean diameter for the VVF was 2.9 cm. 21 women reported altered faecal incontinence, and 30 women reported persistent urinary incontinence.
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    Keywords: Clinical Information, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Risk factors that predict failure after vaginal repair of obstetric vesicovaginal fistulae
    Nardos, R., Browning, A., Chen, C. (2009). Risk factors that predict failure after vaginal repair of obstetric vesicovaginal fistulae. American Journal of Obstetrics and Gynaecology, 200(5), 578.e1-4
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Duration of bladder catheterization after surgery for obstetric fistula
    Nardos, R., Browning, A., Member, B. (2008). Duration of bladder catheterization after surgery for obstetric fistula. International Journal of Gynaecology and Obstetrics, 103(1), 30-32
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    Keywords: Clinical Information, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • A community-based long-term follow up of women undergoing obstetric fistula repair in rural Ethiopia
    Nielson, H.S., et al. (2009). A community-based long-term follow up of women undergoing obstetric fistula repair in rural Ethiopia. International Journal of obstetrics and Gynaecology. Published May 14, 2009, retrieved on June 29, 2009 from http://www3.interscience.wiley.com/journal/122385157/abstract?CRETRY=1&SRETRY=0
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • When giving birth means being damaged and shunned
    Nolan, S. (2006, May 23). When giving birth means being damaged and shunned. The Globe and Mail. Retrieved June 22, 2006 from www.pushjournal.org
    In 1959 Australian missionary gynecologists Reginald and Catherine Hamlin arrived in Ethiopia and opened the Addis Ababa Fistula Hospital. This hospital has been in operation for over 50 years, pioneering the treatment of obstetric fistula---a problem that the WHO reports is afflicting 2 million women world wide. Obstetric Fistula is a hole between the vagina and bladder, or vagina and rectum, caused by obstructed and lengthy labor in which continuous pressure of the fetal head results in the death of tissues in the vaginal walls. The baby generally dies, and the mother is left incontinent and unable to control the flow of fecal matter. As a result, women afflicted by fistula are marked by a foul odor, suffer from sores both on the vulva and legs (aggravated by the uncontrollable flow of fecal matter), are nearly all divorced by their husbands, families, and society. These women live in suffering isolation, pariahs to their former community. Often they go to live on the outskirts of town, or are occasionally taken in by monasteries. The costs to both prevent and treat fistula are relatively small. Prevention of this problem can be accomplished through caesarian section for about $65. Solution of this problem can be accomplished though the sort of surgery performed at the Addis Ababa Fistula Hospital for about $350. 1,500 women receive such treatment here every year, and an additional few thousand women may receive treatment in other countries by doctors who were trained at Addis Ababa. At present, former patients serve all positions as nurse’s aides and cleaning assistants in the hospital. One patient in the hospital was 50 years old, and had been living with her fistula for 30 years. In her life she had given birth to 13 children , but only 3 actually survived delivery. In recent year greater priority is being given to the issue of fistula treatment, and according to a report by the Campaign to End Fistula which is run by the UNFP, Mali now has 4 times the capability to perform fistula repairs than it did when the campaign began its work in 2003.
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    Keywords: News, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Reducing the scourge of obstetric fistulae in sub-Saharan Africa: a call for a global repair initiative
    Okonofua, F. (2005). Reducing the scourge of obstetric fistulae in sub-Saharan Africa: a call for a global repair initiative. African Journal of Reproductive Health, 9(2), 7-13
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    Keywords: program, Obstetric Fistula, Nigeria, Ethiopia, Kenya, Tanzania
     
  • Incontinence and trauma: sexual violence, female genital cutting and proxy measures of gynecological fistula
    Peterman, A., & Johnson, K. (2009). Incontinence and trauma: sexual violence, female genital cutting and proxy measures of gynecological fistula. Social Science and Médicine, 68(5), 971-979
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    Keywords: Statistics, Eastern and Southern Africa, Traumatic Fistula, Malawi, Rwanda, Ethiopia, Uganda
     
  • Ethiopia’s trail of tears.
    Pisik, Betsy. (2004, March 5) Ethiopia’s trail of tears. The Washington Times. Retrieved July 28, 2006 from www.washtimes.com
    The condition of fistula has persisted in the non-Western world due to the limited availability of c-sections in most developing nations; for example, in Sub-Saharan Africa as many as 3 million women are believed to suffer with fistula. One woman at the Hamlin Fistula Hospital in the village of Bahir Dar in Northern Ethiopia suffered a three day long labor only to give birth to a still born son; she believed that her fistula was the result of something either the doctors or God had done to her. This uncomfortable condition of leaking urine and feces may be corrected though with a 30-minute surgery and two weeks recovery. Some US congressmen, including Rep. Christopher H. Smith, New Jersey Republican, and Carolyn B. Maloney, New York Democrat are pushing USAID to channel additional funding into the treatment of fistula. According to the Hamlin Fistula Relief and Aid Fund, the success rate for fistula repair surgery is about 93%. The condition itself may be caused by obstructed child labor that may rupture the birth canal, bladder, and rectum. Other causes may in clued rape, botched female circumcisions, or accidents. An estimated 150,000 Ethiopian women suffer with fistula. According to a survey by the Ethiopian Health Ministry, 9.5% or pregnant women give birth in the presence of a skilled medical attendant, and just 40% of women have access to medical care following difficult labor. In Ethiopia, the majority of women suffering from fistula are first-time pregnancies. Women suffering from incurable fistulas are able to find employment as nurses aids for a small monthly wage and housing at the Addis Ababa hospital. Patients at the hospital receive surgery (that costs between $300-$400) free of charge; an expense funded by the $2 million annual budget from the Hamlin Trust. The Hamlin Fistula Hospital in Addis Ababa was founded in 1959 by Catherine and Reginald Hamlin; since then two smaller satellite facilities in the villages of Bahir Dar and Mekelle. These hospitals not only treat fistula patients, but also provide training for gynecologists and urinary specialists in fistula treatment.
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    Keywords: News, Eastern and Southern Africa, Ethiopia
     
  • Suffering in silence: the isolated and forgotten victims of obstetric fistula.
    Rusu, L. (2002). Suffering in silence: the isolated and forgotten victims of obstetric fistula. UNFPA News & Information. Available at www.unfpa.org
    Almaz, a 13 year old Ethiopian girl, suffered a fistula during labor, lost her baby, and was then rejected by her husband. At least 2 million girls and women worldwide suffer from obstetric fistula, a condition usually caused by complications during childbirth, which leads to physical consequences such as incontinence, as well as dire social consequences, as in the case of Almaz. Still common in the developing world, obstetric fistulas occur as a result of a number of factors, including poverty and early marriage. Social and legal change is necessary to improve the status of girls and women, increase their access to health care, and to give them the choice to postpone marriage and childbirth. Fortunately, most fistulas can be repaired. Almaz’s father took her for repair surgery to the Addis Ababa Fistula Hospital, where she met other girls and women who were victims of fistula and who understood her suffering. In Addis Ababa, the need for fistula repair surgery far exceeds the current capacity of the hospital, which does not bode well for the victims of fistula, who suffer greatly, and may even die as a result of infections caused by the presence of a fistula.
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    Keywords: News, Obstetric Fistula, eastern-and-souther-africa, Ethiopia
     
  • The bride was 7. In the heart of Ethiopia, child marriage takes a brutal toll
    Salopek, P. (2004). The bride was 7. In the heart of Ethiopia, child marriage takes a brutal toll. Chicago Tribune, December 12, 2004. Available at www.chicagotribune.com
    Tihun, a mischievous 7-year old girl in Amharaland, is arranged to be married to a 17-year old deacon in her village. She is one of an estimated 50 million child brides worldwide. While early marriage has a number of grave consequences for young girls, the worst medical cost is subsequent early pregnancies – the leading cause of death for girls age 15 to 19 in the developing world. Child brides also suffer the injustice of being beaten and treated like indentured servants, and if they flee their marriages, often end up in the sex trade. Perhaps the worst injustice, however, is that these girls do not have the chance to obtain an education, condemning them to lives of ignorance and poverty. According to the UNFPA, at least 49 countries in the world, many in sub-Saharan Africa and Asia, have significant child bride problems, with at least 15 percent of girls marrying younger than age 18. Tihun’s home, Amharaland, has the highest child marriage rates in the world, and the Ethiopian Orthodox Church plays a significant role in encouraging the practice. To save on expenses, Tihun is married on the same day as her sister and two brothers. She dreads the arrival of the day, wishing that instead of having to marry and have babies, she could play with her pal Mulusaw, or even go to school. Child-rights workers worldwide concur that education is the single most important key unlocking the prison of child marriage. But many parents distrust education, since educated girls are no longer willing to marry and slave for their mothers-in-law. Runaway child brides often end up in the sex trade, where, among the other dangers, they are vulnerable to HIV infection. Those who stay with their husbands and become pregnant face the possibility of labor complications due to their small statures. Obstetric fistula, a horrible consequence of “too-big babies’ heads blocking too-small pelvises”, result in constant leakage of urine and/or feces from a woman’s vagina, a condition that often leads to families’ disowning the girls. This condition is believed to affect up to 2 million women and girls worldwide, according to UNFPA, and 50,000 to 100,000 new cases emerge annually. Although fistula repair is possible, those who obtain the surgery are the lucky few who make it to places like the Addis Ababa Fistula Hospital. As the day of her wedding arrives, Tihun is enchanted with her new clothes and shoes. At the ceremony, she sits and watches the festivities, never having exchanged a word with her new husband. Like many other girls her age, she will be carried off to her in-laws home, unaware of what lies ahead.
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    Keywords: News, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • The tragedy of obstetric fistula and strategies for prevention
    Shefran, J.M. (2009). The tragedy of obstetric fistula and strategies for prevention. American Journal of Obstetrics and Gynecology, 200(6), 668-671
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    Keywords: Programs, Prevention, Obstetric Fistula, Ethiopia, Eastern and Southern Africa
     
  • Women with obstetric fistula in Ethiopia
    Thomson, A.M. (2007). Women with obstetric fistula in Ethiopia. Midwifery, 23(4), 335-6
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    Keywords: Overview, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Ethiopia: Fistula hospital continues services for young women
    UN Integrated Regional Information Networks. (2005, March 22). Ethiopia: Fistula hospital continues services for young women. Retrieved March 23, 2005 from http://www.irinnews.org
    Dr. Catherine Hamlin, often described as a saint, performs a relatively simple, cheap fistula repair operations that change lives. According to the UN, every year there are an additional 100,00 women who develop fistula. In Ethiopia, there are around 8,000 women who live with fistula and around a third receive treatment of any kind. In Ethiopia the life expectancy of a woman is 44 and she will likely be married at 17 and give birth to 6 children. UNFPA has worked with Hamlin to train new doctors to treat fistula. The hospital is the only one of its kind to only treat fistula, and it recently celebrated its 30th birthday. In those 30 years they have cured over 25,000 women.
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    Keywords: News, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Mulu Muleta: Ethiopian surgeon working to end fistula
    Wakabi, K. (2006). Mulu Muleta: Ethiopian surgeon working to end fistula. The Lancet, 368, 1147
    Mulu muleta has worked for the Addis Ababa Fistula Hospital for 16 years; she is currently the medical director. The Addis Ababa Fistula Hospital, with 5 surgeons, treats more than 1200 patients a year. They have treated more than 24,000 women since Reginald and Catherine Hamlin founded the hospital in 1974. The hospital has trained over 100 surgeons from other countries in fistula repair. Ethiopian obstetric and gynecology residents are also required to do a rotation at the hospital. Dr. Muleta is also a consultant obstetrician and gynecologist for the Organization for African Unity and she is a member of FIGO.
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    Keywords: Programs, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • The Addis Ababa Fistula Hospital: An holistic approach to the management of patients with vesicovaginal fistulae
    Williams, G. (2007). The Addis Ababa Fistula Hospital: An holistic approach to the management of patients with vesicovaginal fistulae. Surgeon, 5(1), 54-47.
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    Keywords: Programs, Eastern and Southern Africa, Obstetric Fistula, Ethiopia
     
  • Destructive vaginal deliveries at a teaching hospital in Addis Ababa, Ethiopia.
    Zeidan, A., & Abdella, A. (2007). Destructive vaginal deliveries at a teaching hospital in Addis Ababa, Ethiopia. Ethiopian Medical Journal, 45(1), 39-45.
    Link to Source
    Keywords: Clinical Information, Eastern and Southern Africa, Ethiopia
     

Ghana

Guinea

India

  • Fistulae in obstetric practice
    Bhasker Rao, K. (Unpublished). (1988). Fistulae in obstetric practice. Madres, 13
    Link to Source
    Keywords: Programs, India, Asia
     
  • Genital fistulae
    Bhasker Rao., K. (1975). Genital fistulae. Journal of Obstetrics and Gynaecology of India, 25, 58-65
    Link to Source
    Keywords: Overview, India, Asia
     
  • Vesicovaginal fistula – a study of 269 cases
    Bhasker Rao, K. (1972). Vesicovaginal fistula – a study of 269 cases. Journal of Obstetrics and Gynaecology of India, 22(5), 536-541.
    Link to Source
    Keywords: Statistics, Asia, India
     
  • Self-reported symptoms of gynecological morbidity and their treatment in south India
    Bhatia, J.C., & Cleland, J. (1995). Self-reported symptoms of gynecological morbidity and their treatment in south India. Studies in Family Planning, 26(4), 203-216
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    Keywords: Maternal Health, Asia, Obstetric Fistula, India
     
  • Genital Fistula- Our experience
    Biswas, A., et al. (2007). Genital Fistula- Our experience. Journal of the Indian Medical Association, 105(3), 123-126
    Link to Source
    Keywords: Statistics, Asia, India
     
  • Maternal mortality and morbidity in the developing countries like India
    Coyaji, B.J. (1991). Maternal mortality and morbidity in the developing countries like India. Indian Journal of Maternal and Child Health, 2(1), 3-9
    Link to Source
    Keywords: Statistics, Asia, Obstetric Fistula, India
     
  • Maternal Mortality Ratio and Predictors of Maternal Deaths in Selected Desert Districts in Rajasthan: A Community-Based Survey and Case Control Study
    Gupta, S. D., Khanna, A., Gupta, R., Sharma, N. K., & Sharma, N. D. Maternal Mortality Ratio and Predictors of Maternal Deaths in Selected Desert Districts in Rajasthan: A Community-Based Survey and Case Control Study. Women's Health Issues, 20(1), 80-85.
    Background Reduction in maternal and child mortality has been a top priority in India, especially in light of the commitment on the part of the national government to the reach the Millennium Development Goals. Despite massive program efforts and availability of technology needed to avert maternal deaths, the maternal mortality ratio (MMR) in India continues to be high. Population-based estimates of MMR are lacking, and reliable evidence of role of socioeconomic determinants and program-related factors that mediate medical causes is not available. The present study was conducted to develop population-based estimates of MMR, and to evaluate the primary causes of maternal deaths and factors associated with excess risk of maternal mortality. Methods The study was conducted in the state of Rajasthan in India, covering 25,926 households in 411 villages. It has two major components: a community-based household survey and a case-control study with cases and controls sampled from the same population. A total of 32 maternal deaths and 6,165 live births were identified. The group of women who died during pregnancy or delivery (cases) is compared with a group of women who gave birth and survived (controls). Results MMR was estimated to be 519 (95% confidence interval [CI], 477–561). Hemorrhage was the chief cause (31%) of maternal deaths; the other causes were obstructed labor, severe anemia, puerperal sepsis, and abortion. Young age at child birth (odds ratio [OR], 2.6; 95% CI, 1.9–3.2) and poverty (OR, 2.5; 95% CI, 1.6–3.4) were independently associated with increased risk of maternal death. Presence of complications during antenatal period was an important predictor of maternal death (OR, 7.8; 95% CI, 6.8–8.8). Childbirth at home (OR, 4.4; 95% CI, 3.3–5.5) was associated with increased risk of maternal death. The study provides clear evidence for renewed program efforts and strategies for reducing complications and maternal deaths.
    Link to Source
    Keywords: Maternal Health, India
     
  • Pregnancy-related deaths in rural Rajasthan, India: exploring causes, context, and care-seeking through verbal autopsy
    Iyengar, K., S. D. Iyengar, et al. (2009). Pregnancy-related deaths in rural Rajasthan, India: exploring causes, context, and care-seeking through verbal autopsy. Journal of Health, Population & Nutrition, 27(2): 293-302.
    In 2002-2003, all deaths (n=156) of women aged 15-49 years in a block of southern Rajasthan were investigated to determine the cause of death and care-seeking behaviour. Family members of 156 (98%) of 160 deceased women were interviewed following the comprehensive listing of all deaths among women of reproductive age. Of the 156 deaths, 31 (20%) were pregnancy-related; 77% of these women died during the postpartum period, and 74% of the deaths occurred in the home. Direct and indirect obstetric causes were responsible for 58% and 29% of the deaths respectively; 12% were injury-related deaths. Medical care was sought for 65% of the women, and 29% were hospitalized. Family perception of not being able to afford treatment at distant hospitals was a major barrier to seeking care, and 60% of those who sought care had to borrow money for treatment. Lack of skilled attendance and immediate postpartum care were major factors contributing to deaths. Improved access to emergency obstetric care facilities in rural areas and steps to eliminate costs at public hospitals would be crucial to prevent pregnancy-related deaths.
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    Keywords: Maternal Health, India
     
  • Urinary fistulae in Government Rajaji Hospital, Madurai
    Logambal, A. and Poongodi, R. (Unpublished). (1989). Urinary fistulae in Government Rajaji Hospital, Madurai
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    Keywords: Statistics, Asia, India
     
  • Vesical fistulae – an experience from a developing country
    Raut, V & Bhattacharya, M. (1993). Vesical fistulae – an experience from a developing country. Journal of Postgraduate Medicine, 39, 20-21
    This study looked at the records 62 cases of vesicovaginal fistula from 1981-1990 at a teaching and refferal hospital in Bombay. 57 of the cases were due to obstructed labor, and of those 57 patients, 44 of had delivered from home. 57 of the patients underwent surgery to repair their fistulae. Repair was succesful in 53 of the cases (87%). The other 4 that were failures were also repeat repairs. One patient died during the repair due to haemorrhage
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    Keywords: Statistics, Obstetric Fistula, Asia, India
     
  • Analysis of genito urinary fistulae
    Swarajylaxmi, K. (1986). Analysis of genito urinary fistulae. Journal of Obstetrics and Gynaecology of India, 36, 1042-1043
    Link to Source
    Keywords: Statistics, Asia, India
     
  • A Study to identify the occurrence of Obstetric Fistula in India
    UNFPA, A Study to identify the occurrence of Obstetric Fistula in India
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    Keywords: Programs, Asia, Obstetric Fistula, India
     

Jordan

Kenya

Kuwait

Liberia

Madagascar

Malawi

Mali

Mexico

Morocco

  • Vesico-vaginal fistulas: About 1050 cases
    Benchekroun, A., et al. (2003). Vesico-vaginal fistulas: About 1050 cases. Annales d’Urologie, 37(4), 194-19
    This study covers the authors’ experience with 1050 cases of fistula over 30 years in Morocco. The authors used the Benchekroun’s classification system based on site of the fistula to describe the different types of fistula: ureto-vaginal fistula or type I (30%); cervico-vaginal fistula or type II (22%); vesico-vaginal fistula or type III(48%). Most of the fistulas were due to obstetric causes (93%). There were associated lesions detected in 10.4% of cases (uterine, ureteral and rectal). The doctors waited the prescribed 3 months after the development of a fistula to perform a repair. Uerto-vaginal fistulas were repaired using a low approach and requiring urethral refection in 100 cases, were only successful in 60% of cases. Cervico-vaginal fistulas, usually treated through a low approach (80%), had a higher success rate of 80%. Vesico-vaginal fistulas were nearly always repaired (98%) after two procedures. The overall results are good in 80% of cases. The failures concerned in majority the complex vesico-vaginal fistulas type I, are treated by urinary diversion (51 Coffey, 5 Bricker) and since 1975, 73 continent ileocecal or ileal bladders using Benchekrouns' technique.
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    Keywords: Clinical Information, Morocco
     

Nepal

Niger