More Ghanaian Women suffering from Fistula - Report reveals

Accra, Feb. 17, GNA - An obstetric fistula needs assessment conducted in Ghana has revealed that 100,000 to 150, 000 expectant women suffer from fistula, a pregnancy related abnormality each year with young girls being the most affected.

Obstetric Fistula is caused by prolonged and obstructed labour, which injures the pelvic tissue that raptures the bladder resulting in uncontrollable leakage of urine or faeces.

Major contributing factors include poverty, illiteracy, low status of women and gender inequality, malnutrition, adolescent pregnancy, lack of awareness, financial and socio-cultural practices, lack of access to family planning and emergency obstetric care.

The rapid assessment, conducted in 2003, by Engender Health, a non-governmental organization for the UNFPA was designed to outline a basic picture of obstetric fistula and services in Ghana. Dr Ali Samba, a Gynaecology Specialist at the Korle-Bu Teaching Hospital, made the revelations at the first National Experts Experience Sharing Session on Obstetric Fistula work in Ghana. The meeting, organized by UNFPA in collaboration with the Ghana Health Service (GHS), Ministry of Health and other stakeholders under the theme: "Strengthening Fistula Prevention Activities and Access to Treatment in Ghana: A day's experience sharing session", brought together health experts, Parliamentarians and the media to build on experiences and map up the way for the implementation of a UNFPA sponsored fistula project in Ghana.

Dr Samba said obstetric fistula was a critical and important aspect of reproductive health but had been neglected with a silent dehumanising effect on women.

He noted that though it was noticed in all the five sites selected for the assessment - Korle-Bu Teaching Hospital; Komfo Anokye Teaching Hospital; Battor Catholic Hospital; Nalerigu Baptist Medical Centre; Eikwe Catholic Hospital and Effia-Nkwanta Hospital, there were no exact figures indicating the prevalence of Visco-Viginal Fistula (VVF). It was estimated that one out of every 1,000 deliveries, 74 per cent were due to obstructed labour.

Dr Samba noted that VVF occurred across the whole country but was more prevalent in the Northern belt due to the poor health delivery system and lack of personnel.

He said though fistula was preventable and treatable, many women refused to report to the hospital because of the bad smell associated with it.

"We saw some women who had lived with fistula for more than 10 years thinking that there was no cure or treatment and those who know of the treatment were sacred of the high cost involved", he said.

Dr Samba said it would cost a fistula client as high as two million cedis at Korle-Bu for its repair and as low as 300,000 in the Nalerigu in the Northern region but because it mostly affected the poor, they could not afford the cost and lived with it.

He said there was only one centre in the Northern belt repairing VVF with most of the hospitals in the Southern belt adding, "currently there is no repair done in the Upper West and Upper East Regions. He called on policy makers to ensure that VVF was made a public health issue through awareness creation, train more surgeons to fix VVF adding that the Ghana Medical Association should include VVF in its campaign to improve maternal health.

Major Courage Quashigah, Minister of Health, requested all service providing agencies to make obstetric fistula a notable disease and be reported on on regular basis.

He said there was the need to institute programmes to educate the public on the abnormality, adding: "Society must be educated on the fact that fistula was only an abnormality resulting from childbirth and not a curse on the victim. "I will start the process of having the repair of fistula included in the free treatment under the National Health Insurance Scheme", he said.

Dr Makane Kane, Country Director of UNFPA, said his outfit believed that prevention and treatment were the key tools to end fistula to make pregnancy and childbirth, moments of joy in the lives of women and families.

Mrs Doris Aglobiste of the UNFPA said the UNFPA project launched in 2003 to end fistula globally was currently covering 30 countries in the Sub-Saharan Africa. She said the project dubbed "Preventing The Harm and Healing the Wounds" ensure the prevention and treatment of fistula, to save millions of lives of women, who die from complications of pregnancy and childbirth.

She noted that many people were unaware of the devastating condition and there was the need for awareness to be created. "Ending obstetric fistula is a long term goal that demands commitment of financial resources, political will, strong partnerships and concerted efforts and there is the need for all to help to save the lives of women", she said. 17 Feb. 06