Amnesty International calls on government to intensify fight against obstetric fistula as women and girls remain at risk

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By Thandiwe Garusa

PREGNANT women and girls in Zimbabwe remain at risk of obstetric fistula as a result of the government’s failures to uphold sexual and reproductive health rights, a new report by human rights watchdog Amnesty International has revealed.

Obstetric fistula is a medical term for an abnormal hole that develops between the vagina and the bladder and or rectum which is caused by prolonged pressure on those tissues during obstructed labour.

The condition, considered as most devastating, results in continued incontinence of urine and or faeces and is one of the major causes of maternal mortality.

According to the report, as many as 90 percent of women who experience obstetric fistula also suffer stillbirth.

Amnesty urged the government to increase efforts to prevent obstetric fistula.

“This report finds that the experiences of fistula patients in Zimbabwe indicate a failure of the Zimbabwean government to uphold sexual and reproductive health rights and the rights to equality and privacy and to be free from torture and other ill-treatment of women and girls in the country, in direct violation of various commitments it has under international and regional law as well as its own Constitution.

“In holding the government of Zimbabwe to these obligations, Amnesty International recommends that the government should urgently increase efforts to prevent obstetric fistula, as well as increase efforts to identify and treat women with maternal morbidities, including obstetric fistula, by adequately funding and operationalising a comprehensive public maternal health care policy; ensuring such policy is in line with the international standards of availability, accessibility, acceptability and quality.

“Importantly, the policy must be contextualized to the COVID-19 crisis. The government of Zimbabwe is also encouraged to take immediate action against any acts of violence and ill-treatment inflicted on women during childbirth and ensure that neither third parties nor harmful social or traditional practices interfere with women and girls’ rights to sexual and reproductive health, including enacting legislation to prohibit child marriage,” the report reads.

According to the World Health Organisation (WHO), obstetric fistula can be prevented by reducing the number of early and unplanned pregnancies, by ending harmful practices, such as child marriage, and by ensuring access to quality emergency obstetric care, especially caesarean section.

Globally, obstetric fistula has been almost entirely eradicated in high-income countries where there is access to quality obstetric care, yet more than two million women in low-income countries, such as Zimbabwe, are living with obstetric fistula.

UNFPA estimates “50,000 to 100,000 new cases develop each year.”

In such contexts, women and girls who are the most marginalised are at the highest risk for obstetric fistula.

Meanwhile, the report also indicates that senior health officials in Zimbabwe have estimated as many as 50 women and girls suffer pregnancy-related morbidities – including obstetric fistula – every day.