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Resources by Programmatic Keywords

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

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Assessment

Classification

  • The classification of obstetric vesico-vaginal fistulas: A call for an evidence-based approach
    Arrowsmith, S.D. (2007). The classification of obstetric vesico-vaginal fistulas: A call for an evidence-based approach. International Journal of Gynaecology and Obstetrics, 99(1), S25-S27
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    Keywords: Clinical Information, Obstetric Fistula, Classification, Nigeria
     
  • A new classification for female genital tract fistula
    Goh, J. (2004). A new classification for female genital tract fistula. Australian and New Zealand Journal of Obstetrics and Gynaecology, 44, 502-504.
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    Keywords: Clinical Information, Classification
     
  • Surgical classification of obstetric fistulas.
    Waaldijk, K. (1995). Surgical classification of obstetric fistulas. International Journal of Gynaecology & Obstetrics, 49(2), 161-163
    Objective: To develop a surgical classification for obstetric fistulas in order to compare surgical techniques and results. Methods: Based on a retrospective analysis of 775 consecutive fistula patients, the following classification is presented: (type I) fistulas not involving the urethral closing mechanism; (type II) fistulas involving the urethral closing mechanism; and (type III) ureter and other exceptional fistulas. Type II fistulas can be further divided into: (A) without (sub)total urethra involvement, and (B) with (sub)total urethra involvement; and (a) without a circumferential defect, and (b) with a circumferential defect. This classification was applied prospectively in over 2700 consecutive fistula patients. Results: The surgical technique becomes progressively more complicated from type I through type IIBb. The results of closure and continence worsen progressively from type I through type IIBb. Personal experience in the case of type III fistulas is very limited. Conclusion: This classification enables a systematic comparison of different surgical techniques and an objective evaluation of results from different centers.
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    Keywords: Clinical Information, Classification, West Africa, Obstetric Fistula, Nigeria
     

Clinical Information

Iatrogenic Fistula

Maternal Health

  • Democratic Republic of Congo: Mass rape: Time for remedies
    Amnesty International. (2004). Democratic Republic of Congo: Mass rape: Time for remedies. Retrieved June 15, 2005 from http://web.amnesty.org/library/pdf/AFR620182004ENGLISH/$File/AFR6201804.pdf
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    Keywords: Maternal Health, West Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Democratic Republic of Congo: The struggle for health care and justice for rape survivors
    Amnesty International. (no date). Democratic Republic of Congo: The struggle for health care and justice for rape survivors. Retrieved March 16, 2005 from http://web.amnesty.org/actforwomen/stories-15-eng.
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    Keywords: Maternal Health, West Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Liberia: No impunity for rape—a crime against humanity and a war crime
    Amnesty International. (2004). Liberia: No impunity for rape—a crime against humanity and a war crime. Retrieved May 27, 2005 from http://web.amnesty.org/library/index/engafr340172004
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    Keywords: Maternal Health, West Africa, Traumatic Fistula, Liberia
     
  • Rwanda: The enduring legacy of the genocide and war
    Amnesty International. (2004). Rwanda: The enduring legacy of the genocide and war. Retrieved May 27, 2005 from http://web.amnesty.org/library/index/engafr470082004
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    Keywords: Maternal Health, Eastern and Southern Africa, Traumatic Fistula, Rwanda
     
  • Sudan—Darfur: Rape as a weapon of war: Sexual violence and its consequences
    Amnesty International. (2004). Sudan—Darfur: Rape as a weapon of war: Sexual violence and its consequences. Retrieved May 26, 2005 from http://web.amnesty.org/library/index/engafr540762004.
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    Keywords: Maternal Health, West Africa, Traumatic Fistula, Sudan
     
  • Women, violence, and health
    Amnesty International. 2005. Women, violence, and health. Retrieved May 11, 2005 from http://web.amnesty.org/library/print/ENGACT770012005
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    Keywords: Maternal Health, Traumatic Fistula
     
  • 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
     
  • Adventures in Arabian obstetrics
    Bickers, W.M. (1977). Adventures in Arabian obstetrics. Southern Medical Journal, 70(9), 1109-1111
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    Keywords: Maternal Health
     
  • Maternal Mortality at the Central Hospital, Benin City Nigeria: A Ten Year Review
    Abe, E. and L. O. Omo-Aghoja (2008). Maternal Mortality at the Central Hospital, Benin City Nigeria: A Ten Year Review. African Journal of Reproductive Health, 12(3): 17-26.
    Maternal mortality remains a major challenge in Nigeria. This retrospective study was conceptualized to document the number and pattern of obstetric deaths at the Central Hospital, Benin City, over a ten year period, to identify common causes of maternal deaths and proffer relevant interventions. The overall maternal mortality ratio (MMR) was 518/100,000. MMR was 30 times higher in unbooked as compared to the booked patients, while 60% of maternal deaths occurred within 24 hours of admission. The leading direct causes of maternal deaths were sepsis, hemorrhage, obstructed labor and preeclampsia/ eclampsia, while the major indirect causes are institutional difficulties and anaemia. Low literacy, high poverty levels, extremes of parity and non-utilization of maternity services were associated with maternal mortality. Recommendations are made for public enlightenment campaign and advocacy activities aimed at mobilizing resources for reducing maternal mortality. Also, female education and poverty alleviation programmes will contribute to the reduction of the burden of maternal mortality (Afr J Reprod Health 2008; 12[3]:17-26).
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    Keywords: Maternal Health, Programs, Nigeria
     
  • Factors associated with maternal mortality in Sub-Saharan Africa: an ecological study
    Alvarez, Jose Luis, Ruth Gil, Valentin Hernandez, and Angel Gil (2009). Factors associated with maternal mortality in Sub-Saharan Africa: an ecological study. BMC Public Health, 9(462)
    Background: Maternal health is one of the major worldwide health challenges. Currently, the unacceptably high levels of maternal mortality are a common subject in global health and development discussions. Although some countries have made remarkable progress, half of the maternal deaths in the world still take place in Sub-Saharan Africa where little or no progress has been made. There is no single simple, straightforward intervention that will significantly decrease maternal mortality alone; however, there is a consensus on the importance of a strong health system, skilled delivery attendants, and women's rights for maternal health. Our objective was to describe and determine different factors associated with the maternal mortality ratio in Sub- Saharan countries. Methods: An ecological multi-group study compared variables between many countries in Sub- Saharan Africa using data collected between 1997 and 2006. The dependent variable was the maternal mortality ratio, and Health care system-related, educational and economic indicators were the independent variables. Information sources included the WHO, World Bank, UNICEF and UNDP. Results: Maternal mortality ratio values in Sub-Saharan Africa were demonstrated to be high and vary enormously among countries. A relationship between the maternal mortality ratio and some educational, sanitary and economic factors was observed. There was an inverse and significant correlation of the maternal mortality ratio with prenatal care coverage, births assisted by skilled health personnel, access to an improved water source, adult literacy rate, primary female enrolment rate, education index, the Gross National Income per capita and the per-capita government expenditure on health. Conclusions: Education and an effective and efficient health system, especially during pregnancy and delivery, are strongly related to maternal death. Also, macro-economic factors are related and could be influencing the others.
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    Keywords: Maternal Health, easter-and-southern africa, West Africa
     
  • Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development.
    Bangser, M., et al. (2010). Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development. International Urogynecology Journal, Online First™, 27 August 2010.
    Authors sought evidence from the testimonies of women living with fistula regarding local risk factors for fistula and the impact of fistula on women's lives. One hundred thirty-seven women recruited from health facilities and at the community level in Tanzania and Uganda were interviewed using quantitative and qualitative methods, including participatory approaches. Women of all ages and parties endured fistula. The testimonies illustrated that physical, socio-economic and cultural constraints, as well as health system failures, led to fistula, and the condition imposed harsh consequences on women's lives. Constraints included deficient maternal health services and personnel, delays in seeking and accessing care, and limited fistula repair services. Women endured severe social stigma and severe economic hardships. Participants' testimonies expand current understanding of women's experience of fistula and point to recommendations that could improve maternal health care, reduce women's risk of fistula, and improve the lives of women living with the condition.
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    Keywords: Maternal Health, Obstetric Fistula, Statistics, Eastern and Southern Africa, Tanzania, Uganda
     
  • Current practices in treatment of female genital fistula: a cross sectional study
    Arrowsmith, S., Ruminjo, R., and Landry, E. (2010). Current practices in treatment of female genital fistula: a cross sectional study. BMC Pregnancy and Childbirth, 10(73), 1-32.
    Every year, more than 500,000 women die in childbirth, mostly in resource-poor countries. Those who survive often suffer from severe and long-term morbidities. One of the most devestating injuries is obstetric fistula, occurring most often in south Asia and sub-Saharan Africa. Fistula treatment and care are available in many countries across Africa and Asia, but there is a lack of reliable data around clinical factors associated with the success of fistula repair surgery. Most published research has been retrospective. While these studies have provided useful information about the care and treatment of fistula, they are limited by the design. This study was designed to identify practices in care that could lead to the design of prospective and randomized controlled trials.
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    Keywords: Obstetric Fistula, Maternal Health, Clinical Information, Eastern and Southern Africa, West Africa, Asia
     
  • Strategies for reducing maternal mortality: getting on with what works
    Campbell, O.M.R., and W.J. Graham, 2006. Strategies for reducing maternal mortality: getting on with what works. The Lancet 368: 1284-1299.
    The concept of knowing what works in terms of reducing maternal mortality is complicated by a huge diversity of country contexts and of determinants of maternal health. Here we aim to show that, despite this complexity, only a few strategic choices need to be made to reduce maternal mortality. We begin by presenting the logic that informs our strategic choices. This logic suggests that implementation of an eff ective intrapartum-care strategy is an overwhelming priority. We also discuss the alternative confi gurations of such a strategy and, using the best available evidence, prioritise one strategy based on delivery in primary-level institutions (health centres), backed up by access to referral-level facilities. We then go on to discuss strategies that complement intrapartum care. We conclude by discussing the inexplicable hesitation in decision-making after nearly 20 years of safe motherhood programming: if the fi fth Millennium Development Goal is to be achieved, then what needs to be prioritised is obvious. Further delays in getting on with what works begs questions about the commitment of decision-makers to this goal.
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    Keywords: Maternal Health
     
  • Indications for caesarean delivery between 1955 and 2005
    Bregar, A. T., Cerar, V. M., Slavec, Z. Z., Verdenik, I. (2008). Indications for caesarean delivery between 1955 and 2005. Wien Klin Wochenschr. 120. 761-765
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    Keywords: Maternal Health, Prevention, Slovenia
     
  • Neglected maternity: making a difference
    Chamberlain, J. (2003). Neglected maternity: making a difference. Journal of Obstetrics and Gynaecology Canada, 25(2), 90-1, 92-93
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    Keywords: Maternal Health, Obstetric Fistula
     
  • 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
     
  • Promoting sexual and reproductive health advances maternal health
    Cohen, S.A. (2009). Promoting sexual and reproductive health advances maternal health. Guttmacher Policy Review, 12(2), 8-12.
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    Keywords: Maternal Health, Prevention
     
  • A global fund for the health MDGs?
    Cometto, G., et al. (2009). A global fund for the health MDGs? The Lancet, 373. MH
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    Keywords: Maternal Health
     
  • Global burden of obstructed labour in the year 2000
    Dolea, C., & AbouZahr, C. (July, 2003). Global burden of obstructed labour in the year 2000. Evidence and Information for Policy (EIP), World Health Organization, Geneva
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Maternal morbidities affect tens of millions
    Finger, W.R. (1994). Maternal morbidities affect tens of millions. Family Health International Network, 14(3), 8-11
    Research finds that maternal morbidities, from life-threatening complications to simple discomforts, are far more prevalent than previously believed. The preliminary findings from a five-country study by FHI reveal that approximately 7 of every 10 women report a health problem related to their last pregnancy. While obstructed labour, complications from unsafe abortions and bacterial infections cause the most significant injury, anemia, hemorrhage and eclampsia are also common. Preliminary results show that for each maternal death, 240 to 340 women suffer from maternal morbidities. These findings could bring new attention to this problem, which has been largely neglected thus far, partly due to improper or lack of measurement. A serious chronic condition called obstetric fistula, which leads to urinary or fecal incontinence, occurs most commonly after prolonged, obstructed labour. Studies have found that limited access to emergency care and community norms contributes to this condition, and that women who suffer from fistula tend to be young. Repair for this debilitating condition is possible. Less serious morbidities, however, are less studied. In the study by FHI, and other studies underway, women (and not health care providers) are being asked about their morbidities. Contrary to expectations, women were willing to speak openly about their ailments. While measuring maternal morbidity is complicated, it has certain advantages over measuring mortality, since a woman is being asked for information about herself and not a deceased woman. A recent DHS Safe Motherhood Project in the Philippines has tested the accuracy of community-based surveys, and finds that women are fairly accurate in problem recognition and perception of their illness. Once completed, the results of these studies will bring to the fore the true magnitude of the problem of maternal morbidities, and will hopefully lead to much-needed action.
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    Keywords: Maternal Health, Obstetric Fistula, Philippines
     
  • A global fund for the health MDG’s
    Giorgio, C., et al. (2009). A global fund for the health MDG’s. Lancet, 373, 1500-1502.
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    Keywords: Maternal Health
     
  • 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
     
  • Childbearing, health and social priorities: a survey of 22,774 consecutive hospital births in Zaria, Northern Nigeria
    Harrison, K.A. (1985) Childbearing, health and social priorities: a survey of 22,774 consecutive hospital births in Zaria, Northern Nigeria. British Journal of Obstetrics and Gynaecology, Supplement 5, 119
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    Keywords: Statistics, Maternal Health, Obstetric Fistula, West Africa, Nigeria
     
  • Still too far to walk: Literature review of the determinants of delivery service use.
    Gabrysch, Sabine & Campbell, Oona MR (2009). Still too far to walk: Literature review of the determinants of delivery service use. BMC Pregnancy & Childbirth, 9(34).
    Background: Skilled attendance at childbirth is crucial for decreasing maternal and neonatal mortality, yet many women in low- and middle-income countries deliver outside of health facilities, without skilled help. The main conceptual framework in this field implicitly looks at home births with complications. We expand this to include “preventive” facility delivery for uncomplicated childbirth, and review the kinds of determinants studied in the literature, their hypothesized mechanisms of action and the typical findings, as well as methodological difficulties encountered. Methods: We searched PubMed and Ovid databases for reviews and ascertained relevant articles from these and other sources. Twenty determinants identified were grouped under four themes: (1) sociocultural factors, (2) perceived benefit / need of skilled attendance, (3) economic accessibility and (4) physical accessibility. Results: There is ample evidence that higher maternal age, education and household wealth and lower parity increase use, as does urban residence. Facility use in the previous delivery and antenatal care use are also highly predictive of health facility use for the index delivery, though this may be due to confounding by service availability and other factors. Obstetric complications also increase use but are rarely studied. Quality of care is judged to be essential in qualitative studies but is not easily measured in surveys, or without linking facility records with women. Distance to health facilities decreases use, but is also difficult to determine. Challenges in comparing results between studies include differences in methods, context-specificity and the substantial overlap between complex variables. Conclusions: Studies of the determinants of skilled attendance concentrate on sociocultural and economic accessibility variables and neglect variables of perceived benefit/need and physical accessibility. To draw valid conclusions, it is important to consider as many influential factors as possible in any analysis of delivery service use. The increasing availability of georeferenced data provides the opportunity to link health facility data with large-scale household data, enabling researchers to explore the influences of distance and service quality.
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    Keywords: Maternal Health, Prevention
     
  • Building capacity for anaesthesia in low resource settings
    Grady K (2009). Building capacity for anaesthesia in low resource settings. BJOG;116 (Suppl. 1):15–17.
    Direct causes of maternal deaths are responsible for about 80% of maternal mortality in developing regions of the world. Death from any one of these can be prevented by the use of relatively inexpensive, simple medical interventions which includes the use of anesthesia and anesthetic techniques. Lack of anesthetic care and anesthesia has been recognized as a limiting factor to successful provision of life saving interventions that could prevent maternal deaths in low resource settings. Doctor anesthetists are few and the anesthetic care has been adequately provided by non doctor anesthetist in many of these settings. Increasing the numbers of non doctor anesthetists and strengthening their capacity where they exist, is a strategy which will contribute to maternal mortality reduction in such settings. Several UK based organizations have contributed to increasing the capacity to deliver anesthesia in developing countries over the past 15-20 years. Learning from their experiences, a high level of training in anesthesia for non doctors can be introduced or existing programmes improved upon. This article proposes a mechanism to achieve this through national and international links for resource poor settings.
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    Keywords: Maternal Health
     
  • 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.
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    Keywords: Maternal Health, India
     
  • La violence sexuelle a l’est de la RDC en periode de conflit. Particularités et conséquences médicales
    Kalume, M. A., et al. (2004). La violence sexuelle a l’est de la RDC en periode de conflit. Particularités et conséquences médicales. Congo Medical Journal, 8(13), 1176–1182
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    Keywords: Maternal Health, Traumatic Fistula, Eastern and Southern Africa, rep-dem-congo
     
  • Vesico-vaginal fistulae
    Kelly, J. Vesico-vaginal fistulae. In: Studd, J. (Ed.). (1983). Progress in Obstetrics and Gynaecology, London: Churchill Livingston, 324-333
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    Keywords: Maternal Health
     
  • The use of ultrasonography in obstetrics in developing countries
    Kongnyuy, E. J., & van den Broek, N. (April, 2007). The use of ultrasonography in obstetrics in developing countries. Tropical Doctor, 70-72
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    Keywords: Maternal Health, Obstetric Fistula
     
  • New paradigm old thinking: the case for emergency obstetric care in the prevention of maternal mortality in Nigeria
    498. Ijadunola, K., M. Ijadunola, et al (2010). New paradigm old thinking: the case for emergency obstetric care in the prevention of maternal mortality in Nigeria. BMC Women's Health 10(1): 6.
    Background: The continuing burden of maternal mortality, especially in developing countries has prompted a shift in paradigm from the traditional risk assessment approach to the provision of access to emergency obstetric care services for all women who are pregnant. This study assessed the knowledge of maternity unit operatives at the primary and secondary levels of care about the concept of emergency obstetric care (EmOC) and investigated the contents of antenatal care (ANC) counseling services they delivered to clients. It also described the operatives’ preferred strategies and practices for promoting safe motherhood and averting maternal mortality in South-west Nigeria. Methods: The study population included all the 152 health workers (doctors, midwives, nurses and community health extension workers) employed in the maternity units of all the public health facilities (n = 22) offering maternity care in five cities of 2 states. Data were collected with the aid of a self-administered, semi-structured questionnaire and non-participant observation checklist. Results were presented using descriptive statistics. Results: Ninety one percent of the maternity unit staff had poor knowledge concerning the concept of EmOC, with no difference in knowledge of respondents across age groups. While consistently more than 60% of staff reported the inclusion of specific client-centered messages such as birth preparedness and warning/danger signs of pregnancy and delivery in the (ANC) delivered to clients, structured observations revealed that less than a quarter of staff actually did this. Furthermore, only 40% of staff reported counseling clients on complication readiness, but structured observations revealed that no staff did. Only 9% of staff had ever been trained in lifesaving skills (LSS). Concerning strategies for averting maternal deaths, 70% of respondents still preferred the strengthening of routine ANC services in the health facilities to the provision of access to EmOC services for all pregnant women who need it. Conclusion: We concluded that maternity unit operatives at the primary and secondary care levels in South-west Nigeria were poorly knowledgeable about the concept of emergency obstetric care services and they still prioritized the strengthening of routine antenatal care services based on the risk approach over other interventions for promoting safe motherhood despite a global current shift in paradigm. There is an urgent need to reorientate/ retrain the staff in line with global best practices.
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    Keywords: Maternal Health, Prevention, nigera
     
  • Obstetric care in low-resource settings: What, who, and how to overcome challenges to scale up?
    Hofmeyr, G. J., R. A. Haws, et al. (2009). Obstetric care in low-resource settings: What, who, and how to overcome challenges to scale up?, International Journal of Gynecology & Obstetrics, 107(Supplement 1): S21-S45.
    Each year, approximately 2 million babies die because of complications of childbirth, primarily in settings where effective care at birth, particularly prompt cesarean delivery, is unavailable. Objective: We reviewed the content, impact, risk-benefit, and feasibility of interventions for obstetric complications with high population attributable risk of intrapartum-related hypoxic injury, as well as human resource, skill development, and technological innovations to improve obstetric care quality and availability. Results: Despite ecological associations of obstetric care with improved perinatal outcomes, there is limited evidence that intrapartum interventions reduce intrapartum-related neonatal mortality or morbidity. No interventions had high-quality evidence of impact on intrapartum-related outcomes in low-resource settings. While data from high-resource settings support planned cesarean for breech presentation and post-term induction, these interventions may be unavailable or less safe in low-resource settings and require risk-benefit assessment. Promising interventions include use of the partograph, symphysiotomy, amnioinfusion, therapeutic maneuvers for shoulder dystocia, improved management of intra-amniotic infections, and continuous labor support. Obstetric drills, checklists, and innovative low-cost devices could improve care quality. Task-shifting to alternative cadres may increase coverage of care. Conclusions: While intrapartum care aims to avert intrapartum-related hypoxic injury, rigorous evidence is lacking, especially in the settings where most deaths occur. Effective care at birth could save hundreds of thousands of lives a year, with investment in health infrastructure, personnel, and research—both for innovation and to improve implementation.
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    Keywords: Maternal Health
     
  • 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
     
  • Sub-Saharan Africa's Mothers, Newborns, and Children: Where and Why Do They Die?
    Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, et al. (2010). Sub-Saharan Africa's Mothers, Newborns, and Children: Where and Why do they Die? Public Library of Science Medicine. 7(6), 1-9.
    The aim of this paper is to present the current situation in sub-Saharan Africa for mothers, newborns, and children under age 5 years--including the progress towards the MDGs for maternal and child health, why and where deaths occur, what known interventions can be employed to prevent these deaths, and current coverage of these interventions. All data used in this review are from the most recent UN databases, national household surveys, and peer-reviewed papers where appropriate, which are referenced accordingly.
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    Keywords: Maternal Health, Statistics, Eastern and Southern Africa, West Africa
     
  • Kenya: A Preventable Childbirth Injury That Ruins Lives
    HRW. (2010). “Kenya: A Preventable Childbirth Injury That Ruins Lives” Retrieved October 18, 2010 from http://www.hrw.org/en/news/2010/07/15/kenya-preventable-childbirth-injury-ruins-lives.
    Tens of thousands of Kenyan women and girls suffer from obstetric fistula, a childbirth injury causing leakage of urine and feces, a direct result of inadequate health services and failed government policies, Human Rights Watch said in a report released today.
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    Keywords: Maternal Health, Eastern and Southern Africa, Kenya, Assessment
     
  • Regional and geographical variations in infertility: effects of environmental, cultural, and socioeconomic factors
    Leke, R.J., et al. (1993). Regional and geographical variations in infertility: effects of environmental, cultural, and socioeconomic factors. Environmental Health Perspectives, 101(2), 73-80.
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Maternal morbidity in developing countries: a review and comments
    Liskin, L.S. (1992). Maternal morbidity in developing countries: a review and comments. International Journal of Gynaecology and Obstetrics, 37, 77-87.
    There is very little published data regarding maternal morbidity rates. The most commonly cited estimate, 16 cases of maternal morbidity to each maternal death, is from a study published in 1980 of 270 women in a small Indian village. The different types of illnesses associated with maternal morbidity are also not completely agreed upon. The author groups the different types of illnesses into 3 categories: 1) short term, acute complications (ie obstructed labor, infection), 2) chronic complications (ie fistulas) 3) associated illnesses (malaria, hepatitis). The author then goes into greater detail on each complication.
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Child mortality 30 years after the Alma-Ata Declaration
    Loaiza E, Wardlaw T, Salama P. (2008). Child mortality 30 years after the Alma-Ata Declaration. Lancet, 372, 874–76
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    Keywords: Maternal Health
     
  • Reducing maternal mortality in Kigoma, Tanzania
    Mbaruku, G., & Bergstrom, S. (1995). Reducing maternal mortality in Kigoma, Tanzania. Health Policy and Planning, 10, 71-78.
    The maternal mortality rate in Tanzania has been estimated at 350 deaths per 100,000 live births. Studies have indicated that the region of Kigoma has one of the highest maternal mortality rates. The purpose of this study was to review data from available sources (predominately the Regional Hospital) on maternal mortality from over a period of three years (1984-1986) and then based on that data, come up with an intervention strategy. The main causes of admission to the Department of Obstetrics and Gynaecology were malaria, anaemia and pelvic infection. Sepsis and septic abortion also made up significant proportions of admissions. An analysis of the contributory causes to maternal deaths was also undertaken. There was a shortage of basic equipment, and water. Staff attitudes were also assessed, and it was noted that there was a “deplorable indifference” towards patients. Patients were also dissatisfied with the treatment received. In the ‘discussion’ section, the authors also mention the critical importance of addressing staff attitudes and staff morale, through improved training, collective problem-solving, and improved working environments.
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    Keywords: Maternal Health, Eastern and Southern Africa, Obstetric Fistula, Tanzania
     
  • A framework for analyzing the determinants of maternal mortality
    McCarthy, J., & Maine, D. (1992). A framework for analyzing the determinants of maternal mortality. Studies in Family Planning, 23(1), 23-33
    The authors state that the framework that they developed can be used for maternal morbidity as well as mortality. The framework is made up of three parts: 1. Distant determinants (socioeconomic and cultural factors), 2. Intermediate determinants (health status, reproductive status, access to health services, and health care behavior/use of health services), and 3. Outcomes (pregnancy, complication, death/disability). The article goes into greater detail for each of these determinants. By using this framework in research, it can clarify how distant and intermediate factors, including social, behavioral and biological, can influence the outcome. By that same token, the framework can be of assistance in program design. One of the main conclusions was that efforts to reduce maternal mortality must done through one of the 3 intermediate outcomes: 1) To reduce the likelihood that a women will get pregnant 2) To reduce that likelihood that a pregnant women will experience serious complication of pregnancy or delivery 3) To improve the outcomes for women who do experience complications.
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Reproductive maternal morbidity
    Mtimavaiye, L. (Unpublished). (1989). Reproductive maternal morbidity
    Link to Source
    Keywords: Maternal Health
     
  • Caesarean sections on the rise
    Muraleedharan, V. R. (December, 1999). Caesarean sections on the rise. The National Medical Journal of India, Vol 13. 46
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    Keywords: Maternal Health, Prevention
     
  • Obstructed Labour
    Nielson, J.P., et al. (2003). Obstructed Labour. British Medical Journal, 67, 191-204
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates
    Prual, A. et al. (2000). Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Bulletin of the World Health Organization, 78(5), 593-602
    In West Africa, the maternal mortality rates are estimated at 1020 deaths per 100,000 births, 38 times higher than in developed countries. Morbidity data is very difficult to assess, so the authors conducted a multicentre, prospective, population-based study to measure the incidence of maternal morbidity and the predictive value of risk factors screened during prenatal care sessions. This study was conducted between December 1994 and June 1996 in sites in Burkina Faso, Cote d’Ivoire, Mali, Mauritania, Niger and in Senegal. Severe hemorrhage was the most frequent direct cause of severe obstetric morbidity. The second most common cause was severe dystocia (difficult labor). They found that there was a general ratio of 1 death for 32 cases of severe morbidity. Given that these rates are based on hospital data, it is likely an underestimation.
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    Keywords: Maternal Health, West Africa, Obstetric Fistula
     
  • L’activité obstétricale d’un centre hospitalier regional an Nord de la Côte d’Ivoire
    Ribault, L. (1989). L’activité obstétricale d’un centre hospitalier regional an Nord de la Côte d’Ivoire. Revue française de Gynaecologie et Obstetrie, 84(5), 377-379
    Link to Source
    Keywords: Maternal Health, West Africa, Cote d'Ivoire
     
  • Making motherhood safe in developing countries
    Rosenfield, A., et al. (2007). Making motherhood safe in developing countries. The New England Journal of Medicine, 356(14), 1395-1397
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    Keywords: Maternal Health, Prevention, Kenya
     
  • National data system on near miss and maternal death: shifting from maternal risk to public health impact in Nigeria
    Oladapo, O., O. Adetoro, et al. (2009). National data system on near miss and maternal death: shifting from maternal risk to public health impact in Nigeria. Reproductive Health 6(1): 8.
    The lack of reliable and up-to-date statistics on maternal deaths and disabilities remains a major challenge to the implementation of Nigeria's Road Map to Accelerate the Millennium Development Goal related to Maternal Health (MDG-5). There are currently no functioning national data sources on maternal deaths and disabilities that could serve as reference points for programme managers, health advocates and policy makers. While awaiting the success of efforts targeted at overcoming the barriers facing establishment of population-based data systems, referral institutions in Nigeria can contribute their quota in the quest towards MDG-5 by providing good quality and reliable information on maternal deaths and disabilities on a continuous basis. This project represents the first opportunity to initiate a scientifically sound and reliable quantitative system of data gathering on maternal health profile in Nigeria.
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    Keywords: Maternal Health, Nigeria
     
  • Non-uptake of facility-based maternity services in an inner-city community in Lagos, Nigeria: An Observational Study
    Olusanya, B. O., et al. (2009). Non-uptake of facility-based maternity services in an inner-city community in Lagos, Nigeria: An Observational Study. J. Biosoc Sci., Cambridge University Press: 1-18.
    Scaling-up of skilled attendants and facility-based services is necessary for improving maternal and child care in developing countries but their effectiveness is crucially influenced by the uptake of such services. This study set out to establish the pattern and uptake of maternity services and associated factors against the backdrop of rapid urbanization in Nigeria. A cross-sectional study of socio-demographic and obstetric characteristics of mothers attending the Bacille Calmette-Guérin (BCG) immunization clinics in inner-city Lagos was conducted from July 2005 to December 2007, and their association with non-hospital delivery and use of unskilled attendants was determined by multiple logistic regression analyses. Of the 6465 participants, over half (51.4%) delivered outside hospital facilities and 81.8% of this group had no skilled attendants at delivery. Non-hospital delivery or the presence of unskilled attendants at delivery was associated with teenage mothers, Muslim religion, low or middle social class and use of herbal drugs in pregnancy. Additionally, non-hospital delivery was associated with ethnicity (Yoruba tribe), lack of tertiary education or full-time employment, accommodation with shared sanitation facilities and multiparity. The results suggest that availability of and access/proximity to hospital facilities or skilled attendants is no guarantee of uptake of maternity services. Efforts aimed at improving maternal and child health in developing countries should take cognisance of the socio-demographic and cultural underpinnings of maternal health-seeking behaviour of urban mothers beyond the provision of facility-based services or strengthening of the existing health care systems.
    Link to Source
    Keywords: Maternal Health, Nigeria
     
  • Obstetric fistula and the challenge to maternal health care systems
    Ruminjo, J.K. (2007). Obstetric fistula and the challenge to maternal health care systems. IPPF Medical Bulletin, 41(4), 3-4
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Averting maternal death and disability: What do doctors think their caseload should be to maintain their skills for delivery care?
    Scotland, G.S., & Bullogh C.H. W. (July, 2004).Averting maternal death and disability: What do doctors think their caseload should be to maintain their skills for delivery care? International Journal of Gynaecology and Obstetrics, 87, 301-307
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    Keywords: Maternal Health
     
  • Has donor prioritization of HIV/AIDS displaced aid for the other health issues?
    Shiffman, J. (2008).Has donor prioritization of HIV/AIDS displaced aid for the other health issues?. Health Policy Plan, 23, 95-100
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    Keywords: Maternal Health
     
  • The state of political priority for safe motherhood in Nigeria
    Shiffman, J., & Okonofua, F.E. (2007). The state of political priority for safe motherhood in Nigeria. International Journal of Obstetrics and Gynaecology, 114, 127-133
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    Keywords: Maternal Health, West Africa, Prevention, Nigeria
     
  • Recommendations for Routine Reporting on Indications for Cesarean Delivery in Developing Countries
    Stanton, C, Ronsmans, C., Baltimore Group on Cesarean. (September, 2008). Recommendations for Routine Reporting on Indications for Cesarean Delivery in Developing Countries. Birth, 35(3), 204-211
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    Keywords: Maternal Health, Prevention
     
  • The untold story: how the health care systems in developing countries contribute to maternal mortality
    Sundari, T.K. (1992). The untold story: how the health care systems in developing countries contribute to maternal mortality. International Journal of Health Services, 22(3), 513-528
    This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.
    Link to Source
    Keywords: Maternal Health, Obstetric Fistula
     
  • Too far to walk: maternal mortality in context
    Thaddeus, S. & Maine, D. (1994). Too far to walk: maternal mortality in context. Social Science & Medicine, 38(8), 1091-1110
    Following an in-depth description of the three-delay model, the authors discuss their findings in the context of program strategies. To impact the factors of distance and cost, they stress the need for governments to improve the distribution and financing of medical care. In terms of distance alone, maternity waiting homes close to the hospital are often a possibility, as are programs to help community members plan ahead for transportation to a facility with emergency care. Although all health facilities cannot treat obstetric complications, the provision of first aid to women with complications, at every facility, can also be an effective strategy. In large hospitals, actions such as proper maintenance and repair of equipment, training programs, and expanding roles for nurses and midwives are mentioned as illustrations of simple interventions that can improve quality of care. Recognition of danger signs during pregnancy, labor and delivery can be addressed through community level programs. Refer to the article for more details, and for information on how the findings of this research were applied in the strategies of the PMM Program.
    Link to Source
    Keywords: Maternal Health, Nigeria, Sierra Leone, West Africa
     
  • How Increased Contraceptive Use has Reduced Maternal Mortality
    Stover, John and John Ross (2009). How Increased Contraceptive Use has Reduced Maternal Mortality. Maternal and Child Health Journal.
    It is widely recognized that family planning contributes to reducing maternal mortality by reducing the number of births and, thus, the number of times a woman is exposed to the risk of mortality. Here we show evidence that it also lowers the risk per birth, the maternal mortality ratio (MMR), by preventing high-risk, high-parity births. This study seeks to quantify these contributions to lower maternal mortality as the use of family planning rose over the period from 1990 to 2005. We use estimates from United Nations organizations of MMRs and the total fertility rate (TFR) to estimate the number of births averted— and, consequently, the number of maternal deaths directly averted—as the TFR in the developing world dropped. We use data from 146 Demographic and Health Surveys on contraceptive use and the distribution of births by risk factor, as well as special country data sets on the MMR by parity and age, to explore the impacts of contraceptive use on high-risk births and, thus, on the MMR. Over 1 million maternal deaths were averted between 1990 and 2005 because the fertility rate in developing countries declined. Furthermore, by reducing demographically high-risk births in particular, especially high-parity births, family planning reduced the MMR and thus averted additional maternal deaths indirectly. This indirect effect can reduce a county’s MMR by an estimated 450 points during the transition from low to high levels of contraceptive use. Increases in the use of modern contraceptives have made and can continue to make an important contribution to reducing maternal mortality in the developing world.
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    Keywords: Maternal Health
     
  • Executive summary of Lancet maternal health series
    The Lancet. (2006). Executive summary of Lancet maternal health series. The Lance
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    Keywords: Maternal Health
     
  • Resume analytique, serie publiee par The Lancet sur la survie maternelle
    The Lancet. (2006). Resume analytique, serie publiee par The Lancet sur la survie maternelle. The Lancet. http://www.familycareintl.org/UserFiles/File/Lancet%20MS%20Exec%20Summary%20French.pdf
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    Keywords: Maternal Health, Prevention
     
  • Overcoming health-systems constraints to achieve the Millennium Development Goals
    Travis, P., Bennett, S., Haines, A. (2004). Overcoming health-systems constraints to achieve the Millennium Development Goals. Lancet, 364, 900–06
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    Keywords: Maternal Health, Prevention
     
  • Incidence and Outcome of Caesarean Section in the Private Sector--3-year Experience at Pretoria Gynaecological Hospital
    Tshibangu, K. C., de Jongh M. A., de Villiers, D. J., du Toit, J.J., Shah, S. (December, 2002). Incidence and Outcome of Caesarean Section in the Private Sector--3-year Experience at Pretoria Gynaecological Hospital. South Africa Medical Journal, 92(12), 956-959.
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    Keywords: Maternal Health, Eastern and Southern Africa, Prevention, South Africa
     
  • New and underutilised technologies to reduce maternal mortality and morbidity: what progress have we made since Bellagio 2003?
    Tsu, V.D., & Coffrey, P.S. (2009). New and underutilised technologies to reduce maternal mortality and morbidity: what progress have we made since Bellagio 2003? International Journal of Obstetrics and Gynecology, 116(2), 247-256
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    Keywords: Maternal Health, Prevention
     
  • Maternal health care in the South Western highlands of Tanzania
    Van Roosmalen, J. (Unpublished). (1987). Maternal health care in the South Western highlands of Tanzania. Leiden, 186 p.
    Link to Source
    Keywords: Maternal Health, Eastern and Southern Africa, Tanzania
     
  • The Missing Link: Applied budget work as a tool to hold governments accountable for maternal mortality reduction commitments
    International Budget Partnership and International Initiative on Maternal Mortality and Human Rights. (2009). The Missing Link: Applied budget work as a tool to hold governments accountable for maternal mortality reduction commitments. International Budget Partnership, USA
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Strengthening public health priotiy-setting through research on fistula, maternal health, and health inequities
    Bangser M., Strengthening public health priotiy-setting through research on fistula, maternal health, and health inequities. International Journal of Gynaecology and Obstetrics, 99(1) S16- S20
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    Keywords: Maternal Health, Obstetric Fistula, Eastern and Southern Africa
     
  • Out-of-pocket costs for facility-based maternity
    Perkins M, Brazier E, Themmen E, Out-of-pocket costs for facility-based maternity care in three African countries, Oxford University Press
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    Keywords: Maternal Health, Burkino Faso, Tanzania, Kenya
     

News

  • Restoring girls’ and women’s lives to dignity in Bugando
    Bangser, M., Leonard, D. and Mach, L. (1999). Restoring girls’ and women’s lives to dignity in Bugando. Safe Motherhood: A Newsletter of Worldwide Activity, 27, 6
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    Keywords: News, Eastern and Southern Africa, Reintegration, Tanzania
     
  • Nigeria’s shunned women
    Beauchemin, E. (2002, March). Nigeria’s shunned women. Radio Nederland Wereldomroep. Retrieved March 10, 2005 from http://www2.rnw.nl/rnw/en/features/development/vvf020306.html
    Each segment summarized below is one part of a six-part series on obstetric fistula in Nigeria, by Radio Netherlands. The first part, entitled ‘Trauma of Childbirth’, is inaccessible online. The subsequent five parts are summarized below. The Social Impact of VVF Many people in Nigeria believe that a woman suffers from an obstetric fistula because she has been cursed by someone, she was promiscuous or she offended the gods. Women with VVF are often deserted by their husbands and ostracized from society, and many resort to prostitution and begging for their livelihood. The mental trauma of VVF is enormous. Some women have lived with this condition for decades. The Hospital In a hospital in the northern Nigerian city of Kano, a Dutch surgeon, Dr. Kees Waaldijk, performs fistula repair surgeries. Having repaired over 16,000 women, Dr. Kees is swift and meticulous, and he documents each and every operation he’s ever performed. On this day, he conducted nine surgeries, and pulls out his laptop to document each one. Dr. Kees’ Story Dr. Kees Waaldijk originally came to Africa to work on leprosy, but when he encountered women with VVF in northern Nigeria, he had found his calling. He has often lived without electricity and water, but despite his hardships, enjoys his work and even feels that Allah has brought him to this world for VVF. Rehabilitation Reintegrating into society is not easy for women who have had VVF. At Dambata center, run by the Foundation for Women’s Health Research and Development (FORWARD), women are given psychological counseling and are equipped with literacy and income-generating skills. They often return to their villages empowered with knowledge that they can share with other women. FORWARD also tries to help women reconcile with their husbands when possible. Shelter for VVF Patients The Ministry of Social Affairs runs a shelter for VVF patients to stay while awaiting surgery or recovering from it. They receive skills training, literacy classes, and counseling.
    Link to Source
    Keywords: News, West Africa, Nigeria
     
  • Congo militiamen wreak havoc with rape as a weapon
    Blair, D. 2004 (December 27, 2004). Congo militiamen wreak havoc with rape as a weapon. News Telegraph; retrieved February 23, 2005 from http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2004/12/27/wcongo27.xml&sSheet=/news/2004/12/27/ixworld.html.
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Women, Peace and Security: Responding to the Needs of Victims of Gender-Based Violence
    Ahmed, T. (2004, October 28). Women, Peace and Security: Responding to the Needs of Victims of Gender-Based Violence. UNFPA. N. Retrieved May 11, 2005 from http://www.unfpa.org
    Thoraya Ahmed Obaid, the UNFPA Executive Director, gave this statement as part of the United Nations Security Council Debate on Security Council Resolution 1325, which was passed in 2000 and specifically addressed the impact of war on women, and women’s contributions to conflict resolution and sustainable peace. In a multitude of countries, women and girls, and even men and boys, are still subjected to sexual violence. The effects of sexual violence have long-lasting effects, including fistula, depression, PTSD, becoming infected with STIs or HIV/AIDS. While it has been four years since the adoption of resolution 1325, women continue to experience little peace and security. While the resolution provides a policy framework, it needs to be turned into action. Several concrete actions are outlined, including increasing protection for women at refugee camps, having a minimum initial service package for RH services and implementing programmes that stress the importance of not stigmatizing victims of sexual violence. All these programs need to be funded, which have often gone unheeded by the donor community. The Government of Belgium has funded a program in the DRC, to respond to sexual violence and interventions at all levels.
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    Keywords: News, Traumatic Fistula
     
  • 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
     
  • Hope after Fistula
    Emasu, Alice. (2005, January 25). Hope after Fistula. All Africa. Retrieved February 16, 2005 from http://allafrica.com
    Rebecca has just had an operation at the Soroti hospital to repair her rector-vaginal fistula. While Rebecca did go to a hospital when her labor began and a doctor diagnosed obstructed labour, it took them three days to operate. The operation was only able to contain the faeces, she will need a second operation to repair her bladder. Surgeons at the Soroti hospital have been trained by AMREF. AMREF plans to work with UNFPA to train more doctors to manage fistula. Parts of northern Uganda have higher rates of fistula due to the war. Unfortunately, more than half the women who undergo successful surgery fail to observe the conditions for recovery and most experience a re-occurrence.
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    Keywords: News
     
  • Hope after Fistula
    Emasu, Alice. (2005, January 25). Hope after Fistula. All Africa. Retrieved February 16, 2005 from http://allafrica.com
    Last year, a study that was conducted in Soroti, Masaka and Kasese revealed that the majority of patients suffering from obstetric fistula are girls under the age of 18, who are poor, and who were unable to independently make decisions regarding their own pregnancy, or labor and delivery. Some hope can be found by women afflicted with obstetric fistula in the increased activity of Government and NGO’s to combat the fistula problem. An example of such government intervention was seen last December when six Ugandan hospitals (Mulago, Soroti, Kitovu, Arua, Lacor, and Mbarara) were equipped with doctors and equipment necessary for fistula repair surgery (although not all have begun operating). Some private hospitals like IAA in Kampala have built “charitable wards” where subsidized fees allow for women to receive fistula repair. NGO’s like EngenderHealth and TERREWODE (The Association for the Re-orientation and Rehabilitation of Teso Women for Development) are working to preserve the dignity of mothers suffering from obstetric fistula. Joyce Mary Igwedo (age 42) is an example of one such woman; prior to her surgery (received at a TERREWODE supported hospital) she had suffered from her fistula for over 20 years, and as a result was divorced by her husband, and shunned by both her family and society. While the availability of fistula treatment has improved through increased government and NGO intervention, many women remain untreated because they cannot afford transportation to hospitals, and because of the social stigma associated with fistula, these afflicted women are fearful of using public transportation. To target this issue, TERREWODE provides women with counseling, soap and clean pads, and money for private transport to the hospital. Once women have successfully received fistula repair, TERREWODE helps ease their transition back into society and restore their sense of self worth through the financial support of businesses and projects created by these women.
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    Keywords: News, Uganda
     
  • Publicity will highlight problem of obstetric fistula
    Cole, A. (2006). Publicity will highlight problem of obstetric fistula. BMJ, 333(7557), 8
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    Keywords: News, Obstetric Fistula
     
  • Supporting surgery for obstetric fistula
    Coombes, R. (2004). Supporting surgery for obstetric fistula. British Medical Journal, 329: 1125
    Obstetric fistula is a devastating injury that generally occurs due to prolonged obstructed labor, and renders a woman incontinent of urine and/or feces, and often outcast from society. Poverty is the main risk factor for fistula. The Addis Ababa Fistula Hospital in Ethiopia offers free surgery and rehabilitation to fistula patients, and also trains surgeons from all over the world. WHO and UNFPA have initiatives aimed at fistula prevention and treatment in a number of countries. In Pakistan, professionals were inspired by the Addis model and have raised money to build a hostel for fistula patients. They have also set up surgical camps in rural areas, but progress is slow in a country where there are increasing numbers of women with fistula, and limited attention to this problem. Worldwide, there are an estimated 100,000 new cases of fistula each year, but only about 6,500 are treated.
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    Keywords: News, Obstetric Fistula
     
  • James Marion Sims: some speculations and a new position
    de Costa, CM. (2003). James Marion Sims: some speculations and a new position. Medical Journal of Australia, 178(12), 660-663
    The 19th century US gynecologist James Marion Sims still arouses controversy in the 21st century. Often referred to as the Father of Gynecology for his numerous contributions to the field, feminist writers and social historians criticize his experimentation with female slave’s bodies. After studying medicine, Sims made great progress in the understanding and techniques of obstetric fistula repair by designing a speculum to properly view the fistula, and by practicing surgical techniques on slaves with the condition. These surgeries were performed without anaesthesia, but his patients were agreeable to the surgery. While Sims claimed to have cured the fistula of a slave named Anarcha, and subsequently other women, critics are doubtful. But Sims also contributed to the field of gynecology in other ways, one of which was the opening of a women’s hospital in New York in 1850, which treated women with fistulas as well as other gynecological ailments. In defense of Sims, his pioneering efforts to repair fistulas were crucial at a time when safe childbirth, including cesarean sections, were not readily available to prevent the formation of the fistulas. And while critics claim that he practiced surgery on black women to later benefit wealthy white women, Sims could not have foreseen his subsequent success in the field of gynecology, a specialty that did not yet exist. While it is true that he did not use anaesthesia to perform his surgeries on the female slaves, it was not yet widely available, and many surgeries in those days, on slaves and non-slaves, were performed in the absence of anaesthesia. While Sims’ role in the development of the field of gynecology was indeed very important, the names of the slaves Anarcha, Betsey and Lucy, on whom many surgeries were performed, should also be remembered.
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    Keywords: News
     
  • Tanzania women’s pains of poverty
    Dickinson, D. (2004, January 12). Tanzania women’s pains of poverty. BBC News. Retrieved February 24, 2005 from http://news.bbc.co.uk/
    25 year old Rukia Pendeza is recovering from an operation to repair her fistula which happened during a protracted childbirth when she was just 15. Her father saved a few pennies a day to pay for the $60 operation. It is thought that the number of new fistula cases each year in Tanzania is 1,200. The Women’s Dignity Project, based in Dar es Salaam is an organization dedicated to helping women who have fistula and raising awareness. The Tanzanian government has earmarked money to treat fistula cases.
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    Keywords: News, Eastern and Southern Africa, Tanzania
     
  • Healing for women victims in Congo
    Doctors on Call for Service (DOCS). (2004). Healing for women victims in Congo. Retrieved February 9, 2005 from http://www.docs.org/VVFLeafletMarch04.pdf.
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    Keywords: News, West Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Fistula-A disaster for teenage mothers
    Fistula-A disaster for teenage mothers. (1995). AIDS Analysis Africa, 5(5), 3.
    Link to Source
    Keywords: News
     
  • What are VVF and RVF?
    FORWARD Nigeria. (2004). What are VVF and RVF? Retrieved March 10, 2005 from http://www.forwardnigeria.org/projects/vvf/watsvvf.htm
    FORWARD Nigeria
    Link to Source
    Keywords: News, West Africa
     
  • Silence=Rape
    Goodwin, J. (March 8, 2004). Silence=Rape. The Nation. Retrieved May 27, 2005 from http://www.thenation.com/doc.mhtml?i=20040308&s=goodwin.
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • 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.
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    Keywords: News, Bangladesh, Asia, Obstetric Fistula
     
  • 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
     
  • Human Rights Watch applauds Rwanda rape verdict
    Human Rights Watch (HRW). (September 2, 1998). Human Rights Watch applauds Rwanda rape verdict. HRW press release. Retrieved June 3, 2005 from http://www.hrw.org/press98/sept/rrape902.htm.
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    Keywords: News, Traumatic Fistula, Eastern and Southern Africa, Rwanda
     
  • Seeking justice: The prosecution of sexual violence during the Congo war
    HRW. (2005). Seeking justice: The prosecution of sexual violence during the Congo war. Retrieved June 7, 2005 from http://hrw.org/reports/2005/drc0305/index.htm.
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Struggling to survive: Barriers to justice for rape victims in Rwanda
    HRW. (2004). Struggling to survive: Barriers to justice for rape victims in Rwanda. Retrieved February 9, 2005 from http://www.hrw.org/reports/2004/rwanda0904
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Rwanda
     
  • The Human Rights Watch global report on women’s human rights
    HRW. (1995). The Human Rights Watch global report on women’s human rights. Retrieved June 2, 2005 from http://www.hrw.org/about/projects/womrep/
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    Keywords: News
     
  • The war within the war: Sexual violence against women and girls in eastern Congo.
    HRW. (2002). The war within the war: Sexual violence against women and girls in eastern Congo. Retrieved May 27, 2005 from http://www.hrw.org/reports/2002/drc/
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • ‘We’ll kill you if you cry’: Sexual violence in the Sierra Leone conflict.
    HRW. (2003). ‘We’ll kill you if you cry’: Sexual violence in the Sierra Leone conflict. Retrieved February 28, 2005 from http://hrw.org/reports/2003/sierraleone/sierleon0103.pdf.
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    Keywords: News, West Africa, Traumatic Fistula, Sierra Leone
     
  • 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
     
  • Our bodies—Their battle ground: Gender-based violence in conflict zones.
    Integrated Regional Information Networks (IRIN). (2004). Our bodies—Their battle ground: Gender-based violence in conflict zones. IRIN Web Special. Retrieved May 27, 2005 from http://www.irinnews.org/webspecials/GBV/gbv-webspecial.PDF
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    Keywords: News, Traumatic Fistula
     
  • IMAP statement on the elimination of female genital mutilation
    International Medical Advisory Panel (IMAP). (2007). IMAP statement on the elimination of female genital mutilation. IPPF Medical Bulletin, 41(4), 1
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    Keywords: News
     
  • Where we work: Sierra Leone
    International Medical Corps (IMC). (No Date Given). Where we work: Sierra Leone. Retrieved June 2, 2005 from http://www.imcworldwide.org/loc_sierraLeone.shtml
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    Keywords: News, West Africa
     
  • A damp nightmare: the management of vesico vaginal fistulae in Africa
    Kelly, J. (1987). A damp nightmare: the management of vesico vaginal fistulae in Africa. NAT News, 24(11), 20
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    Keywords: News
     
  • The burden of maternal ill health
    Kelly, J. (1999). The burden of maternal ill health. Safe Motherhood: A Newsletter of Worldwide Activity, 27: 5
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    Keywords: News, Obstetric Fistula, Nigeria, West Africa
     
  • 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
     
  • The danger of obstetric fistula
    Krishnakumar, A. (2004). The danger of obstetric fistula. Frontline-USAID employee newsletter, 21(16)
    There are between 50,000 and 100,000 new cases of fistula worldwide each year. These cases are extensively prevalent in Asia and sub-Saharan Africa. Obstetric fistula is usually the result of obstructed childbirth in young pregnant women. According to Family Care International, pregnancy-related deaths are the leading cause of mortality among 15-19 year olds worldwide. In Niger, 88 percent of women with obstetric fistula were aged between 10-15 at marriage. Child marriage is a major cause of serious health risks for women. Women who are very young going through their first childbirth and women whose growth has been stunted owing to malnutrition and childhood illness are most at risk for fistula.
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    Keywords: News, Obstetric Fistula, Tanzania, Eastern and Southern Africa
     
  • 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
     
  • Nightmare for African Women: Birthing Injury and Little Help
    LaFraniere, S. (2005, September 28). Nightmare for African Women: Birthing Injury and Little Help. The New York Times
    Inno Usman, 25, waited for surgery this month in Babbar Ruga Hospital in Nigeria. She suffered from an obstetric fistula, an injury, suffered by many African women, that can be prevented with a Caesarean section. What brings the girls to Dr. Waaldijk - and him to Nigeria - is the obstetric nightmare of fistulas, unknown in the West for nearly a century. Mostly teenagers who tried to deliver their first child at home, the girls failed at labor. Their babies were lodged in their narrow birth canals, and the resulting pressure cut off blood to vital tissues and ripped holes in their bowels or urethras, or both. The number of new cases is far outpacing repairs - not just here, but in other sub-Saharan nations like Kenya, Malawi and Uganda. Despite recent strides, said Thoraya Ahmed Obaid, the Population Fund's executive director, 'at the current rate of action it will take decades to end fistula.'
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    Keywords: News, Obstetric Fistula, Nigeria, West Africa
     
  • UNHCR, UNFPA fund surgery for refugee and local women in Chad.
    Le Breton, G. (March 17, 2005). UNHCR, UNFPA fund surgery for refugee and local women in Chad. Office of the United Nations High Commissioner for Refugees (UNHCR) news story. Retrieved May 26, 2005 from http://www.unhcr.ch/cgibin/texis/vtx/news/opendoc.htm?tbl=NEWS&id=4239519f4
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    Keywords: News, Traumatic Fistula, Obstetric Fistula, West Africa, Chad
     
  • Scholars argue over legacy of surgeon who was lionized, then vilified
    Lerner, B. H. (2003, October 28). Scholars argue over legacy of surgeon who was lionized, then vilified. The New York Times.
    J. Marion Sims, often referred to as the ‘father of gynecology’, is a controversial figure. He pioneered the surgery for repairing vesico-vaginal fistula, by practicing repeatedly on slaves in the mid 1800’s, without anesthesia. While this surgery has undoubtedly helped many women all over the world, critics in the 1970’s civil rights era argue that Sims used these powerless women as guinea pigs. A surgeon at Washington University, Dr. L. Lewis Wall, defends Sims, and blames scholars for their ‘presentism’ - for evaluating past events based on their own current values. The debate over Sims remains unresolved.
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    Keywords: News
     
  • Canada squanders opportunity to help third world mothers.
    LifeSiteNews. (2002, November 13). Canada squanders opportunity to help third world mothers. Retrieved March 2, 2005 from http://www.lifesite.net/ldn/2002/nov/02111301.html
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    Keywords: News, Obstetric Fistula
     
  • Congo rape victims seek solace
    Martens, J. (January 24, 2004). Congo rape victims seek solace. BBC News. Retrieved February 23, 2005 from http://news.bbc.co.uk/1/hi/world/africa/3426273.stm
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    Keywords: News, eastern-and-souther-africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Uganda’s Fistula Patients Lack Knowledge of Prevention and Treatment
    Matsamura, E.K. (2004, March). Uganda’s Fistula Patients Lack Knowledge of Prevention and Treatment. Population Reference Bureau. Retrieved March 24, 2005. http://www.prb.org
    Martina Nakamya (not her real name) was having her first baby after having left school at age 16 because of her pregnancy. Preparations were made with the birth attendant in the village. Nakamya’s labor lasted almst four days. When she finally pushed the baby out, it was dead, and Nakamya was not well. She “leaked” and smelled of urine and feces all day, everyday. The teenager had obstetric fistula. Most fistula patients in Uganda are young and poor with little education and limited access to quality health care, including emergency obstetric care. Often, patients lack the knowledge that the condition can be repaired and are too ashamed of their condition to seek help. Those who remain untreated may be shunned by their communities and relatives and must find new ways to support themselves. It is difficult to know the extent of the problem in Uganda. Poor knowledge of the causes and treatment of fistula within communities, long distances to health facilities, and inability to pay for services all result in limited use of the services that do exist.
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    Keywords: Eastern and Southern Africa, News, Obstetric Fistula, Prevention, Uganda
     
  • The crushing burden of rape: sexual violence in Darfur
    Médecins Sans Frontières. (2005). The crushing burden of rape: sexual violence in Darfur. Retrieved June 10, 2005 from http://www.artsenzondergrenzen.nl/usermedia/files/Report%20Sexual%20Violence%20march%202005.pdf
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Sudan
     
  • ‘Not Women Anymore...’ The Congo’s rape survivors face pain, shame and AIDS
    Nolan, S. (2005). ‘Not Women Anymore...’ The Congo’s rape survivors face pain, shame and AIDS. Ms. Magazine (Spring). Retrieved May 11, 2005 from http://www.msmagazine.com/spring2005/congo.asp
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • 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
     
  • Obstetric Fistula
    Obstetric Fistula. (1991). Newsletter: Women’s Global Network on Reproductive rights, 37, 8-9
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    Keywords: News
     
  • Helping Girls to Keep Marriage Under Wraps
    Ouedraogo, Brahima. (2004, March 24). Helping Girls to Keep Marriage Under Wraps. Inter Press Service News Agency. Retrieved May 11, 2005 from http://ipsnews.net
    It is an article of faith in development circles that assisting girls to complete their education-and postponing the age at which they have children-benefits both the girls and the communities they live in. This truth is proving difficult to entrench in Burkina Faso, however, where early marriages-and worse still, forced marriages-are often the norm. This is despite a 1990 law that sets the marriage ate fro girls at 18 and for boys at 22. Eleven-year-old Sylvie Sawadogo is one of those who narrowly escaped this fate. She lives with nuns at that Kaya Sisters Centre in northern Sanmantinga province: a home that caters for girls who have managed to fend of early marriage. While early wedlock can dramatically reduce a girl’s educational and economic prospects, it also holds health risks. These include the possibility of obstetric fistulas in girls who fall pregnant after being married at a very young age.
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    Keywords: News, Obstetric Fistula, West Africa, brukina-faso
     
  • War-related sexual violence in Sierra Leone: A population-based assessment
    Physicians for Human Rights. (2002). War-related sexual violence in Sierra Leone: A population-based assessment. Retrieved May 11, 2005 from http://www.phrusa.org/research/sierra_leone/report.html
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    Keywords: News, West Africa, Traumatic Fistula, Sierra Leone
     
  • Sierra Leone’s silent sufferers
    Pigott, R. (2004, June 18). Sierra Leone’s silent sufferers. BBC News. Retrieved February 24, 2005 from http://news.bbc.co.uk/
    Fatmata Kargbo was unaware of the risks of fistula when she became pregnant, though she was aware there were other health risks. Her experience after her obstructed labour and resulting fistula are typical as well as catastrophic. She was rejected by her husband and family and driven out of her village. She works breaking stones for builders on the outskirts of Freetown, though no one will work with her. Christian charity Mercy ships, such as the Anastasis, are moored in the Freetown harbour and are used as floating hospitals where fistula repairs can be done. Only a hundred fistulas were repaired on its last visit.
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    Keywords: News, West Africa, Obstetric Fistula, Sierra Leone
     
  • 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
     
  • An open wound: The issue of gender-based violence in North Kivu
    Pole Institute. (2004). An open wound: The issue of gender-based violence in North Kivu. Regards Croisés Quarterly Magazine 11 (August). Retrieved June 12, 2005 from http://www.poleinstitute.org/documents/regard11bis.pdf
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Lives Left Ruptured By Labor Neglect: In poor countries, fistulas still scare
    Rabin, R. (2003, October 7). Lives Left Ruptured By Labor Neglect: In poor countries, fistulas still scare. Newsday.
    Nolia Namukanje was taken to a health clinic on her second day of labor, but after laboring for three days, she delivered a still-born and developed a fistula. Engenderhealth and UNFPA are heading a campaign to raise awareness, develop services to prevent it, and expand medical treatment for those who already have it. U.S. Representative Carol Maloney is also introducing a bill asking fo r$25 million to fund UNFPA’s work on fistula, since most of those funds were cut by President George W. Bush. In Zambia, there are 870 maternal deaths for every 100,000 live births. Nolia was lucky; her husband helped her seek treatments at the Monze Mission hospital, the only facility in Zambia where fistula repair is done year round. Clients come from as far away as Angola and the DRC for fistula repair. However, they often lack supplies and trained physicians and nurses who know how to operate on fistulas.
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    Keywords: News
     
  • Gender-based violence
    Reproductive Health Response in Conflict Consortium [RHRC]. (2004). Gender-based violence. Retrieved from http://www.rhrc.org/rhr_basics/gbv/, February 9, 2005
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    Keywords: News
     
  • Women’s bodies as a battleground: Sexual violence against women and girls during the war in the Democratic Republic of Congo
    Réseau des Femmes pour un Dévelopement Associatif [RFDA], Réseau des Femmes pour la Défense des Droits et la Paix [RFDP], and International Alert. (2005). Women’s bodies as a battleground: Sexual violence against women and girls during the war in the Democratic Republic of Congo (South Kivu: 1996–2003). Retrieved June 10, 2005
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    Keywords: News, Eastern and Southern Africa, Democratic Republic of Congo
     
  • 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
     
  • Fistula Pilgrims
    Safehands for Mothers & FIGO. (2004). Fistula Pilgrims. Available at www.safehands.org
    The film Fistula Pilgrims was written, produced and directed by Nancy Durrell McKenna for Safehands, in partnership with the International Federation of Obstetrics and Gynaecology (FIGO). It tells the story of Telanish, a young girl in Ethiopia who was married at 10, pregnant at 11 and gave birth to a stillborn child at 12. As a result of a long and obstructed labour, she has a fistula and is left incontinent, an outcast from her community. There are approximately two million women who suffer from obstetric fistula around the world with more added every day. With training, the complications that cause fistula can be avoided and spare young women like Telanish a lifetime of misery.
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    Keywords: News
     
  • Early marriage survives in the U.S
    Salopek, P. (2004). Early marriage survives in the U.S. Chicago Tribune, December 12, 2004. Available at www.chicagotribune.com
    Liset and James Landeros, both high school dropouts, married at the ages of 14 and 18 years respectively, when the state of Texas threatened to charge James with the statutory rape of a minor. Now 17, Liset is a waitress at a Mexican restaurant, and the mother of a baby girl. James works two shifts in a cafeteria to make ends meet. While early marriage is typically associated with the developing world, it is not foreign to the United States. Child brides in the U.S. tend to be older than their developing world counterparts, yet they too face poverty, domestic violence, and other problems associated with early marriage. American girls, however, often have the luxury of marrying for love, and are usually not forced into union. While the issue remains controversial, some experts suggest that the number of married teenagers in the U.S. is actually on the rise, possibly due to a variety of factors, including increased conservatism, the fear of AIDS, or the spread of abstinence-only-until-marriage sex education. A handful of states sanction early marriages with parental consent, allowing girls as young as 12 and 13 to marry. Liset and James lead a difficult life and work long hours, while Liset’s mother looks after the 3 year old Mersaydiz. Liset’s mother, an immigrant from Mexico, was also married at the age of 14. Some experts believe that immigration from developing countries, particularly in Latin America, may be the reason behind the rise in the number of teenage wives in the United States.
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    Keywords: News, USA
     
  • 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
     
  • Shame and Pain Torment Fistula Sufferers
    Sandrasagra, Mithre J. (2006). Shame and Pain Torment Fistula Sufferers. Inter Press Service News Agency. Retrieved July 28, 2008 from www.ipsnews.ne
    Based on the number of women seeking treatment, the WHO estimated in 1989 that more than two million women in developing countries are living with fistula. More recent statistics are unavailable because fistula has become an “under-prioritized issue” says Kate Ramsey of the UNFPA. According to the First Lady of Burkina Faso, each day approximately 236 severe obstetric complications occur in her country. These complications may result in the sort of prolonged labor that causes the soft tissues between a mother’s vagina and bladder, vagina and rectum, or both to die. The consequence is fistula; a small hole that allows for the constant leaking of urine or feces or both. Women afflicted with this condition suffer psychologically as well as physically. The UNFPA cites malnutrition, poor health services, early marriage and gender discrimination as contributing causes to fistula. In addition, poverty leaves women vulnerable and without timely obstetric care. The first worldwide campaign to end fistula was launched by UNFPA in 2003. In Bangladesh, about 71,000 women are living with fistula, and about 90% of women deliver at home. In 2004 in Niger, 140 fistula repairs were performed and 600 community health workers received fistula training. Kalilou Ouattara, a fistula surgoun on Mali, points out that, “The existence of fistula is the barometer of maternal health in the country.” Prevention more than treatment is the key to ending fistula---this may be accomplished with increased presence of skilled attendants at births and increased availability of emergency obstetric care for women experiencing complications during labor. The cost of fistula repair surgery is 300 dollars, and the success rate can be as high as 90%, but still the costs for treatment are beyond the means of most women with the condition. At the 2000 Millennium Summit to achieving the Millennium Development Goal, all the world’s governments committed to reducing maternal mortality by 75% and universal access to reproductive health by 2015. To fulfill the next five-year plan of its campaign, the UNFPA is requesting 78 million dollars.
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    Keywords: News, Obstetric Fistula
     
  • Obstetric Fistulas Signal Poor Health Care for Women
    Schiff, J. (2004, June 9). Obstetric Fistulas Signal Poor Health Care for Women. All News Africa. Retrieved March 21, 2006 from http://www.allafrica.com.
    Obstetric fistulas were the topic of a panel at the Global Health Council’s annual conference in Washington DC. Fistulas are a reflection of where maternity health systems are failing and usually affect the poorest of the poor. Fistulas are both preventable and treatable. There are serious social consequences to fistula, including isolation, divorce, abuse, lack of opportunity, and ostracism from the community.
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    Keywords: News, Obstetric Fistula
     
  • In honor of International Women’s Day, take a stand for Darfur
    Spicyn, N., and Sweetser, C. (March 4, 2005). In honor of International Women’s Day, take a stand for Darfur. Yale Daily News. Retrieved March 16, 2005 from http://www.yaledailynews.com/article.asp?AID=28742
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula
     
  • Delaying marriage gets passing grade.
    Spolar, C. (2004, December 13). Delaying marriage gets passing grade. In rural Egypt, special program empowers girls to be students before brides. Chicago Tribune. Available at www.chicagotribune.com.
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    Keywords: News, Prevention, West Africa, Egypt
     
  • Obstetric fistula: a catastrophic maternal disability
    Stanton, ME. (2004, Summer). Obstetric fistula: a catastrophic maternal disability. Connect: A newsletter for the CEDPA TAACS Community
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    Keywords: News, Obstetric Fistula
     
  • Women’s fistula repaired as surgeons trained
    Stanton, M.E. (June-August 2004). Women’s fistula repaired as surgeons trained. Frontlines-USAID Employee News, 7
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    Keywords: News, Obstetric Fistula, Training
     
  • 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.
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    Keywords: News, Obstetric Fistula, Asia, Bangladesh
     
  • La place de la dystocie osseuse dans les fistules vésico-vaginales
    Sylla, S. et al. (1975). La place de la dystocie osseuse dans les fistules vésico-vaginales. Bulletin de la Société de Médecine de l’Afrique Noire de Langue Française, 20(3), 315-322
    Link to Source
    Keywords: News
     
  • Rejected for leaking urine
    Thawite, J. B. (2006, May 15). Rejected for leaking urine. The New Vision. Retrieved June 22, 2006 from http://www.newvision.co.ug/index.php
    Good Hope Foundation Rural Development and Women’s Dignity Project (WDP) collaboratively conducted research in Kasese, Soroti, and Masaka in order to understand, demystify, and alleviate the socio-economic factors contributing to the fistula problem facing Uganda. The sample of respondents used in this research involved women with fistulas and women without, traditional birth attendants, families, communities and health providers. According to Obed Kabanda, leader of the obstetric research team, women who are poor and without emergency obstetric care are most vulnerable to obstetric fistula. Most of the women interviewed reported that the child birth which resulted in their fistula also resulted in the death of their child. Fistula results in the woman’s uncontrollable leakage of urine, thus due to bed-wetting many husband divorce or separate from their afflicted wives. Women also face social stigmatization and isolation. Some women are unable to perform household duties, suffer from sores, inflammation, illness, and dizziness. To combat the leakage resulting from fistula, women constantly pad themselves and often avoid drinking water. Other socio-economic effects are seen in the overspending these women must do on medications, and soap and water for washing themselves. According to the research, Kanada identifies a few causes for fistula. Some women are told during ante-natal visits that they are ok and do not need to deliver in a hospital, long distance to clinics and poor public transportation, trust of traditional birth attendants and fear of harassment from hospital nurses (previously experienced), lack husbands’ monetary and emotional support, fear that placentas may be incinerated rather than given to the mother, fear of the instruments used in delivery rooms at hospitals and health clinics, etc. The research also revealed misconceptions held by women about the causes of fistula, ie. being bewitched, and delivering a large baby. The report maintains that fistula is preventable, and that prevention is the key to ending fistula. The prevalence of fistula signifies that health systems are not succeeding in meeting women’s needs. According to a United Nations Population Fund (UNFPA) report: every minute a women somewhere dies in pregnancy or childbirth (about 529,000 women die each year from pregnancy related causes), 1 in 16 African women is a risk for dying from a pregnancy related complication, but in the developed world that risk is about 1 in 2,800, every year poor maternal healthcare and poor delivery care result in about 3.4 million of the 8 million infant deaths.
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    Keywords: News, Obstetric Fistula, Uganda, Eastern and Southern Africa
     
  • Married at 11, A Teen in Niger Returns to School
    Thurow, Roger. (2005, June 13). Married at 11, A Teen in Niger Returns to School. The Wall Street Journal. Retrieved June 27, 2006 from www.nigerfistula.org
    According to statistics compiled but he United Nations Children’s Fund, in Niger almost 50% of all girls are married by age 15, 90% of girls are married by 18, and 50% of women have had their first pregnancy with still a teenager. The tradition of early marriage is seen as a solution to the problem of unwanted pregnancy out of wed lock. Most teenage female bodies, though, are not mature enough to deliver vaginally. Only 10 medical centers in Niger are able to perform much needed caesarean sections to these young mothers. Fistula is caused by lengthy and obstructed labor that goes unrelieved by surgical intervention. The UN reports that Niger has one of the highest maternal-mortality rates in the world. 80% of women in Niger give birth at home, and without medical assistance. It is suggested that promoting girls education and changing traditions which uphold early marriage will have positive effects not merely on women’s bodies, but also for the nation as a whole. Sabou Ibrahim, director of the National Hospital (Niger), points out that when a women receives fistula repair surgery she may return to her village, and through her own experiences, initiate discussion about the risks of pregnancy at such a young age, and hopefully incite change.
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    Keywords: News, Obstetric Fistula, West Africa, Niger
     
  • Obstetric Fistula
    Tuncalp, O., & Sze E. (2005) Obstetric Fistula. Student British Medical Journal. Retrieved February 16, 2005 from http://www.studentbmj.com.
    Imagine you are a 14-year-old girl in a society where you are considered mature enough to get married. Imagine you are 15 years old with a belly getting larger every day, and all you can do is try to get used to the idea of becoming a mother. Imagine you are almost 16 and your body is enduring relentless pain and you wonder how much more you can endure. Just the thought of seeing your little baby soon keeps you going. After several days, there is still no baby. But the pain keeps coming. And then…some of you may assume that this story has a happy ending. Unfortunately for over 2 million women in developing countries, it is just the beginning of a nightmare. Because they have experienced one of the worst complications of childbirth, obstetric fistula-a complication which has been long forgotten in the western world.
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    Keywords: News, Obstetric Fistula
     
  • 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
     
  • Fortnight of fistula correction kicked off in Nigeria, UN Population Fund says
    UN News Service. (2005). Fortnight of fistula correction kicked off in Nigeria, UN Population Fund says. Retrieved February 23, 2005 from http://www.un.org/News/
    UNFPA is sponsoring a t two-week campaign to treat hundreds of women with fistula, and to also train more doctors and nurses to treat it. Dutch surgeon Kees Waaldijk is involved as well as Nigerian surgeon Said Ahmad. Other campaign sponsors include Federal and State Government agencies, the Nigerian Red Cross, and Virgin Unite.
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    Keywords: News, West Africa, Obstetric Fistula, Nigeria
     
  • 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.
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    Keywords: News, Asia, Obstetric Fistula, Bangladesh
     
  • UN-backed conference calls for ‘zero tolerance’ for sexual violence in conflict
    UN News Service. (2006, June 23). UN-backed conference calls for ‘zero tolerance’ for sexual violence in conflict. UN News Centre. Retrieved July 28, 2006 from www.un.org/apps/news/printnews.asp?nid=18977
    On June 23, 2006 the UN backed an International conference of more that 30 countries which was sponsored by the UNFPA, the Belgian Government, and then European Union. The conference focused on sexual violence in conflict and the development of plans for action; these plans ranged from ending impunity to developing national preventative plans. Among the attendees were doctors and social service providers from nations affected by conflict. Thoraya Ahmad Obaid, executive director UNFPA, asserted the need for governments to make and fulfill promises to make the end of sexual violence a national priority. Traumatic fisutula is an example of what can be caused by violent rape, the condition occurs when vaginal tissues are ruptured, resulting in the formation of passages that constantly leak urine or feces or both. DR. Jean Pascal Manga, of the Democratic Republic of the Congo, reported finding a girl under the age of 5 suffering with this condition. He called for Western nations to join in the movement towards treating these problems. Dr. Manga went on to report that there were about 25,000 women and girls who were raped and in need of continuing support because as a result of the social stigmas attached to both rape and fistula, these women are abandoned by their entire families. Of the 226 cases of traumatic fistula, 20% of corrective surgeries failed. Dr. Manga also reported that 90% of women and girls who were raped had some STI, and almost 10% of them were HIV positive. A presentation by Feryal Thabet, of the Bureij Women’s Health Centre in Haza, revealed that with escalating conflict on the border with Israel has resulted in increased violence against women and deteriorating women’s health: 1/3 of pregnant Palestinian women are anaemic; both early marriage and high-risk pregnancy are on the rise; antenatal visits to the Women’s health center were decreasing; In 2005, 80% of women did not receive any post-natal care; there were 61 births at checkpoints with no medical assistance. Participants of the convention presented their own national action plans to address these issues, and called for the development of a longer-term, more holistic approach to addressing these issues of sexual and gender-based violence.
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    Keywords: News, Traumatic Fistula, Eastern and Southern Africa, Democratic Republic of Congo
     
  • 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.
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    Keywords: News, Asia, Obstetric Fistula, Bangladesh
     
  • Enduring and Overcoming the Ordeal of Fistula.
    UNFPA: News. (2004, October 19). Enduring and Overcoming the Ordeal of Fistula. Retrieved May 11, 2005 from http://unfpa.org
    Dr. Abbo has dedicated himself to the plight of women with fistula, which is especially difficult in an impoverished country where the health infrastructure is in shambles. In 1972 he established the Dr. Abbo Fistula Centre within the Khartoum Teach Hospital. They are only able to treat one patient a day and are often running out of essential supplies. Najwa and Eltoma are two women who had severe fistulas and their stories are representative of what women often endure. The UNFPA Sudan Office has launched the Campaign to End Fistula in Sudan with the slogan “We MUST Care”. Part of the campaign will be upgrading the services at the Dr. Abbo Fistula Centre.
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    Keywords: News, Obstetric Fistula, Eastern and Southern Africa, Sudan
     
  • Experts in Africa Meet to Develop Training Guidelines for Fistula Treatment
    UNFPA: News. (2005, April 27). Experts in Africa Meet to Develop Training Guidelines for Fistula Treatment. Retrieved May 11, 2005 from www.unfpa.org
    Improved training for medical workers providing fistula treatment would help end the needless suffering of thousands of African women with obstetric fistula, experts meeting in Niger agreed on Friday. It is critical that providers receive quality training to treat the backlog of fistula patients, experts attending the Niamey meeting agreed. Hospital staff should be trained as a team to manage fistula cases. Simple cases should be handled at district hospitals, while more complicated cases should be referred to specialized regional hospitals. Furthermore, medical students should be encouraged to assist in fistula repair centers to gain the required surgical expertise.
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    Keywords: News, Obstetric Fistula, Training, Niger
     
  • Healing wounds, restoring hope: proposal to train doctors and treat women living with fistula in Nigeria.
    UNFPA: News. (2004). Healing wounds, restoring hope: proposal to train doctors and treat women living with fistula in Nigeria. Available at www.unfpa.org.
    Link to Source
    Keywords: News, Training, West Africa, Nigeria
     
  • Obstetric fistula: UN and international obstetricians meet to combat hidden disease
    UNFPA: News. (2001). Obstetric fistula: UN and international obstetricians meet to combat hidden disease. Available at www.unfpa.org.
    UNFPA and the International Federation of Obstetricians and Gynecologists (FIGO) are bringing together experts for a meeting in London to discuss obstetric fistula. Obstetric fistula, which occurs as a result of prolonged and obstructed labor, has severe physical (leaking urine) and social (abandonment and isolation) consequences for a woman. Unheard of in developed countries, obstetric fistulas are common in developing countries, often among poor women and adolescents. These fistulas affect up to 2 million worldwide, and up to 50,000 to 100,000 more women each year. They are repairable surgically, costing about USD $150. The meeting in London seeks to raise funds and increase awareness.
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    Keywords: News, Obstetric Fistula
     
  • UNFPA Initiative Raises Awareness of Fistula Cases in Sudan
    UNFPA: News. (2003). UNFPA Initiative Raises Awareness of Fistula Cases in Sudan. Retrieved May 11, 2005 from www.unfpa.org
    UNFPA held an AIDS Day commemoration, which included a football match between two of Khartoum’s most popular teams. Some of the proceeds when to buy medical equipment and medicines for Dr. Abbo’s Fistula Centre in Khartoum, the country’s only facility. UNFPA recently organized a visit to the centre that included members of the government, other UN agencies and the Swiss Ambassador. The UNFPA representative to Sudan committed further support to Dr. Abbo’s Fistula Centre.
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    Keywords: News, Eastern and Southern Africa, Sudan
     
  • Obstetric fistula and the ethics of care: Listeni8ng for the answers
    Wagner, M.N. (2005). Obstetric fistula and the ethics of care: Listeni8ng for the answers. The POP Reporter, 5(14). Retrieved on June 25, 2009 from http://www.infoforhealth.org/popreporter/2005/04-04.shtml.
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    Keywords: News, Obstetric Fistula
     
  • How can human beings do that to each other?’ Rape joins plunder of diamonds and gold as a hallmark of Congo’s bloody conflict.
    Walsh, D. (November 2, 2003). ‘How can human beings do that to each other?’ Rape joins plunder of diamonds and gold as a hallmark of Congo’s bloody conflict. The Independent Online Edition. Retrieved February 23, 2005 from http://www.rense.com/general45/congo.htm
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    Keywords: News, West Africa, Traumatic Fistula
     
  • A brutal legacy of Congo war: Extent of violence against women surfaces as fighting recedes
    Wax, E. (October 25, 2003). A brutal legacy of Congo war: Extent of violence against women surfaces as fighting recedes. Washington Post. Retrieved February 9, 2005 from http://www.washingtonpost.com/ac2/wp-dyn/A14059-2003Oct24?language=printer
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Democratic Republic of Congo
     
  • Women Deliver conference-London
    Women Deliver conference-London (2007). IPPF Medical Bulletin, 41(4), 2-3.
    Link to Source
    Keywords: News
     
  • Women’s Fistula Repaired as Surgeons Trained
    Women’s Fistula Repaired as Surgeons Trained. (2004, July-August). Frontlines-USAID Employee New
    USAID is spending $800,000 to train doctors in fistula-repair surgery in Uganda and Bangladesh. They also support education in communities to prevent fistula and counseling to help women who have undergone surgery reintegrate into their communities. Doctors from two hospitals in Bangladesh and three hospitals in Uganda will be trained, and two more hospitals from Uganda are expected to join. In Uganda, an awareness program targeting men will also be supported. This campaign will teach men about the importance of safe childbirth.
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    Keywords: News, Obstetric Fistula, Training
     
  • UK grant for raped Rwandan women.
    Wooldridge, M. (February 2, 2005). UK grant for raped Rwandan women. BBC News UK Edition. Retrieved March 14, 2005 from http://news.bbc.co.uk/1/hi/uk/4228339.stm
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    Keywords: News, Eastern and Southern Africa, Traumatic Fistula, Rwanda
     
  • Vesico-vaginal fistula – a major cause of unnecessary and avoidable suffering.
    WHO. (1999). Vesico-vaginal fistula – a major cause of unnecessary and avoidable suffering. Safe Motherhood: A Newsletter of Worldwide Activity, 27(1)
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    Keywords: News
     
  • Women, Peace and Security: Responding to the Needs of Victims of Gender-Based Violence
    Obaid, T.A. (2004, October 28). Women, Peace and Security: Responding to the Needs of Victims of Gender-Based Violence. UNFPA. N. Retrieved May 11, 2005 from http://www.unfpa.org
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    Keywords: News, Traumatic Fistula
     

Obstetric Fistula

  • Enabling to Ensure Women's Rights: Help an Obstetric Fistula Patient brochure
    EngenderHealth. Enabling to Ensure Women's Rights: Help an Obstetric Fistula Patient brochure [Brochure]. http://www.fistulacare.org/pages/pdf/Communications/BrochureComplete2.pdf
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    Keywords: program, Obstetric Fistula
     
  • Fact Sheet, Facts about Obstetric Fistula: The Hidden Outbreak
    EngenderHealth. Fact Sheet, Facts about Obstetric Fistula: The Hidden Outbreak
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    Keywords: Overview, Assessment, Obstetric Fistula
     
  • Reproductive functions after the repair of obstetric vesico-vaginal fistulae
    Aimakhu, V.E. (1974).Reproductive functions after the repair of obstetric vesico-vaginal fistulae. Fertility and Sterility, 25(7), 586-591
    Link to Source
    Keywords: clincial-information, Obstetric Fistula
     
  • The classification of obstetric vesico-vaginal fistulas: A call for an evidence-based approach
    Arrowsmith, S.D. (2007). The classification of obstetric vesico-vaginal fistulas: A call for an evidence-based approach. International Journal of Gynaecology and Obstetrics, 99(1), S25-S27
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    Keywords: Clinical Information, Obstetric Fistula, Classification, Nigeria
     
  • Obstructed Labor Injury Complex: Obstetric Fistula Formation and the Multifaceted Morbidity of Maternal Birth Trauma in the Developing World
    26. Arrowsmith, S., Hamlin, E., Wall, L. (1996). Obstructed Labor Injury Complex: Obstetric Fistula Formation and the Multifaceted Morbidity of Maternal Birth Trauma in the Developing World. Obstetrical and Gynecological Survey, 51(9), 568-574.
    The purpose of this review, therefore, is to emphasize that the injuries resulting from prolonged obstructed labor represent a syndrome that often involves multiple organ systems. Caring for these patients requires much more than simply 'repairing' a vesicovaginal fistula. The process of carefully collecting and tabulating clinical data from the major fistula repair centers around the world has only just begun, so the picture presented here is only preliminary. Complete understanding of this syndrome, which we have chosen to call 'obstructed labor injury complex' lies some distance in the future; however, by emphasizing the multidimensional pathology from which these patients suffer, we appeal to fistula surgeons around the world to broaden their perspective to include treatment of the 'whole-person' when that person has been a victim of unrelieved obstructed labor.
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    Keywords: Obstetric Fistula, Clinical Information
     
  • 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
     
  • Strengthening public health priority-settings through research on fistula, maternal health, and health inequalities
    Bangser, M. (2007). Strengthening public health priority-settings through research on fistula, maternal health, and health inequalities. International Journal of Gynaecology and Obstetrics, 99(1), S16-S20
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    Keywords: Programs, Obstetric Fistula
     
  • 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
     
  • Pituitary and ovarian function in women with vesico-vaginal fistulae after obstructed and prolonged labour
    Bieler, E.U., & Schnabel, T. (1976). Pituitary and ovarian function in women with vesico-vaginal fistulae after obstructed and prolonged labour. South African Medical Journal, 50, 257-266
    Link to Source
    Keywords: Clinical Information, Obstetric Fistula, Eastern and Southern Africa, South Africa
     
  • Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development.
    Bangser, M., et al. (2010). Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development. International Urogynecology Journal, Online First™, 27 August 2010.
    Authors sought evidence from the testimonies of women living with fistula regarding local risk factors for fistula and the impact of fistula on women's lives. One hundred thirty-seven women recruited from health facilities and at the community level in Tanzania and Uganda were interviewed using quantitative and qualitative methods, including participatory approaches. Women of all ages and parties endured fistula. The testimonies illustrated that physical, socio-economic and cultural constraints, as well as health system failures, led to fistula, and the condition imposed harsh consequences on women's lives. Constraints included deficient maternal health services and personnel, delays in seeking and accessing care, and limited fistula repair services. Women endured severe social stigma and severe economic hardships. Participants' testimonies expand current understanding of women's experience of fistula and point to recommendations that could improve maternal health care, reduce women's risk of fistula, and improve the lives of women living with the condition.
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    Keywords: Maternal Health, Obstetric Fistula, Statistics, Eastern and Southern Africa, Tanzania, Uganda
     
  • Current practices in treatment of female genital fistula: a cross sectional study
    Arrowsmith, S., Ruminjo, R., and Landry, E. (2010). Current practices in treatment of female genital fistula: a cross sectional study. BMC Pregnancy and Childbirth, 10(73), 1-32.
    Every year, more than 500,000 women die in childbirth, mostly in resource-poor countries. Those who survive often suffer from severe and long-term morbidities. One of the most devestating injuries is obstetric fistula, occurring most often in south Asia and sub-Saharan Africa. Fistula treatment and care are available in many countries across Africa and Asia, but there is a lack of reliable data around clinical factors associated with the success of fistula repair surgery. Most published research has been retrospective. While these studies have provided useful information about the care and treatment of fistula, they are limited by the design. This study was designed to identify practices in care that could lead to the design of prospective and randomized controlled trials.
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    Keywords: Obstetric Fistula, Maternal Health, Clinical Information, Eastern and Southern Africa, West Africa, Asia
     
  • Social and economic consequences of obstetric fistula: Life changed forever?
    Ahmed, S., & Holtz, S.A. (2007). Social and economic consequences of obstetric fistula: Life changed forever? International Journal of Gynaecology and Obstetrics, 99(1), S10-S15
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    Keywords: Overview, Obstetric Fistula
     
  • Dead women walking: Neglected millions with obstetric fistula
    Ahmed, S., et al. (2007). Dead women walking: Neglected millions with obstetric fistula. International Journal of Gynaecology & Obstetrics, 99, S1-S3
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    Keywords: Overview, Obstetric Fistula
     
  • An overview of the socio-cultural and psychiatric aspects of women's reproductive health in West Africa
    Aina, O.F. (2007). An overview of the socio-cultural and psychiatric aspects of women's reproductive health in West Africa. The Nigerian Postgraduate Medical Journal, 14(3), 231-237
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    Keywords: maternal health, West Africa, Obstetric Fistula, Nigeria
     
  • 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
     
  • The obstetric fistula: factors associated with improved pregnancy outcome after a successful repair
    Emembolu, J. (1992). The obstetric fistula: factors associated with improved pregnancy outcome after a successful repair. International Journal of Gynaecology and Obstetrics, 39, 205-212
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    Keywords: Clinical Information, Obstetric Fistula, Nigeria, West Africa
     
  • The Relationship Between Female Genital Cutting and Obstetric Fistulae
    Browning, A, Jenifer Allsworth and Lewis Wall (2010). The Relationship Between Female Genital Cutting and Obstetric Fistulae. American College of Obstetricians and Gynecologists, 115(3), 578-583.
    OBJECTIVE: To evaluate any association between female genital cutting and vesicovaginal fistula formation during obstructed labor. METHODS: A comparison was made between 255 fistula patients who had undergone type I or type II female genital cutting and 237 patients who had not undergone such cutting. Women were operated on at the Barhirdar Hamlin Fistula Centre in Ethiopia. Data points used in the analysis included age; parity; length of labor; labor outcome (stillbirth or not); type of fistula; site, size, and scarring of fistula; outcomes of surgery (fistula closed; persistent incontinence with closed fistula; urinary retention with overflow; site, size, and scarring of any rectovaginal fistula; and operation outcomes), and specific methods used during the operation (use of a graft or not, application of a pubococcygeal or similar autologous sling, vaginoplasty, catheterization of ureters, and flap reconstruction of vagina). Primary outcomes were site of genitourinary fistula and persistent incontinence despite successful fistula closure. RESULTS: The only statistically significant differences between the two groups (P.05) were a slightly greater need to place ureteral catheters at the time of surgery in women who had not undergone a genital cutting operation, a slightly higher use of a pubococcygeal sling at the time of fistula repair, and a slightly longer length of labor (by 0.3 day) in women who had undergone genital cutting. CONCLUSION: Type I and type II female genital cutting are not independent causative factors in the development of obstetric fistulae from obstructed labor
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    Keywords: Ethiopia, Clinical Information, Obstetric Fistula, Prevention
     
  • [Retrospective study of 34 urogenital fistulas of obstetrical origin]
    Bouy, P.A., et al. (2002). [Retrospective study of 34 urogenital fistulas of obstetrical origin] [French]. Gynecologie, obstetrique and fertilite, 30(10), 780-783
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    Keywords: Statistics, Obstetric Fistula, West Africa, Congo
     
  • 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).
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    Keywords: Overview, 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 recently published retrospective case note review provides new data on obstetric fistula in northern Nigeria. 34 cases were reviewed from over a two year period from teh Univeristy of Ilorin Teaching hospital. The mean age was 23.9 and 32 of the 34 women were illiterate. Half were primaparous and the most common cause was obstructed, prolonged labour. The incidence rate at this hospital was lower than a hospital in Zaria. Their study did reconfirm the trends in aetiology and epidemiology of obstetric fistula in the developing world. Clearly more centres are needed that are equipped to care for women with fistula. More importantly, emergency obstetric centres need to be built. However, there are many obstacles, including little money and few professionals availabe.
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    Keywords: Overview, Obstetric Fistula, West Africa, Nigeria
     
  • Perspectives: Obstetric Fistula in Ilorin, Nigeria
    Browning, A. (2004) Perspectives: Obstetric Fistula in Ilorin, Nigeria. Public Library of Science: Medicine. Retrieved March 21, 2006 from http://www.plosmedicine.org
    A recently published retrospective case note review provides new data on obstetric fistula in northern Nigeria. 34 cases were reviewed from over a two year period from teh Univeristy of Ilorin Teaching hospital. The mean age was 23.9 and 32 of the 34 women were illiterate. Half were primaparous and the most common cause was obstructed, prolonged labour. The incidence rate at this hospital was lower than a hospital in Zaria. Their study did reconfirm the trends in aetiology and epidemiology of obstetric fistula in the developing world. Clearly more centres are needed that are equipped to care for women with fistula. More importantly, emergency obstetric centres need to be built. However, there are many obstacles, including little money and few professionals availabe.
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    Keywords: Statistics, Obstetric Fistula, West Africa, Nigeria
     
  • 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
     
  • Fistula de origin obstétrico
    Calle, A. (Unpublished). (1982). Fistula de origin obstétrico. Quito, 2 p.
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    Keywords: Clinical Information, Obstetric Fistula, Ecuador
     
  • Neglected maternity: making a difference
    Chamberlain, J. (2003). Neglected maternity: making a difference. Journal of Obstetrics and Gynaecology Canada, 25(2), 90-1, 92-93
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula
    Chong, E. (2004). Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula. Quality/Calidad/Qualité, 16.
    Quality/Calidad/Qualité is a publication from the Population Council that highlights innovative and thoughtful approaches to issues of sexual and reproductive health. This article highlights the history of the Fistula Project, which is based out of the Bugando Medical Center in Mwanza. The Fistula Project has not only concentrated on increasing the quality and number of fistula repairs being conducted, they have also included public education and advocacy as part of their mission. The Fistula Project makes sure that they are sensitive to the women coming for treatment at all stages of their stay at the Bugando Medical Center. The Women’s Dignity Project, a partner in the Fistula Project has worked to build demand for fistula repair, as well continuing to educate the populace around fistula issues. The article also highlights 4 women who have obstetric fistulas, and includes the causes, as well as the outcome of treatment.
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    Keywords: Programs, Eastern and Southern Africa, Obstetric Fistula, Tanzania
     
  • Pubic changes associated with obstetric vesico-vaginal fistulae
    Cockshott, W.P. (1973). Pubic changes associated with obstetric vesico-vaginal fistulae. Clinical Radiology, 24, 241-247.
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    Keywords: Clinical Information, Obstetric Fistula
     
  • Publicity will highlight problem of obstetric fistula
    Cole, A. (2006). Publicity will highlight problem of obstetric fistula. BMJ, 333(7557), 8
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    Keywords: News, Obstetric Fistula
     
  • Obstetric fistula: the challenge to human rights
    Cook, R.J., Dickens, B.M., Syed, S. (2004). Obstetric fistula: the challenge to human rights. International Journal of Gynaecology and Obstetrics, 87(1), 72-77
    Obstetric fistula can be explained to result from different causes. These holes in the tissue wall between the vagina and bladder and/or rectum are most prevalent in resource-poor countries, attributable to prolonged obstructed labor and absent or inaccessible remedial prenatal services. Obstructed labour is often due to small pelvic size, resulting from women’s youth and premature childbearing and/or malnutrition. Poverty at national health-service and family levels often predisposes pregnant populations to suffer high rates of fistula. Global estimates showing up to 100,000 new cases each year and 2 million affected girls and women are probably gross underestimates. Fistula devastates lives of sufferers, who are often expelled by husbands and become isolated from their families and communities. Failures of states to provide prenatal preventive care (including medically indicated cesarean deliveries) and timely fistula repair violate women’s internationally recognized human rights, especially to healthcare in general and reproductive healthcare in particular.
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    Keywords: Overview, Obstetric Fistula
     
  • Supporting surgery for obstetric fistula
    Coombes, R. (2004). Supporting surgery for obstetric fistula. British Medical Journal, 329: 1125
    Obstetric fistula is a devastating injury that generally occurs due to prolonged obstructed labor, and renders a woman incontinent of urine and/or feces, and often outcast from society. Poverty is the main risk factor for fistula. The Addis Ababa Fistula Hospital in Ethiopia offers free surgery and rehabilitation to fistula patients, and also trains surgeons from all over the world. WHO and UNFPA have initiatives aimed at fistula prevention and treatment in a number of countries. In Pakistan, professionals were inspired by the Addis model and have raised money to build a hostel for fistula patients. They have also set up surgical camps in rural areas, but progress is slow in a country where there are increasing numbers of women with fistula, and limited attention to this problem. Worldwide, there are an estimated 100,000 new cases of fistula each year, but only about 6,500 are treated.
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    Keywords: News, Obstetric Fistula
     
  • Obstetric fistulae: A review of available information
    Cottingham, J. & Royston, E. (1991). Obstetric fistulae: A review of available information. World Health Organization (Safe Motherhood Programme), 39pp. Retrieved from http://whqlibdoc.who.int/hq/1991/WHO_MCH_MSM_91.5.pdf, September 18, 2006
    The authors carried out a thorough literature review, as well as writing over 250 individuals and institutions about the extent of obstetric fistulae in their area. The literature review covers defining obstetric fistula, the extent of the problem, characteristics of women who have fistula, including poverty, age and parity, height, social status and traditional practices, health and social consequences, managment including repair and prevention and a selected annotated bibliography. The extent of the problem includes information received from published and unpublished reports and is primarily from Africa and Asia. The report found that women came almost exclusively from poor families and communities. In Africa, studies have shown that 50-80% of women with fistula were under the age of 20. In Asia, the majority were under the age of 30. In most studies from Asia, primiparious ranged from 30%-95%, though three studies showed a higher percentage of grandmultiparae. Some studies suggested that height could have an influence, with shorter women having higher rates of fistula. Secondary amenorrhoea is a condition frequently associated with fistula and in some studies, up to 100% of women suffer from it before the repair of their fistulae. All authors agreed that repair of fistula cannot be managed until three months after caustive labour. Prevention of fistula can be reduced by making basic maternity services available to all women.
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    Keywords: Overview, Obstetric Fistula, Prevention
     
  • 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
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    Keywords: Statistics, Asia, Obstetric Fistula, India
     
  • Obstetric fistulas: A clinical review
    Creanga, A.A., & Genardy, R. (2007). Obstetric fistulas: A clinical review. International Journal of Gynaecology and Obstetrics, 99(1), S40-S47
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    Keywords: Clinical Information, Obstetric Fistula
     
  • Prevention and treatment of obstetric fistula: Identifying research needs and public health priorities
    Creanga, A.A., et al. (2007). Prevention and treatment of obstetric fistula: Identifying research needs and public health priorities. International Journal of Gynaecology and Obstetrics, 99(1), S151-S154
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    Keywords: Programs, Obstetric Fistula, Prevention
     
  • Lessons from the developing world: obstructed labor and the vesico-vaginal fistula
    Cron, J. (2003). Lessons from the developing world: obstructed labor and the vesico-vaginal fistula. Medscape General Medicine, 5(3). Retrieved February 23, 2005 from http://www.medscape.com.
    This review focuses on vesico-vaginal fistula as one of the major morbidities associated with pregnancy in the developing world. The mummy of Queen Henhenit, the wife of Egypt’s ruler in 2050 BC, is the oldest evidence of an obstetric fistula. Dr. John Peter Mettauer of Virginia was the first American surgeon to successfully close a vesico-vaginal fistula in 1838, contrary to the popular belief that this achievement was that of J. Marion Sims. Regardless, Sims’ contribution to the field of gynecology was enormous, and his pioneering efforts set the standards for a number of techniques in fistula repair. While now nearly obsolete in the United States, vesico-vaginal fistula remains a significant problem in many developing countries. In Ethiopia, the renowned Addis Ababa Fistula Hospital, in operation since 1975, has treated more than 15,000 women.
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    Keywords: Overview, Obstetric Fistula
     
  • The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992
    Danso, J, Martey, K., Wall, L.L, Elkins T. (1996) The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992. International Urogynecology Journal, 7(3), 117-120
    The objective of the study was to determine the clinical epidemiology of genitourinary fistulae at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. A record review was carried out from January 1977-December 1992. There were a total of 164 cases of genitourinary fistulae, 150 of which were due to obstetric causes. Of those 150, 121 were due to obstructed labor, and 14 were due to complications associted with caesarean sections. There were 5 cases of RVF. Almost 25% of the patients had 5 or more children, and over 50% were multiparous. Fistulas were found in in the extermes of reproductive age and parity.
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    Keywords: Statistics, Obstetric Fistula, West Africa, Ghana
     
  • Obstetric fistula admissions at Komfo Anokye Teaching Hospital, Kumasi, Ghana
    Danso, K.A., Opare-Addo, H.S., Turpin, C.A. (2007). Obstetric fistula admissions at Komfo Anokye Teaching Hospital, Kumasi, Ghana. International Journal of Gynaecology and Obstetrics, 99(1), S69-S70.
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    Keywords: Statistics, West Africa, Obstetric Fistula, Ghana
     
  • Obstetric fistula: Guiding principles for clinical management and programme development, a new WHO guideline
    de Bernis, L. (2007). Obstetric fistula: Guiding principles for clinical management and programme development, a new WHO guideline. International Journal of Gynaecology and Obstetrics, 99(1), S117-S121
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    Keywords: Programs, Obstetric Fistula
     
  • Fistules recto-vaginales d’origine obstétricale
    Docquler, J., & Sako, A. (1983). Fistules recto-vaginales d’origine obstétricale. Médecine d’Afrique Noire, 30(5), 213-215
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    Keywords: Clinical Information, Obstetric Fistula, Niger, West Africa
     
  • Global burden of obstructed labour in the year 2000
    Dolea, C., & AbouZahr, C. (July, 2003). Global burden of obstructed labour in the year 2000. Evidence and Information for Policy (EIP), World Health Organization, Geneva
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    Keywords: Maternal Health, Obstetric Fistula
     
  • 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
     
  • 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
     
  • Reproductive performance after the repair of obstetric vesico-vaginal fistulae
    Evoh, N.J., & Akinia, O. (1978). Reproductive performance after the repair of obstetric vesico-vaginal fistulae. Annals of Clinical Research, 10, 303-306
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    Keywords: Statistics, Obstetric Fistula, Nigeria, West Africa
     
  • Vesicovaginal fistula repair combined with cesarean section
    Ezegwui, H.U. & Ezegwui, G.C. (2005). Vesicovaginal fistula repair combined with cesarean section. International Journal of Gynaecology and Obstetrics, 90(2), 146-147
    A 20-year-old woman was unsuccessful in terminating a pregnancy with local traditional drugs, and so went to full term without any formal anesnatal care. She spontaneously went into labor at home, and after 4 days of labor had a stillbirth and developed a vesicovaginal fistula. She was diagnosed with the condition by a dye test, administered under anesthesia, but fistula repair through the vagina to repair her juxta cervical fistula proved unsuccessful.
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    Keywords: Clinical Information, Nigeria, West Africa, Obstetric Fistula
     
  • Vesico-vaginal fistula in Eastern Nigeria
    Ezegwui, H.U., & Nwogu-Ikojo, E.E. (2005). Vesico-vaginal fistula in Eastern Nigeria. Journal of Obstetrics and Gynaecology, 25(6), 589-591.
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    Keywords: Statistics, West Africa, Nigeria, Obstetric Fistula
     
  • Necrotic obstetric vesico-vaginal fistulae.
    Fahmy, K. (1972). Necrotic obstetric vesico-vaginal fistulae. Journal of the Kuwait Medical Association, 8(3), 167-176
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    Keywords: Clinical Information, Obstetric Fistula, Kuwait
     
  • La double autoplastie de la grande lèvre dans la cure des fistules vesico-recto-vaginales d’origine obstétricale
    Falandry, L. (1990). La double autoplastie de la grande lèvre dans la cure des fistules vesico-recto-vaginales d’origine obstétricale. Journal de Chirurgie (Paris), 127(2), 107-112
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    Keywords: Clinical Information, Obstetric Fistula
     
  • [Urethroplasty using a pedicled labial flap in the treatment of urethral destruction of obstetrical origin: technics and results]
    Falandry, L. (1997). [Urethroplasty using a pedicled labial flap in the treatment of urethral destruction of obstetrical origin: technics and results] [French]. Progrès en Urologie, 7(1), 64-73
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    Keywords: Clinical Information, Obstetric Fistula, West Africa, Niger
     
  • La Fistule Obstétricale en Afrique
    Falandry, L, et al. (1989). La Fistule Obstétricale en Afrique. Médecine et Armées, 17(8), 571-578
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    Keywords: Statistics, Obstetric Fistula
     
  • [Pediculated labial ureteroplasty: an original treatment procedure for ureteral lesions of obstetric origin]
    Falandry, L., et al. (1997). [Pediculated labial ureteroplasty: an original treatment procedure for ureteral lesions of obstetric origin] [French]. Médecine Tropicale, 57(3), 273-279
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    Keywords: Clinical Information, Obstetric Fistula, Niger, West Africa
     
  • Ethical guidelines on obstetric fistula
    FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health. (2006). Ethical guidelines on obstetric fistula. International Journal of Gynaecology and Obstetrics, 94(2), 174-175
    The FIGO Committee Report gives a background to obstetric fistula, including definitions, occurrences, factors that contribute, consequences, and general success rates. Their recommendations are that priority needs to be given to ensure access to adequate health care for women, which included EmOC facilities. It also required improving women’s health, empowerment and discouraging harmful cultural practice (such as early childbirth and FGC). They also suggest that family planning be available to all who need it. There should also be a focus on fistula repair and coordination among services. Prevention, treatment and reintegration are all areas that should be focused on.
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    Keywords: Programs, Obstetric Fistula
     
  • Maternal morbidities affect tens of millions
    Finger, W.R. (1994). Maternal morbidities affect tens of millions. Family Health International Network, 14(3), 8-11
    Research finds that maternal morbidities, from life-threatening complications to simple discomforts, are far more prevalent than previously believed. The preliminary findings from a five-country study by FHI reveal that approximately 7 of every 10 women report a health problem related to their last pregnancy. While obstructed labour, complications from unsafe abortions and bacterial infections cause the most significant injury, anemia, hemorrhage and eclampsia are also common. Preliminary results show that for each maternal death, 240 to 340 women suffer from maternal morbidities. These findings could bring new attention to this problem, which has been largely neglected thus far, partly due to improper or lack of measurement. A serious chronic condition called obstetric fistula, which leads to urinary or fecal incontinence, occurs most commonly after prolonged, obstructed labour. Studies have found that limited access to emergency care and community norms contributes to this condition, and that women who suffer from fistula tend to be young. Repair for this debilitating condition is possible. Less serious morbidities, however, are less studied. In the study by FHI, and other studies underway, women (and not health care providers) are being asked about their morbidities. Contrary to expectations, women were willing to speak openly about their ailments. While measuring maternal morbidity is complicated, it has certain advantages over measuring mortality, since a woman is being asked for information about herself and not a deceased woman. A recent DHS Safe Motherhood Project in the Philippines has tested the accuracy of community-based surveys, and finds that women are fairly accurate in problem recognition and perception of their illness. Once completed, the results of these studies will bring to the fore the true magnitude of the problem of maternal morbidities, and will hopefully lead to much-needed action.
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    Keywords: Maternal Health, Obstetric Fistula, Philippines
     
  • Complex obstetric fistula
    Genardy, R.R., et al. (2007). Complex obstetric fistula. International Journal of Gynaecology and Obstetrics, 99(1), S51-S56
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    Keywords: Clinical Information, Obstetric Fistula
     
  • 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
     
  • [A rare case of post-partum urethrovaginal fistula. Management of obstetric complications]
    Golka, K.A., et al. (2008). [A rare case of post-partum urethrovaginal fistula. Management of obstetric complications] [Polish]. Ginekologia Polska, 79(1), 56-59
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    Keywords: Clinical Information, Obstetric Fistula
     
  • Complications of treatment of obstetric fistula in developing world: Gynatresia, urinary incontinence, and urinary diversion
    Gutman, R.R., Dodson, J.L., Mostwin, J.L. (2007). Complications of treatment of obstetric fistula in developing world: Gynatresia, urinary incontinence, and urinary diversion. International Journal of Gynaecology and Obstetrics, 99(1), S57-S64.
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    Keywords: Clinical Information, Obstetric Fistula
     
  • Providing an obstetric fistula service
    Hamlin, E.C., Muleta, M., Kennedy, R.C. (2002). Providing an obstetric fistula service. British Journal of Urology International, 89 (Suppl. 1), 50-53.
    When developing a fistula service program, there are four prerequisites that need to be covered. First, one needs to know the perceived need or demand for obstetric fistula services, which can be determined by looking at the maternal mortality and morbidity rates (which have a correlation with obstetric fistula). Second, actual need is also important to determine, though this can be more difficult to surmise. Finding out actual need can be done through a small study. Government permission then needs to be obtained, and effort should be made to work with the government. Government permission can then move into government support, especially in cases where the government receives funding for health project. There are four types of possible service provisions: a fistula hospital, a health centre, a hospital wing, and outreach services. A fistula hospital would be the gold standard. At these facilities, there are recommended requirements. First, the sites should have one obstetric gynecologist, surgeon, or physician, two qualified nurses and three-four nursing aides for every 25 patients. The buildings should also strive to fit in with the social and cultural norms of the community.
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    Keywords: Programs, Obstetric Fistula
     
  • 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.
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    Keywords: News, Bangladesh, Asia, Obstetric Fistula
     
  • La fistule vesico-vaginal de cause obstetricale: Enquete aupres de 52 femmes admises au village des fistuleuses.
    Harouna, Y.D., et al. (2001). La fistule vesico-vaginal de cause obstetricale: Enquete aupres de 52 femmes admises au village des fistuleuses. Medecine d’Afrique Noire, 48(2), 55-59.
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    Keywords: Clinical Information, West Africa, Obstetric Fistula, Niger
     
  • 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
     
  • Childbearing, health and social priorities: a survey of 22,774 consecutive hospital births in Zaria, Northern Nigeria
    Harrison, K.A. (1985) Childbearing, health and social priorities: a survey of 22,774 consecutive hospital births in Zaria, Northern Nigeria. British Journal of Obstetrics and Gynaecology, Supplement 5, 119
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    Keywords: Statistics, Maternal Health, Obstetric Fistula, West Africa, Nigeria
     
  • Obstetric fistulae
    Harrison, K.A. (Unpublished). (1989). Obstetric fistulae. Paper prepared for Technical Working Group. Geneva: WHO, 38
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    Keywords: Overview, Obstetric Fistula
     
  • Obstetric fistula: One social calamity too many
    Harrison, K.A., et al. (1983). Obstetric fistula: One social calamity too many. An International Journal of Obstetrics and Gynaecology, 90(5), 385-386
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    Keywords: Overview, Obstetric Fistula
     
  • On behalf of the Maternal Mortality Working Group. Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data
    Hill K, Thomas K, AbouZahr C, et al, (2007). On behalf of the Maternal Mortality Working Group. Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet, 370, 1311–19.
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    Keywords: Statistics, Obstetric Fistula
     
  • 'Learn from my story': A partcipatory media initiative for Ugandan women affected by obstetric fistula
    Hill, Amy L. (2008). 'Learn from my story': A partcipatory media initiative for Ugandan women affected by obstetric fistula. Agenda (77), 48-60.
    Silence Speaks is an international digital storytelling initiative offering a supportive environment for telling stories that too often remain unspoken and unseen and bringing these stories to relevant audiences. It facilitates workshops in which participants share and bear witness to tales of struggle and courage, resulting in short digital videos known as ‘digital stories’. The workshops challenge media legacies of voyeurism and naturalised representation by ensuring that participants, not producers, have primary control over what is shared. The guiding vision is to listen deeply, facilitate reflection and transformation and encourage involvement in collective action to support justice and human rights. In 2006, the project travelled to Uganda to gather stories of rural women who have endured obstetric fistula. This focus describes the methodology used, which offered opportunities for counselling, health education and women’s leadership development. It includes story excerpts and emphasises concrete local uses for these unique media pieces for health trainings and in policy advocacy settings.
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    Keywords: Eastern and Southern Africa, Uganda, Obstetric Fistula
     
  • 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
     
  • Obstetric Fistula: Ending the Silence, Easing the Suffering
    Hinrichsen, D., et al. (2004, September). Obstetric Fistula: Ending the Silence, Easing the Suffering. INFO Reports, No. 2. Baltimore, Johns Hopkins Bloomberg School of Public Health, The INFO Project
    An obstetric fistula is an abnormal opening between the vagina and the bladder or rectum of a woman. Obstetric fistula results from prolonged (> 24 hours) obstructed labor that occurs due to cephalo-pelvic disproportion, malpresentation or ineffective uterine contractions. Obstructed labor is an important maternal health issue in itself, as it accounts for 8% of maternal deaths. Women who survive this birth complication may suffer from other physical problems in addition to fistula, such as infections, paralysis of muscles in the lower legs, amenorrhea, infertility, and damage to vaginal tissue that may make sexual intercourse impossible.
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    Keywords: Overview, Obstetric Fistula
     
  • The Mitrofanoff urinary diversion for complex vesicovaginal fistulae: experience from Uganda
    Hodges, A.M. (1999). The Mitrofanoff urinary diversion for complex vesicovaginal fistulae: experience from Uganda. The British Journal of Urology, 84, 436-439
    Objective: To evaluate the results of Mitrofanoff continent urinary diversion in a group of women with persistent severe incontinence after vesicovaginal fistula (VVF) secondary to obstructed labour. Patients and Methods: Seven women with severe incontinence following a VVF were offered the Mitrofanoff procedure after all other attempts had failed to restore continence. In three patients a caecocystoplasty formed the urinary reservoir and in four the bladder was used. In all seven patients the appendix was used as the conduit for self-catheterization. The mean (range) follow-up was 10 (3-14) months. Results: One patient died postoperatively from hepatic failure, which could not be attributed to the particular procedure. One patient required re-operation at 10 days to adjust the conduit, but of the six patients who recovered, all are fully continent and self-catheterizing with no difficulty. Conclusion: The Mitrofanoff procedure appears to be a valuable technique to restore continence in this difficult group of patients.
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    Keywords: Eastern and Southern Africa, Clinical Information, Obstetric Fistula, Uganda
     
  • Obstetric fistulae: a study of women managed at the Monze Mission Hospital, Zambia
    Holme, A., et al. (2007). Obstetric fistulae: a study of women managed at the Monze Mission Hospital, Zambia. International Journal of Obstetrics and Gynaecology, 114(8), 1010-1017.
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    Keywords: Statistics, Obstetric Fistula, Eastern and Southern Africa, Zambia
     
  • 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
     
  • Obstetric urogenital fistula: The Ilorin experience, Nigeria.
    Ijaiya, M.A., & Aboyeji, P.A. (2004). Obstetric urogenital fistula: The Ilorin experience, Nigeria. West African Journal of Medicine, 23(1), 7-9
    A study of thirty-four cases of obstetric urogenital fistula managed over a ten-year period (1st January, 1989 to 31st December, 1998) at the University of Ilorin Teaching Hospital is reported. The incidence of obstetric urogenital fistula is 1.1 per 1000 births. The condition is associated with illiteracy and poorly supervised delivery. The mean age was 23.9 (range 15-43) with a peak incidence in the 15-19 years age group (26.5%). 50 % were primiparous and 32.4% were grandmultiparous.
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    Keywords: Clinical Information, West Africa, Obstetric Fistula, Nigeria
     
  • 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
     
  • Obstetric fistula: Ending the silence, easing the suffering
    INFO Reports. (September 2004). Obstetric fistula: Ending the silence, easing the suffering. The INFO Project, Issue 2, 12p. Available at www.infoforhealth.org/inforeports/fistula/fr/ofbib.shtml .
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    Keywords: Overview, Obstetric Fistula
     
  • Fistule obstetricale: Fin du silence, moins de souffrance.
    INFO Reports. (September 2004).Fistule obstetricale: Fin du silence, moins de souffrance. The INFO Project, Issue 2, 12p. Available at www.infoforhealth.org/inforeports/fistula/fr/ofbib.shtml
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    Keywords: Overview, Obstetric Fistula
     
  • Complications of obstructed labour: pressure necrosis of neonatal scalp and vesicovaginal fistula
    J van Beekhuizen, H, et al. (2006). Complications of obstructed labour: pressure necrosis of neonatal scalp and vesicovaginal fistula. The Lancet, 368, 1210
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    Keywords: Clinical Information, Obstetric Fistula, Tanzania, Eastern and Southern Africa
     
  • 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.
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    Keywords: Overview, Obstetric Fistula, Asia, Pakistan
     
  • Commentary: Outreach programmes for obstetric fistulae
    Kelly, J. (2004). Commentary: Outreach programmes for obstetric fistulae. Journal of Obstetrics and Gynaecology, 24(2), 117-118
    Outreach programs for obstetric fistula must be designed with careful consideration. In order to set up a fistula repair center, a few key considerations are the provision of free or low cost services, and the teamwork and capacity building of local health care workers and health care groups, nurses, volunteers, physiotherapists, anesthetists, and even the patient and her relatives. The types of fistulas encountered are VVF (74%), VVF and RVF (21%) and RVF alone (5%). Essential techniques include fistula repair, catheterization, re-implanting of ureters and urethra creation, as well as special training for all members of the team. Fistula surgeons require not only skill, but dedication as well. Surgical trainees should perform simple surgeries for at least one year after training. Outreach programs must also be aware of strategies for reduction of maternal mortality and morbidity, such as training of traditional birth attendants and introduction of maternity waiting homes. Reduction in overcrowding at teaching hospitals can be achieved by improving services at other health centers.
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    Keywords: Programs, Obstetric Fistula, Eastern and Southern Africa
     
  • Kelly
    Kelly, J. (1991). Fistulae of obstetric origin. Midwifery, 7(2), 71-73
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    Keywords: Overview, Obstetric Fistula
     
  • Random sample of 310 patients admitted for obstetric fistulae at the Addis Ababa Fistula Hospital. Addis Ababa, Ethiopia
    Kelly, J. (Unpublished). (1976-1989). Random sample of 310 patients admitted for obstetric fistulae at the Addis Ababa Fistula Hospital. Addis Ababa, Ethiopia
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula
     
  • The burden of maternal ill health
    Kelly, J. (1999). The burden of maternal ill health. Safe Motherhood: A Newsletter of Worldwide Activity, 27: 5
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    Keywords: News, Obstetric Fistula, Nigeria, West Africa
     
  • 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
     
  • 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.
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    Keywords: Clinical Information, Obstetric Fistula, Eastern and Southern Africa, Ethiopia
     
  • Reflections on the knowledge base for obstetric fistula
    Kelly, J., & Winter, H.R. (2007). Reflections on the knowledge base for obstetric fistula. International Journal of Gynaecology and Obstetrics. 99(1), S21-S24
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    Keywords: Clinical Information, Obstetric Fistula
     
  • The use of ultrasonography in obstetrics in developing countries
    Kongnyuy, E. J., & van den Broek, N. (April, 2007). The use of ultrasonography in obstetrics in developing countries. Tropical Doctor, 70-72
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    Keywords: Maternal Health, Obstetric Fistula
     
  • 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
     
  • The danger of obstetric fistula
    Krishnakumar, A. (2004). The danger of obstetric fistula. Frontline-USAID employee newsletter, 21(16)
    There are between 50,000 and 100,000 new cases of fistula worldwide each year. These cases are extensively prevalent in Asia and sub-Saharan Africa. Obstetric fistula is usually the result of obstructed childbirth in young pregnant women. According to Family Care International, pregnancy-related deaths are the leading cause of mortality among 15-19 year olds worldwide. In Niger, 88 percent of women with obstetric fistula were aged between 10-15 at marriage. Child marriage is a major cause of serious health risks for women. Women who are very young going through their first childbirth and women whose growth has been stunted owing to malnutrition and childhood illness are most at risk for fistula.
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    Keywords: News, Obstetric Fistula, Tanzania, Eastern and Southern Africa
     
  • 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
     
  • Nightmare for African Women: Birthing Injury and Little Help
    LaFraniere, S. (2005, September 28). Nightmare for African Women: Birthing Injury and Little Help. The New York Times
    Inno Usman, 25, waited for surgery this month in Babbar Ruga Hospital in Nigeria. She suffered from an obstetric fistula, an injury, suffered by many African women, that can be prevented with a Caesarean section. What brings the girls to Dr. Waaldijk - and him to Nigeria - is the obstetric nightmare of fistulas, unknown in the West for nearly a century. Mostly teenagers who tried to deliver their first child at home, the girls failed at labor. Their babies were lodged in their narrow birth canals, and the resulting pressure cut off blood to vital tissues and ripped holes in their bowels or urethras, or both. The number of new cases is far outpacing repairs - not just here, but in other sub-Saharan nations like Kenya, Malawi and Uganda. Despite recent strides, said Thoraya Ahmed Obaid, the Population Fund's executive director, 'at the current rate of action it will take decades to end fistula.'
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    Keywords: News, Obstetric Fistula, Nigeria, West Africa
     
  • Incontinence Data from the Demographic and Health Surveys: Comparative Analysis of a Proxy Measurement of Vaginal Fistula and Recommendations for Future Population-Based Data Collection
    Johnson, Kiersten, and Amber Peterman. 2008. Incontinence Data from the Demographic and Health Surveys: Comparative Analysis of a Proxy Measurement of Vaginal Fistula and Recommendations for Future Population-Based Data Collection. DHS Analytical Studies No. 17. Calverton, Maryland, USA: Macro International Inc.
    Until recently, the problem of gynecological fistula has been a low-priority issue on international agendas, in part because its prevalence is perceived to be low. In fact, however, the true prevalence of fistula is not known. This report represents an effort to begin to fill the gaps in knowledge about the prevalence and covariates of fistula, a condition that causes immense suffering and yet is completely preventable. Increasing knowledge about the condition, its prevalence, and its risk factors improves the chances that maternal health in general, and the issue of fistula specifically, will receive appropriate political, financial, and programmatic attention. Establishing a baseline for prevalence will allow for the possibility of an assessment of programmatic and policy interventions. The Demographic and Health Surveys (DHS) program has therefore initiated the collection of data on the problem of fistula. This document reports on that effort, including a critique of data collection methods and an analysis of the collected data on fistula symptoms and their covariates. This report demonstrates the effects that methodological approaches to survey implementation have on self-reported prevalence of severe incontinence and its covariates, and it underscores the need for careful consideration in sample selection and questionnaire construction. As a remedy for the suboptimal approaches to data collection that have been used in the past in the DHS program, this report presents a newly developed fistula survey module. Above all, it must be understood that all women are at risk for developing fistula, and, therefore, in the collection of prevalence data on symptoms of fistula, all women must have the opportunity to respond to a carefully considered set of questions, such as the module presented here (Figure 1.3). While the findings highlight the difficulties of data collection on fistula specifically and on maternal morbidity in general, they also indicate that, where data were correctly collected, the majority of the reported risk factors found in the literature on fistula in the developing world were indeed correlated with women’s reported symptoms. Further, the fact that the prevalence of any incontinence in an unselected population of women can be quite high, when compared with the lower prevalence of fistula symptoms reported here, suggests that over-reporting of these symptoms in DHS surveys may not be egregious. This report also serves to establish baseline levels of symptoms of fistula in several countries. Only through establishing the prevalence of fistula can contributing factors be identified, appropriate and sufficient resources be allocated, and interventions be evaluated at the national level. As the effort to collect data on fistula evolves, more standardized and appropriate data for analysis will become available, which will further assist the development of programmatic interventions (focused both on prevention and on repair and rehabilitation) and will better guide policymaking. Findings from these analyses include both the expected and the unexpected. It was expected that, when women have limited access to health care, they will be at higher risk for experiencing symptoms of fistula. An association between stillbirth and reporting of fistula symptoms also was expected. In contrast, the fairly consistent association between sexual violence and fistula symptoms underscores the unexpected: resources to eradicate the suffering caused by fistula must be directed not only to improving maternal health care services, and access thereto, but also to supporting survivors of sexual violence and ultimately eradicating sexual violence against women. Preventing pregnancy, specifically unwanted pregnancy, is a key primary prevention approach to maternal morbidity and mortality. The findings of this report indicate that, to the degree that fistulae develop through obstetric causes, there is a critical need to re-emphasize the role of family planning in ensuring maternal health and survival. xii Finally, our results suggest that women who struggle with their labors do indeed seek medical care but too late to preclude severe morbidity. Women and families must be supported at the community, district, and national levels to recognize the signs of prolonged labor, to make appropriate and timely decisions about care during labor and delivery, and to have quick access to effective emergency care. While the implementation of policy and programmatic strategies to eliminate fistula—whether of violent, obstetric, or iatrogenic derivation—will differ depending on national and subnational contexts, the driving element behind such efforts will be rooted in the same place: a sense of value and respect for the lives of women.
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    Keywords: Statistics, Overview, Obstetric Fistula
     
  • Pregnancy and delivery after ureterosigmoidotomy for vesicovaginal fistula
    Lassey, A.T., et al. (2002). Pregnancy and delivery after ureterosigmoidotomy for vesicovaginal fistula. International Journal of Obstetrics and Gynecology, 79(1), 25-26
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    Keywords: Clinical Information, Obstetric Fistula, Ghana, West Africa
     
  • UNHCR, UNFPA fund surgery for refugee and local women in Chad.
    Le Breton, G. (March 17, 2005). UNHCR, UNFPA fund surgery for refugee and local women in Chad. Office of the United Nations High Commissioner for Refugees (UNHCR) news story. Retrieved May 26, 2005 from http://www.unhcr.ch/cgibin/texis/vtx/news/opendoc.htm?tbl=NEWS&id=4239519f4
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    Keywords: News, Traumatic Fistula, Obstetric Fistula, West Africa, Chad
     
  • Regional and geographical variations in infertility: effects of environmental, cultural, and socioeconomic factors
    Leke, R.J., et al. (1993). Regional and geographical variations in infertility: effects of environmental, cultural, and socioeconomic factors. Environmental Health Perspectives, 101(2), 73-80.
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    Keywords: Maternal Health, Obstetric Fistula
     
  • Genitourinary fistula experience in Sierra Leone: review of 505 cases
    Lewis, A., et al. (2009). Genitourinary fistula experience in Sierra Leone: review of 505 cases. Journal of Urology, 181(4), 1725-31
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    Keywords: Statistics, West Africa, Obstetric Fistula, Sierra Leone
     
  • Obstetric Fistula: Guiding principles for clinical management and programme development
    Lewis, G., & de Bernis, L (Eds.). (2005) Obstetric Fistula: Guiding principles for clinical management and programme development. Geneva: WHO
    This guide was put together by the Fistula Manual Steering Committee and included input from fistula surgeons, the AMDD programme at Columbia University, UNFPA, and FIGO. The manual has two sections: 1) Understanding the problem and developing a national approach and 2) Basic principle for caring for women undergoing obstetric fistula repair. In the first section, it details developing an OF prevention and treatment strategy as well as putting together national policy committee. It further describes how to develop realistic policies and strategies, how to set up services and how to make sure there are adequately trained medical staff to work on fistula repairs. The second section goes into the clinical and surgical principles for the management and repair of obstetric fistula as well as the principles of nursing care and pre-and post-operative physiotherapy. The last chapter focuses on the principles for the social re-integration and rehabilitation of women who have had an obstetric fistula repair.
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    Keywords: Programs, Obstetric Fistula
     
  • Canada squanders opportunity to help third world mothers.
    LifeSiteNews. (2002, November 13). Canada squanders opportunity to help third world mothers. Retrieved March 2, 2005 from http://www.lifesite.net/ldn/2002/nov/02111301.html
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    Keywords: News, Obstetric Fistula
     
  • Bladder and urethral injuries following prolonged labour
    Linke, C.A. et al. (1971). Bladder and urethral injuries following prolonged labour. Journal of Urology, 105, 679-68.
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    Keywords: Clinical Information, Obstetric Fistula
     
  • Maternal morbidity in developing countries: a review and comments
    Liskin, L.S. (1992). Maternal morbidity in developing countries: a review and comments. International Journal of Gynaecology and Obstetrics, 37, 77-87.
    There is very little published data regarding maternal morbidity rates. The most commonly cited estimate, 16 cases of maternal morbidity to each maternal death, is from a study published in 1980 of 270 women in a small Indian village. The different types of illnesses associated with maternal morbidity are also not completely agreed upon. The author groups the different types of illnesses into 3 categories: 1) short term, acute complications (ie obstructed labor, infection), 2) chronic complications (ie fistulas) 3) associated illnesses (malaria, hepatitis). The author then goes into greater detail on each complication.
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    Keywords: Maternal Health, Obstetric Fistula
     
  • L’Incidence de l’infection urinaire dans la cure des fistules vésico-vaginales obstétricales
    Lufuma, L.N. and Tshipeta. (1978). L’Incidence de l’infection urinaire dans la cure des fistules vésico-vaginales obstétricales. A propos de 60 cas. Médecine d’Afrique Noire, 25(2), 107-110
    Link to Source
    Keywords: Clinical Information, obstetrical
     
  • Obstetrical fistulae & efforts of the United Nations
    Luthra, R. Obstetrical fistulae & efforts of the United Nations. (no date). Women’s Health and Education Center. Retrieved March 2, 2005 from http://www.womenshealthsection.com.
    The United Nations provides a valuable forum for international dialogue on maternal mortality and morbidity. The Millennium Development Goals, to be achieved by 2015, include as goals the improvement of maternal health, the empowerment of women and the promotion of gender equality. Addressing maternal mortality and addressing obstetric fistulae are merely the tip of the iceberg in improving maternal health. Obstetric fistula, an injury that can occur during prolonged labour, results in constant leakage of urine and/or feces from a woman’s vagina. Highly prevalent in Africa, this condition is a result of a myriad of factors, including poverty, lack of emergency obstetrical care, lack of knowledge etc. In addition to its devastating social and physical consequences, obstetrical fistulae can also render a woman childless, which affects her social status in many parts of the world. Public health work in general must incorporate improvements in food, water, sanitation and shelter. Efforts in the African region, which is currently caught in a downward spiral, must include information, education and communication, based on what African people themselves perceive their needs to be, in their own languages. Safe Motherhood Initiatives have demonstrated that there is no single magic solution to reducing maternal mortality, but rather multiple efforts together can have an impact, including training TBAs in the context of a referral system, raising awareness in the community etc. To achieve safe motherhood, proper infrastructure of the organizational framework must be in place so that women and communities can access different levels of the health care system.
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    Keywords: Programs, Obstetric Fistula
     
  • Characteristics of women admitted with obstetric fistula in the rural hospitals in West Pokot, Kenya
    Mabeya, H. M. (2004) Characteristics of women admitted with obstetric fistula in the rural hospitals in West Pokot, Kenya. Geneva Foundation for Medical Education and Research
    Objective: To determine the prevalence rate and characteristics of women admitted with obstetric fistula in rural hospitals in West Pokot, Kenya. Design: A 5-year descriptive study from January 1999 to December 2003 including all obstetric fistula patients. A total number of 66 patients were analyzed. Information extracted included age, age at onset of fistula, parity, education, occupation, marital status, duration of labor, place and mode of delivery, obstetric outcome, presence or absence of severe female genital mutilation (infibulation) and surgical outcome. Results: The prevalence of obstetric fistula was 1 per 1000 women. Sixty five percent had onset of fistula at 20 years of age and less; 55% were primigravida; 59% had no formal education. The success rate at first repair attempt was 87%. Eighty percent had undergone severe female genital mutilation, 68% of the deliveries were stillbirths and 73% of women had prolonged labor. Conclusion: Prolonged labor, age, severe female genital mutilation, level of education, parity, occupation, lack of access to transport and primary health care in the rural community and early marriage were characteristics of the fistula patients. Successful repair was high at first attempt in good hands of trained fistula surgeons, trained nurses and well set hospital facilities.
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula, Kenya
     
  • USAID program for the prevention and the treatment of vaginal fistula
    MacDonald, P., Stanton, M.E. (2007). USAID program for the prevention and the treatment of vaginal fistula. International Journal of Gynaecology and Obstetrics, 99(1), S112-S116
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    Keywords: Programs, Prevention, Traumatic Fistula, Obstetric Fistula
     
  • Uganda’s Fistula Patients Lack Knowledge of Prevention and Treatment
    Matsamura, E.K. (2004, March). Uganda’s Fistula Patients Lack Knowledge of Prevention and Treatment. Population Reference Bureau. Retrieved March 24, 2005. http://www.prb.org
    Martina Nakamya (not her real name) was having her first baby after having left school at age 16 because of her pregnancy. Preparations were made with the birth attendant in the village. Nakamya’s labor lasted almst four days. When she finally pushed the baby out, it was dead, and Nakamya was not well. She “leaked” and smelled of urine and feces all day, everyday. The teenager had obstetric fistula. Most fistula patients in Uganda are young and poor with little education and limited access to quality health care, including emergency obstetric care. Often, patients lack the knowledge that the condition can be repaired and are too ashamed of their condition to seek help. Those who remain untreated may be shunned by their communities and relatives and must find new ways to support themselves. It is difficult to know the extent of the problem in Uganda. Poor knowledge of the causes and treatment of fistula within communities, long distances to health facilities, and inability to pay for services all result in limited use of the services that do exist.
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    Keywords: Eastern and Southern Africa, News, Obstetric Fistula, Prevention, Uganda
     
  • Extra-urethral urinary incontinence after incompetent vaginal obstetrics
    Mattelaer, J., & Williams, G. (1999). Extra-urethral urinary incontinence after incompetent vaginal obstetrics. BJU International, 84(1), 10-13
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    Keywords: Clinical Information, Obstetric Fistula
     
  • Reducing maternal mortality in Kigoma, Tanzania
    Mbaruku, G., & Bergstrom, S. (1995). Reducing maternal mortality in Kigoma, Tanzania. Health Policy and Planning, 10, 71-78.
    The maternal mortality rate in Tanzania has been estimated at 350 deaths per 100,000 live births. Studies have indicated that the region of Kigoma has one of the highest maternal mortality rates. The purpose of this study was to review data from available sources (predominately the Regional Hospital) on maternal mortality from over a period of three years (1984-1986) and then based on that data, come up with an intervention strategy. The main causes of admission to the Department of Obstetrics and Gynaecology were malaria, anaemia and pelvic infection. Sepsis and septic abortion also made up significant proportions of admissions. An analysis of the contributory causes to maternal deaths was also undertaken. There was a shortage of basic equipment, and water. Staff attitudes were also assessed, and it was noted that there was a “deplorable indifference” towards patients. Patients were also dissatisfied with the treatment received. In the ‘discussion’ section, the authors also mention the critical importance of addressing staff attitudes and staff morale, through improved training, collective problem-solving, and improved working environments.
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    Keywords: Maternal Health, Eastern and Southern Africa, Obstetric Fistula, Tanzania
     
  • A framework for analyzing the determinants of maternal mortality
    McCarthy, J., & Maine, D. (1992). A framework for analyzing the determinants of maternal mortality. Studies in Family Planning, 23(1), 23-33
    The authors state that the framework that they developed can be used for maternal morbidity as well as mortality. The framework is made up of three parts: 1. Distant determinants (socioeconomic and cultural factors), 2. Intermediate determinants (health status, reproductive status, access to health services, and health care behavior/use of health services), and 3. Outcomes (pregnancy, complication, death/disability). The article goes into greater detail for each of these determinants. By using this framework in research, it can clarify how distant and intermediate factors, including social, behavioral and biological, can influence the outcome. By that same token, the framework can be of assistance in program design. One of the main conclusions was that efforts to reduce maternal mortality must done through one of the 3 intermediate outcomes: 1) To reduce the likelihood that a women will get pregnant 2) To reduce that likelihood that a pregnant women will experience serious complication of pregnancy or delivery 3) To improve the outcomes for women who do experience complications.
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    Keywords: Maternal Health, Obstetric Fistula
     
  • [Neurologic aspects of vesico-vaginal fistula of obstetrical origin]
    Mensah, A., et al. (1996). [Neurologic aspects of vesico-vaginal fistula of obstetrical origin] [French]. Progres en Urologie, 6(3), 398-402
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    Keywords: Clinical Information, Obstetric Fistula
     
  • Risk Factors for Obstetric Fistulae in North- eastern Nigeria
    Melah, G.S., et al. (2007). Risk Factors for Obstetric Fistulae in North- eastern Nigeria. Journal of Obstetrics and Gynaecology, 27(8), 819-823
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    Keywords: Statistics, West Africa, Obstetric Fistula, Nigeria
     
  • Commonalities among women who experienced vesico-vaginal fistulae as a result of obstetric trauma in Niger: results form a survey given at the National Hospital Fistula Center Niamey, Niger
    Meyer, L., et al. (2007). Commonalities among women who experienced vesico-vaginal fistulae as a result of obstetric trauma in Niger: results form a survey given at the National Hospital Fistula Center Niamey, Niger. American Journal of Obstetrics and Gynaecology, 197(1), 90.e1-4
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    Keywords: Statistics, West Africa, Obstetric Fistula, Niger
     
  • Obstetrci Fistula: A preventable tragedy
    Miller, et al. (2005). Obstetrci Fistula: A preventable tragedy. Journal of Midwifery and Women’s Health, 50(4), 286-94
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    Keywords: Overview, Obstetric Fistula
     
  • 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
     
  • Le remplacement du vagin par un greffon sigmoidien pour la cure des grandes necroses uro-génitales post partum Africaines
    Monseur, J. (1980). Le remplacement du vagin par un greffon sigmoidien pour la cure des grandes necroses uro-génitales post partum Africaines. Journal d’Urologie, 86(3), 159-166
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    Keywords: Clinical Information, Obstetric Fistula, Eastern and Southern Africa, Democratic Republic of Congo
     
  • 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.
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric 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
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    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
     
  • Faces of dignity: seven stories of girls and women with fistula
    Mwanamke, (2003). Faces of dignity: seven stories of girls and women with fistula. Reproductive Health Matters, Women’s Dignity Project
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    Keywords: Overview, Obstetric Fistula
     
  • Obstetric vesico-vaginal fistulas at the National Hospital of Niamey, Niger
    Nafiou, I., et al. (2007). Obstetric vesico-vaginal fistulas at the National Hospital of Niamey, Niger. International Journal of Gynaecology and Obstetrics, 99(1), S71-S74.
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    Keywords: Statistics, West Africa, Obstetric Fistula, Niger
     
  • 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
     
  • 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
     
  • 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
     
  • [The musculo-fascial graft from the elevator muscle of the anus. Importance for plastic surgery of the bladder in the treatment of obstetric vesico-vaginal fistulas]
    N’Guessan, G., et al. (2000). [The musculo-fascial graft from the elevator muscle of the anus. Importance for plastic surgery of the bladder in the treatment of obstetric vesico-vaginal fistulas] [French]. Morphologie, 83(261), 51-55.
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    Keywords: Clinical Information, Obstetric Fistula
     
  • 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
     
  • Obstructed Labour
    Nielson, J.P., et al. (2003). Obstructed Labour. British Medical Journal, 67, 191-204
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    Keywords: Maternal Health, Obstetric Fistula
     
  • 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
     
  • Prevention of obstetric urogenital fistulae: some thoughts on a daunting task
    Norman, A.M., et al. (2007). Prevention of obstetric urogenital fistulae: some thoughts on a daunting task. International Urogynecology Journal and Pelvic Floor Dysfunction, 18(5), 485-491
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    Keywords: Overview, Obstetric Fistula, Prevention
     
  • Healing wounds, instilling hope: The Tanzanian Partnership against Obstetric Fistula
    Obaid, T.A., & Chong, E. (2004). Healing wounds, instilling hope: The Tanzanian Partnership against Obstetric Fistula. Population Council, 34p
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    Keywords: Programs, Eastern and Southern Africa, Obstetric Fistula, Tanzania
     
  • Preventing birth injury among women in Africa: Case studies in Northern Nigeria
    Ojanuga, D. (1991). Preventing birth injury among women in Africa: Case studies in Northern Nigeria. American Journal of Orthopsychiatry, 61(4), 533-539
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    Keywords: Programs, West Africa, Obstetric Fistula, Nigeria
     
  • Social Work Practice with Childbirth-Injured Women in Nigeria
    Ojanuga, D. (1994). Social Work Practice with Childbirth-Injured Women in Nigeria. Health and Social Work, 19(2), 120-124.
    This article details a social work program established at hostels for VVF patients at Ahmadu Bello University Teaching Hospital in Zaria and the Murtala Mohammed Specialist Hospital in Kano. 127 patients and 7 social workers were interviewed. The mean age of the patients was 20.8, most had married between the ages of 12 and 15, and none had completed primary school. All the women had begun labor at home and most were in labor of 2-3 days. Only 1 woman had a live birth.
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    Keywords: Statistics, West Africa, Obstetric Fistula, Nigeria
     
  • Local anesthesia: An appropriate technology for simple fistula repair
    Ojengbede, O.A., & Morhason-Bello, I.O. (2007). Local anesthesia: An appropriate technology for simple fistula repair. International Journal of Gynaecology and Obstetrics, 99(1), S40-S47
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    Keywords: Clinical Information, Obstetric Fistula, West Africa, Nigeria
     
  • Surgical management of ruptured gravid uterus in Bida, North Central Nigeria
    Ojenuwah, S.A., & Olowosulu, R.O. (2007). Surgical management of ruptured gravid uterus in Bida, North Central Nigeria. Tropical Doctor, 37(4), 219-221
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    Keywords: Clinical Information, West Africa, Obstetric Fistula, Nigeria
     
  • 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
     
  • Major injuries to the urinary tract in association with childbirth
    Onuora, V.C., et al. (1997). Major injuries to the urinary tract in association with childbirth. East African Medical Journal, 74(8), 523-526.
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    Keywords: Statistics, Obstetric Fistula, Saudi Arabia
     
  • Iye Sowodie's 'Gladdie, Gladdie' day. Mercy Ships treats women made incontinent by birth injuries
    Osborne, M. (2006). Iye Sowodie's 'Gladdie, Gladdie' day. Mercy Ships treats women made incontinent by birth injuries. Midwifery Today with International Midwife, 80, 60-61
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    Keywords: Programs, Obstetric Fistula
     
  • Pregnancy and delivery after successful repair of vesicovaginal fistula
    Otubu, J.A. et al. (1982). Pregnancy and delivery after successful repair of vesicovaginal fistula. International Journal of Gynaecology and Obstetrics, 20, 163-166
    Link to Source
    Keywords: Statistics, Obstetric Fistula, Nigeria, West Africa
     
  • Helping Girls to Keep Marriage Under Wraps
    Ouedraogo, Brahima. (2004, March 24). Helping Girls to Keep Marriage Under Wraps. Inter Press Service News Agency. Retrieved May 11, 2005 from http://ipsnews.net
    It is an article of faith in development circles that assisting girls to complete their education-and postponing the age at which they have children-benefits both the girls and the communities they live in. This truth is proving difficult to entrench in Burkina Faso, however, where early marriages-and worse still, forced marriages-are often the norm. This is despite a 1990 law that sets the marriage ate fro girls at 18 and for boys at 22. Eleven-year-old Sylvie Sawadogo is one of those who narrowly escaped this fate. She lives with nuns at that Kaya Sisters Centre in northern Sanmantinga province: a home that caters for girls who have managed to fend of early marriage. While early wedlock can dramatically reduce a girl’s educational and economic prospects, it also holds health risks. These include the possibility of obstetric fistulas in girls who fall pregnant after being married at a very young age.
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    Keywords: News, Obstetric Fistula, West Africa, brukina-faso
     
  • Fistules vésico-vaginales obstétricales en Afrique Noire
    Perquis, P. (1971). Fistules vésico-vaginales obstétricales en Afrique Noire. Médecine Tropicale, 31(5), 1-9.
    Link to Source
    Keywords: Statistics, Obstetric Fistula
     
  • Sierra Leone’s silent sufferers
    Pigott, R. (2004, June 18). Sierra Leone’s silent sufferers. BBC News. Retrieved February 24, 2005 from http://news.bbc.co.uk/
    Fatmata Kargbo was unaware of the risks of fistula when she became pregnant, though she was aware there were other health risks. Her experience after her obstructed labour and resulting fistula are typical as well as catastrophic. She was rejected by her husband and family and driven out of her village. She works breaking stones for builders on the outskirts of Freetown, though no one will work with her. Christian charity Mercy ships, such as the Anastasis, are moored in the Freetown harbour and are used as floating hospitals where fistula repairs can be done. Only a hundred fistulas were repaired on its last visit.
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    Keywords: News, West Africa, Obstetric Fistula, Sierra Leone
     
  • Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates
    Prual, A. et al. (2000). Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Bulletin of the World Health Organization, 78(5), 593-602
    In West Africa, the maternal mortality rates are estimated at 1020 deaths per 100,000 births, 38 times higher than in developed countries. Morbidity data is very difficult to assess, so the authors conducted a multicentre, prospective, population-based study to measure the incidence of maternal morbidity and the predictive value of risk factors screened during prenatal care sessions. This study was conducted between December 1994 and June 1996 in sites in Burkina Faso, Cote d’Ivoire, Mali, Mauritania, Niger and in Senegal. Severe hemorrhage was the most frequent direct cause of severe obstetric morbidity. The second most common cause was severe dystocia (difficult labor). They found that there was a general ratio of 1 death for 32 cases of severe morbidity. Given that these rates are based on hospital data, it is likely an underestimation.
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    Keywords: Maternal Health, West Africa, Obstetric Fistula
     
  • 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.
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    Keywords: Statistics, Obstetric Fistula, Asia, Pakistan
     
  • Surgical treatment of rectovaginal fistula of obstetric origin: A review of 15 years’ experience in teaching hospital
    Rahman, M., et al. (2003). Surgical treatment of rectovaginal fistula of obstetric origin: A review of 15 years’ experience in teaching hospital. Journal of obstetrics and Gynaecology, 23(6), 607-610
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    Keywords: Clinical Information, obstetrical, Saudi Arabia
     
  • An audit of obstetric fistulae in teaching hospital in South Africa
    Ramphal, S. R., et al. (2008). An audit of obstetric fistulae in teaching hospital in South Africa. Tropical Doctor, 38, 162-163
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    Keywords: Statistics, Eastern and Southern Africa, Obstetric Fistula, South Africa
     
  • Role of the martius procedure in the management of urinary-vaginal fistulas
    Rangnekar, N.P., et al. (2000). Role of the martius procedure in the management of urinary-vaginal fistulas. Journal of the American College of Surgeons, 191(3), 259-263
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    Keywords: Clinical Information, Obstetric Fistula
     
  • 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
     
  • Of flukes and fistulae
    Richter, J., et al. (2008). Of flukes and fistulae. The Lancet, 371, 1308.
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    Keywords: Clinical Information, Obstetric Fistula, West Africa
     
  • Repair of obstetric vesicovaginal fistulas in Africa
    Roenneburg, M.L., Genardy, R., Wheeless, C.R. Jr. (2006). Repair of obstetric vesicovaginal fistulas in Africa. American Journal of Obstetrics and Gynecology, 195(6), 1748-1752
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    Keywords: Clinical Information, Obstetric Fistula, Niger
     
  • Traumatic absence of the proximal urethra.
    Roenneburg, M.L., & Wheeless, C.R. Jr. (2005). Traumatic absence of the proximal urethra. American Journal of Obstetrics and Gynaecology, 193(6) 2169-2172.
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    Keywords: Clinical Information, Obstetric Fistula, Niger
     
  • Social Implications of obstetric fistula: An integrative review.
    Roush, K. M. (2009). Social Implications of obstetric fistula: An integrative review. Journal of Midwifery and Women’s Health, 54(2), e21-33.
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    Keywords: Overview, Obstetric Fistula
     
  • Vesicovaginal fistula: obstetric causes.
    Ramphal, S., & Moodley, J. (2006). Vesicovaginal fistula: obstetric causes. Current Opinion in Obstetrics and Gynnecology, 18(2), 147-151
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    Keywords: Overview, Obstetric Fistula
     
  • Obstetric fistula and the challenge to maternal health care systems
    Ruminjo, J.K. (2007). Obstetric fistula and the challenge to maternal health care systems. IPPF Medical Bulletin, 41(4), 3-4
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    Keywords: Maternal Health, Obstetric Fistula
     
  • 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
     
  • Shame and Pain Torment Fistula Sufferers
    Sandrasagra, Mithre J. (2006). Shame and Pain Torment Fistula Sufferers. Inter Press Service News Agency. Retrieved July 28, 2008 from www.ipsnews.ne
    Based on the number of women seeking treatment, the WHO estimated in 1989 that more than two million women in developing countries are living with fistula. More recent statistics are unavailable because fistula has become an “under-prioritized issue” says Kate Ramsey of the UNFPA. According to the First Lady of Burkina Faso, each day approximately 236 severe obstetric complications occur in her country. These complications may result in the sort of prolonged labor that causes the soft tissues between a mother’s vagina and bladder, vagina and rectum, or both to die. The consequence is fistula; a small hole that allows for the constant leaking of urine or feces or both. Women afflicted with this condition suffer psychologically as well as physically. The UNFPA cites malnutrition, poor health services, early marriage and gender discrimination as contributing causes to fistula. In addition, poverty leaves women vulnerable and without timely obstetric care. The first worldwide campaign to end fistula was launched by UNFPA in 2003. In Bangladesh, about 71,000 women are living with fistula, and about 90% of women deliver at home. In 2004 in Niger, 140 fistula repairs were performed and 600 community health workers received fistula training. Kalilou Ouattara, a fistula surgoun on Mali, points out that, “The existence of fistula is the barometer of maternal health in the country.” Prevention more than treatment is the key to ending fistula---this may be accomplished with increased presence of skilled attendants at births and increased availability of emergency obstetric care for women experiencing complications during labor. The cost of fistula repair surgery is 300 dollars, and the success rate can be as high as 90%, but still the costs for treatment are beyond the means of most women with the condition. At the 2000 Millennium Summit to achieving the Millennium Development Goal, all the world’s governments committed to reducing maternal mortality by 75% and universal access to reproductive health by 2015. To fulfill the next five-year plan of its campaign, the UNFPA is requesting 78 million dollars.
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    Keywords: News, Obstetric Fistula
     
  • Obstetric Fistulas Signal Poor Health Care for Women
    Schiff, J. (2004, June 9). Obstetric Fistulas Signal Poor Health Care for Women. All News Africa. Retrieved March 21, 2006 from http://www.allafrica.com.
    Obstetric fistulas were the topic of a panel at the Global Health Council’s annual conference in Washington DC. Fistulas are a reflection of where maternity health systems are failing and usually affect the poorest of the poor. Fistulas are both preventable and treatable. There are serious social consequences to fistula, including isolation, divorce, abuse, lack of opportunity, and ostracism from the community.
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    Keywords: News, Obstetric Fistula
     
  • Current profile of obstetrical vesicovaginal fistulas at the maternity unit of the University of Casablanca]
    Sefrioui, O., et al. (2001). [Current profile of obstetrical vesicovaginal fistulas at the maternity unit of the University of Casablanca] [French]. Annales d’Urologie, 35(5), 276-279.
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    Keywords: Statistics, West Africa, Obstetric Fistula, morrocco
     
  • Obstetric fistula: Living with incontinence and shame
    Semere, L., & Nour, N.M. (2008). Obstetric fistula: Living with incontinence and shame. Reviews in Obstetrics and Gynecology, 1(4), 193-197.
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    Keywords: Overview, Obstetric 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
     
  • 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
     
  • A review of postoperative care for the obstetric fistulas in Nigeria
    381. Shittu, O.S., Ojengbede, O.A., Wara, L.H.I. (2007). A review of postoperative care for the obstetric fistulas in Nigeria. International Journal of Gynaecology and Obstetrics, 99(1), S79-S84
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    Keywords: Statistics, West Africa, Obstetric Fistula, Nigeria
     
  • Challenges in measuring obstetric fistula
    Stanton, C., Holtz, S.A., Ahmed, S. (2007). Challenges in measuring obstetric fistula. International Journal of Gynaecology and Obstetrics, 99(1), S4-S9
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    Keywords: Statistics, Obstetric Fistula
     
  • Obstetric fistula: a catastrophic maternal disability
    Stanton, ME. (2004, Summer). Obstetric fistula: a catastrophic maternal disability. Connect: A newsletter for the CEDPA TAACS Community
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    Keywords: News, Obstetric Fistula
     
  • Women’s fistula repaired as surgeons trained
    Stanton, M.E. (June-August 2004). Women’s fistula repaired as surgeons trained. Frontlines-USAID Employee News, 7
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    Keywords: News, Obstetric Fistula, Training
     
  • 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.
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    Keywords: News, Obstetric Fistula, Asia, Bangladesh
     
  • The untold story: how the health care systems in developing countries contribute to maternal mortality
    Sundari, T.K. (1992). The untold story: how the health care systems in developing countries contribute to maternal mortality. International Journal of Health Services, 22(3), 513-528
    This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.
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    Keywords: Maternal Health, Obstetric Fistula
     
  • What of those injured mothers who did not die? Obstetric fistulae – a cause for concern
    Tahzib, F. (Unpublished). (1988). What of those injured mothers who did not die? Obstetric fistulae – a cause for concern. Sokoto, 19p
    Link to Source
    Keywords: Overview, Obstetric Fistula, West Africa, Nigeria
     
  • [Knowledge, attitude and perception about obstetric fistula by Cameroonian women]
    Tebeu, P.M., et al. (2008). [Knowledge, attitude and perception about obstetric fistula by Cameroonian women] [French]. Progres en Urologie, 18(6), 379-389
    Link to Source
    Keywords: Statistics, Obstetric Fistula, West Africa, Cameroon
     
  • The problem of post-partum fistulas in developing countries
    Steiner, A.K. (1996). The problem of post-partum fistulas in deve