Fistula Eradication: Healthcare accessibility becomes a critical need in Eritrea

Obstetric fistula is among the most dangerous and devastating childbirth injuries that can happen nowadays. In Eritrea, one of several nations where obstetric fistula persists, there seems to be a long-standing dedication to eliminating, treating, and rehabilitating fistula patients.

Obstetric fistula is a gap (hole) between the cervical canal and the bladder and/or rectum bladder that induces incontinence or feces leakage. It deprives afflicted women and girls of their wellness, fundamental human rights, and basic dignity. Obstetric fistula is connected to one of the main factors contributing to maternal death: protracted, obstructed labor, which can occur due to a lack of prompt, high-quality medical care or emergency treatment during delivery.

Fistula has a broad range of physical, societal, and psychological implications, with people who suffer from it experiencing excruciating pain and distress, as well as chronic medical difficulties. If left unattended, the illness can result in repeated skin infections, ulcers, kidney problems, severe sores, infertility, and even fatality. 

Misconceptions and the odor of frequent leakage of urine, feces, or both alienate women who are often ridiculed and humiliated, deserted or disregarded by their friends, relatives, or neighbors, and shunned by their communities.

Women and girls who have the syndrome are more likely to experience sadness, depressive thoughts such as suicide and self-harm, and other major mental health problems. Furthermore, persons with fistula are frequently unable to work or maintain meaningful livelihood possibilities. As a result, individuals may be pushed deeper into poverty, increased vulnerability, and a lower standard of living.

Obstetric fistula is still a problem in Eritrea, as it is in many other nations in Sub-Saharan Africa (and the rest of the developing nations). In Eritrea, the frequency of fistula is estimated to be 34 in ten thousand women, with a higher incidence among girls under the age of 18. Furthermore, obstetric fistula is linked to maternal fatalities. Stillbirths account for a significant portion of obstetric fistula instances.

Obstetric fistula treatment is a critical component of Eritrea's greater maternal and reproductive health initiatives, with the nation trying to eliminate the ailment as soon as possible. Eritrea's attempts to combat fistula are supported by a comprehensive and multidimensional approach, similar to several of the nation's other very effective health-related measures.

The Health Ministry (MoH), in collaboration with various local and international partners, offers fistula-free repair procedures, transport reimbursement, and a complete treatment facility for women and girls. The National Fistula Diagnosis & Treatment Center (NFDTC) in Mendefera, Eritrea, is committed to diagnosing and treating fistula patients.

The facility is endowed with cutting-edge technology and offers diagnosis for zero charge, treatments, maintenance, and lodging to patients from all across the nation. Maintenance and rehabilitation procedures have had a high rate of success throughout the years, allowing survivors to regain their livelihoods and honor while also restoring their health and aspirations.

A follow-up is an important part of the total therapy process, with women and girls undergoing routine checks to ensure the damage does not resurface. Fistula survivors can also get psychiatric, emotional, financial, and social assistance to help them get back on their feet. In addition, the Ministry of Health, the National Family Drug Treatment Center, and other partners collaborate to assist survivors with counseling and facilitate their rehabilitation and reintegration.

Furthermore, communities are being approached for participation to remove stigma and misconceptions regarding prenatal care and delivery in healthcare facilities, as well as to promote a general understanding of the importance of antenatal care and delivery in healthcare facilities.

Preventive measures, concerning repair and rehabilitation, are an important aspect of addressing the problem holistically. Many of the measures that boost maternal and reproductive wellness, as well as women's rights, are also critical in avoiding obstetric fistula.

Traditional practices such as female genital mutilation and cutting, as well as child or underage marriage, are prohibited by national legislation and strict disciplinary measures, and awareness programs and comprehension of their hazards are growing. Although these practices were historically widespread across Eritrea, they are now significantly less common—in fact, they are on the verge of being phased out—helping to reduce the incidence of obstetric fistula.

Eritrea's efforts in extending access to quality healthcare and improving the quality of services have been critical, as obstetric fistula is intimately linked to a lack of accessibility and quality of treatment. Many healthcare services and facilities have been built or rebuilt, and the number of doctors and health workers has expanded significantly. There are currently 335 health care facilities (hospitals, health care facilities, medical and health stations, and clinics) spread throughout the country, up roughly fourfold from 1991.

Finally, some of the fundamental or underlying causes that correlate to women's and girls' exclusion and are associated with the incidence of obstetric fistulae are being targeted, such as access to quality education, chronic poverty, and gender and socioeconomic disparity. 

Massive advances in education for women and girls in Eritrea, for example, have assisted in promoting their agency, independence, and decision-making as well as improving their comprehension and health care utilization, assisting in raising the marriage age, and enabling them to better restrict the number, timeframe, and spacing of their toddlers and avoid unexpected pregnancy.