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Eritrean women's project response to wall paper: "hard questions concerning fistula surgery in third world countries" [letter]
Journal of Women's Health. 2007 Mar; 16(2):281-282.We read with interest Dr. Wall's editorial, "Hard Questions Concerning Fistula Surgery in Third World Countries."1 Dr. Wall has correctly identified the major issues in performing fistula surgery in the developing world, which include adequate preparation and screening of patients, appropriate logistical support (including anesthesia, sutures, catheters, equipment required for complicated vaginal abdominal surgery), and excellent postoperative follow-up, which mandates medical and surgical training for both local physicians and nurses in the hospitals where such surgery is to be performed. Given Dr. Wall's concern about "fistula tourism," we would like to provide the readers of this journal with a more complete description of our program, which has been designed as a sustainable program to address not simply surgical repair but also the issue of prevention, which remains paramount. Prevention is the only way to restore dignity to women of Africa along with the ability to have families without suffering the devastating consequences of obstructed labor. (excerpt)
BMJ. British Medical Journal. 2006 Jul 1; 333(7557):8.Hundreds of thousands of women in developing countries suffer the devastating injury during child bearing of obstetric fistula. But the agency behind a global campaign to eradicate the condition says it is simple to prevent and easy to treat. The global campaign, led by the international development agency the United Nations Population Fund, has launched a month long advertising drive in the United Kingdom to raise awareness of a condition that is believed to affect between 50 000 and 100 000 women each year. Obstetric fistula is usually caused by several days of obstructed labour without prompt medical intervention and leaves the woman with agonising, long term pain, chronic incontinence, and--in most cases--a stillborn baby. (excerpt)
Demographer John Caldwell and the Addis Ababa Fistula Hospital win 2004 United Nations Population Award.
Population 2005. 2004 Jun; 6(2):12.Well-known Australian demographer, John C. Caldwell, and the Addis Ababa Fistula Hospital, a pioneer in the treatment of childbirth injuries, have won the 2004 United Nations Population Award. The Award is given annually to individuals and institutions for their outstanding work in the field of population and in the improvement of the health and welfare of individuals. The Award Committee, chaired by Ambassador Iftekhar Ahmed Chowdhury of Bangladesh, selected the two winners after a review of nominations received from around the world. The Committee is made up of Member States of the United Nations, with UNFPA, the United Nations Population Fund, serving as its secretariat. Each winner will receive a certificate, a gold medal and an equal share of a monetary prize. Awards will be presented to winners in July at a ceremony at the United Nations Headquarters, New York. (excerpt)
Population 2005. 2003 Dec; 5(4):16.In July 2002, the United States government withheld $34 million in funding for the United Nations Population Fund (UNFPA). According to UNFPA, the withheld U.S. funds could prevent 4,700 maternal deaths, 60,000 serious maternal illnesses and more than 70,000 infant and child deaths. Without this crucial funding from the United States, UNFPA, with a budget of only $270 million worldwide, will struggle financially to adhere to women throughout the world. Jane Roberts of California and Lois Abraham of New Mexico both independently struck up the idea of a grassroots campaign to raise the $34 million that the U.S. withheld from UNFPA. The goal of the 34 Million Friends of the UNFPA campaign is to enlist 34 million Americans to send one dollar to UNFPA to show support for the organization’s important work worldwide. With the campaign in action for almost a year and a half, 34 Million Friends has raised over $1.5 million as of December 2003. (excerpt)
Lancet. 2003 Dec 31; 363(9402):71-72.The advent of modern obstetric care has led to the eradication of obstetric fistula in nearly every industrialized country. However, in the developing world obstetric fistula continues to cause untold pain and suffering in millions of women. The very existence of this condition is the result of gross societal and institutional neglect of women that is, by any standard, an issue of rights and equity. In the developing world, obstetric fistula is almost always the result of obstructed labour. During prolonged obstructed labour the soft tissues of the pelvis are compressed between the descending baby’s head and the mother’s pelvic bone. The lack of blood flow to these tissues leads to necrosis and ultimately a hole forming between the mother’s vagina and bladder (vesicovaginal) or vagina and rectum (rectovaginal), or both, that leaves her with urinary or faecal incontinence, or both. Early intervention to relieve obstructed labour will restore perfusion to these tissues and, in most cases, will prevent fistula. The results of fistula are devastating. In nearly every case the baby is stillborn. Women and girls with fistula are unable to stay dry. They smell of urine or faeces and are shunned by the community and, at times, even by their own husbands and families. They remain hidden, shamed, and forgotten. (excerpt)