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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)
Lancet. 1989 Jun 10; 1(8650):1316-7.Vesicovaginal fistula (VVF), commonly caused by prolonged obstructed labor, is one of the worst complications of childbirth. Afflicted women continuously leak urine and sometimes feces, excoriating their mutilated vulvas and vaginas and often becoming social outcasts. Until the early part of this century, VVF was common in the United States and European countries, but today it is rarely encountered in developed countries. It is still, however, a major problem in many developing countries, where it is generally caused by neglect and mismanagement in labor. As many as 300 women suffering from VVF come to gynecology clinics for treatment every month in some areas of northern Nigeria. But many doctors do not wish to deal with VVF and their Western training does not equip them to perform needed surgery. The major thrust of research and development of services must be in prevention of VVF. But much can be learned about the disorder through treatment of its victims, and their suffering in and of itself demands a major treatment effort. This will require establishment of specialized centers, including hostel accommodations. International and national teams of medical experts would go periodically to needy areas to train local surgeons, advise on difficult cases, and help reduce patient backlogs. Such a program can only be set in motion through funds provided by international organizations. A WHO working group on VVF recently recommended urgent measures to prevent the disorder and to clear the backlog of patients waiting for operations. And an organization known as the VVF Initiative has been established in Nigeria and is in need of practical and financial assistance.