16 years – that was how long Dah had to live with the annoying state and undergo eight different surgical procedures before finally getting the fistula repaired.

In recognition of the over 500,000 women like Dah, forced to endure what is a very treatmentable state, the international day is marked to end obstetric fistula on Friday.

Obstetric fistula is a medical condition that refers to the development of a small gap between the birth canal and the bladder or the rectum, leading to leaking urine or faeces.

The theme of the year, “Her health, her right: to shape a future without fistula” will try to make progress towards the goal of eliminating fistula in 2030.

Women’s bodies become battlefields – not only through sexual violence, but through conscious denial of reproductive rights and health
– Sima Bahous, CEO of UN women

“Women’s bodies become battlefields – not only through sexual violence, but through the conscious denial of reproductive rights and healthcare,” said Sima Bahous, CEO of UN women.

‘A quiet crisis’

It is often brought further by prolonged or difficult birth. Most of the half millions of women suffering from the condition live in the global south.

Many women who have a fistula experience of social insulation and exclusion produced by leaking urine or faeces. This in turn can lead to depression and worsening poverty.

Kambiré, a small business owner who lives in Bouna, lived with obstetric fistula for 23 years. She even had another child before she got medical attention.

“I preferred to isolate myself because of the fistula,” she said. “I couldn’t sit long for fear of getting wet.”

She only learned that it could be treated when she listens to a radio program, and inspired her to go to a UN -sexual and reproductive health agency (UNFPA) -supported hospital for treatment. Now she owns a small pot making business.

Completely preventable and treatable

UNFPA set the goal of elimination in 2030 – which seems to be possible, as it is both completely preventable and fully treated as a medical condition.

Between 2003 and 2024, UNFPA supported nearly 150,000 surgical fistula repairs, of which 4,400 only happened in the Côte d’Ivoire for women like Dah and Cambiré.

Catherine, a mother of two in Bouna, also received medical assistance from an UNFPA-supported hospital.

“Now that I’m healthy, I’m happy. I can run my business and spend time with my friends,” she said.

Nevertheless, obstetric fistula has remained stubbornly persistently throughout the world due to differences in global health systems.

UNFPA says midwives are the key to preventing fistula and other birth damage. However, there is a global lack of over 900,000 midwives, 500,000 of whom are in Africa south of the Sahara.

Reproductive health education and empowerment are similarly important to tackle and prevent obstetric fistula.

“The most effective shield we can offer women and girls is their own power, voice and leadership,” said Ms. Bahous.

Network of Solidarity

After Dah received a successful treatment of her obstetric fistula, she began as a cambiré a seasonal food business through which she prepares and sells products.

She has also tied up with other fistle survivors from BOUNA to improve the attention of society and reduce stigma.

“When women lead, they not only protect themselves, but their families and communities … The impact is transformative,” said Ms. Bahous.