KARACHI: Health professionals emphasised the importance of providing appropriate obstetric care in all sections of the country, particularly in remote areas, adding that Pakistan recorded 3,000 to 5,000 occurrences of obstetric fistula each year, a severe childbirth injury that leaves women incontinent.

The Pakistan National Forum on Women’s Health, in collaboration with the Fistula Foundation, the United Nations Population Fund, the Pakistan Medical Association (PMA), the Pakistan Midwifery Association, and Tehrik-i-Niswan, hosted an event on Saturday evening in honour of International Day to End Fistula.

They said that training and appointing qualified midwives at every basic health facility and the tehsil/taluka headquarters hospital was the key to solving the problem.

Sheema Kermani, an activist, believes the government must prioritise reproductive well-being, poverty, and early marriage.

“In Pakistan, an estimated 30,000 women die each year from pregnancy-related problems, with the majority of fistula cases involving poor teenage girls.” She stated that “a holistic approach to maternal health is required.”

“Because affected women generally lose familial support once they have this illness, the true number of cases could be significantly higher.” Such cases go undiagnosed and untreated,” stated leading gynaecologist Dr. Shaheen Zafar, emphasising the importance of raising awareness so that patients can be recognised and treated.

Dr. Zafar described obstetric fistula as “one of the most devastating delivery injuries.”

“Fistula, an abnormal opening between a woman’s vaginal tract and her urinary tract or rectum, affects an estimated 2 million women in developing nations,” she said.

“The disease resulted in urine or faecal incontinence, or both.” “The development of a fistula is closely linked to obstructed labour, which is one of the leading causes of maternal mortality,” she said.

She said that the illness could be avoided if pregnant women received timely, high-quality medical treatment, and that it could be treated with surgery.

“Fistula sufferers received free treatment and rehabilitation at the Koohi Goth Hospital – Landhi. Doctors also hold camps across the country to identify cases like these. Fistula centres are currently located in Karachi, Larkana, Lahore, Hyderabad, Multan, Quetta, Peshawar, Abbottabad, and Islamabad, according to Dr. Zafar.

While there has been a decrease in the incidence of obstetric fistula produced by untrained dais, there has been an increase in cases of surgical fistula caused by doctors, according to Prof Nighat Shah, Pro Vice Chancellor at the Dow University of Health Sciences.

“These doctors either lack proper training or are not supposed to take on the patients because gynaecology is not their expertise,” she added, adding that there were no checks on the surgeons who were engaging in unethical operations.

Dr. Sonia Naqvi, president of the Pakistan Medical Association-Karachi, urged the government to use all available resources to prevent fistula. “The government should improve healthcare services, begin large-scale midwifery training, and equip midwives with a better service framework.”

She also talked about the trauma that fistula patients went through because they were avoided and rejected by their communities. “While treating a fistula is simple, repairing the psychological scars that may last a lifetime,” she explained.

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