Surveys include obstetric fistula
One of the pioneers
Filling the data gap
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Haiti: another pioneer Port-au-Prince, Haiti
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Obstetric fistula, a severe condition caused by prolonged obstructed labour
After a major earthquake struck the capital city of Haiti, Port-au-
unrelieved by timely medical intervention, remains as one of the most severe
Prince, and its surroundings in January 2010, more than just debris
unsolved reproductive health issues affecting developing countries. Estimates
was left as testimony to one of the worst natural disasters in the
point to at least two million women living with the condition worldwide, with
region. Along with helpless injured people, razed buildings and fallen
50,000 to 100,000 new cases occurring each year.
power lines, this Western Hemisphere’s poorest nation had to contend
Difficulties in obtaining accurate and comparable data on obstetric
with a collapsed health infrastructure. Nurses, midwives and doctors
fistula prevalence continue to hinder efforts to address maternal deaths
were among the quake’s victims, increasing people’s vulnerability and
and disabilities more efficiently. In some countries, obstetric fistula might
health related risk factors, especially among women.
be considered a low-priority issue in part because its prevalence is
Homeless women and girls in tent camps, those recovering from
perceived to be low or non-existent. However, the true prevalence of
quake-related injuries and pregnant women were amid the most
fistula is likely to be quite high.
vulnerable. According to specialists, at the time of the earthquake
Needs assessments conducted in early phases of the Campaign to End Fistula were a first effort to gather national data on obstetric fistula, and they
some 63,000 were estimated to be pregnant in the country, 7,000 of whom were in the last month of pregnancy.
revealed a lot about the condition. However, these were often restricted to some centers providing obstetric-related services and captured mainly information related to the facilities that provide treatment and not the realities of all women, in particular those without access to care. Without reliable knowledge about the number of women living with fistula, it is very challenging to plan an effective response. “We know from previous studies on maternal morbidity that women may be suffering from other conditions, such as severe stress incontinence, which is also challenging for the woman but is not a fistula and requires a different response,” explains Ms. Kate Ramsey, Africa Regional Programme Coordinator, Averting Maternal Death and Disability Programme, Columbia University. Establishing functioning services for fistula treatment has been possible, but getting the big picture and tracking the real numbers will help show whether all pregnant women are receiving timely access to skilled assisted
General Hospital’s maternity ward after the earthquakes. Photo: UNFPA Haiti.
delivery and emergency obstetric care. Where obstetric fistulas continue to occur, it will highlight the need for further action to save women from maternal death and disability. The good news is that more and more countries are including ques-
The news, filled with stories of women delivering their babies in parks and tents and lacking the most basic medical care, portrayed the inhumane conditions of a disaster zone. However, an anthropologi-
tions on obstetric fistula prevalence in their Demographic and Health
cal study on obstetric fistula recently conducted in Haiti by UNFPA
Surveys (DHS). This will shed more light on the problem and pave the
showed that even before the disaster (and certainly after it) most of
way for solutions.
those vulnerabilities were already commonplace for the women there.
The Democratic Republic of the Congo, Ethiopia, Malawi, Mali, Niger,
“As Haiti recovers from the earthquake, the country will have
Pakistan, Rwanda, and Uganda are examples of countries where questions
to face not only a collapsed health infrastructure, but also a deeply
regarding fistula have been included in the DHS. Although the form varies
entrenched inequality and the lack of in-country trained professional
among countries, all these surveys contained questions regarding obstetric
staff to deal with key maternal health problems, like obstetric fistula,”
fistula knowledge and symptoms.
explained UNFPA Reproductive Health Advisor, Michel Brun.
As part of a process led by the international Obstetric Fistula Working
According to Mr. Brun, many of the vulnerabilities which had been
Group, of which UNFPA, the United Nations Population Fund, serves as the
identified in an assessment of maternal health care availability before
secretariat, a standard obstetric fistula module has now been developed
the earthquake are certainly more acute now. “Before, we didn’t have
for new DHS. This will allow collection of comparable data across coun-
enough professionals, awareness about the problems or access to
tries, which may help improve maternal health in general and promote
health care. Now, even if we did, we wouldn’t be able to attend to
political commitment to address the problem.
the demand because the facilities are not there anymore,” he said. In addition, the lack of accurate information about maternal health
Cover photo: Elanie Jacques holds her three day old granddaughter, born to Katiana Bourdeaux, 18, in a medical tent in Port-au-Prince, Haiti, February 2010. Photo: courtesy of Lynsey Addario, VII Photo Agency.
problems, like fistula prevalence, has always been an overwhelming obstacle in Haiti. Although the study carried out by UNFPA Haiti a few months ago shed some light on the problem, obstetric fistulas are,
according to Mr. Brun, completely ignored as a public health issue
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in the country: “That’s why we strongly advocated for the
Spearheaded by UNFPA and supported by numerous generous
inclusion of a fistula module in the
donors, the presence of the global Campaign to End Fistula has
Demographic and Health Survey
grown tremendously since its inception in 2003 — from 12 initial
(DHS) wave to be conducted this
countries to now 47 countries in Sub-Saharan Africa, Asia and
year in Haiti,” he said.
the Arab region. The majority of countries is now in the full
The data collected in the
Reproductive Health Advisor, Michel Brun. Photo: Voices.
implementation phase — a shift that illustrates the momentum
2010 DHS wave, the fifth to be
and demand gathering at country level. With the support of
conducted in Haiti, will help
the Campaign, governments and partners, increasing numbers
researchers estimate the preva-
of women and girls are accessing the care necessary to prevent
lence of the condition, and support
and treat fistula — and to return to full and productive lives.
advocates’ demand to have obstetric fistula placed as a priority in national programmes and for development assistance. “We presented the DHS committee our preliminary study, which was a qualitative research focused on social, psychological and economic impacts of obstetric fistula. It confirmed the importance of including a fistula module in this wave. It was unanimous, they all agreed,” Mr. Brun said. The Institut Haïtien de l’Enfance and the Institut Haïtien de Statistique et d’Informatique will be in charge of data collection, with UNFPA technical support, on questions of sexual and reproductive health in general
Since the launch of the Campaign in 2003: More than 16,000 women received fistula treatment and care with support from UNFPA; More than 38 countries conducted situational analyses of the issue; and More than 28 countries integrated obstetric fistula in national health policies or plans.
and fistula in particular. Mr. Brun said that UNFPA will not wait for the results to start working on the problem. “We know that women living with fistula will benefit
Key 2009 UNFPA Highlights: Provided support for more than 4,400 women to receive
from what we discover” he
said. “This is considered a
Supported more than 100 health facilities in 23 countries to
shameful condition here. In terms of the social impact of
strengthen fistula prevention and treatment capacity;
obstetric fistula, the fact that
Facilitated the training of more than 1,000 healthcare
we are looking for answers is
personnel – including over 160 doctors, 245 nurses and
already a way to respond to
midwives; and more than 600 community health workers;
the problem. Now it’s still in
Facilitated the participation of fistula surgeons from Benin,
the private sphere, a trouble
Democratic Republic of Congo, Senegal and Somalia at
only for the women who live with it. They are isolated, stigmatized, and they don’t have any hope that they will get a solution for their affliction.
the International Society of Fistula Surgeons 2nd Annual Dr. Peck (right), head of community relations for GHESKIO, a UNFPA-funded health clinic in the heart of Port-au-Prince, offers counseling to a woman who lives in the new earthquake survivors’ camp that mushroomed near the institution.*
This research and our work in collaboration with the Government of Haiti will show that this is also a
Conference, 25-27 November 2009 in Nairobi, Kenya. The Conference drew several participants and allowed for knowledge exchange, professional development, and learning in fistula prevention, treatment and reintegration (see page 6); Eighteen Campaign countries supported fistula survivors to
public problem. We know that we have obstetric fistulae in this country and
sensitize communities, provide peer support and advocate
we have to take it out of the shadows so that we can respond to it.”
for improved maternal health at both the community and national levels. The work of fistula survivors is expanding
*Since 1995, UNFPA has provided support to the Groupe Haïtien d’Etude du Syndrome de Kaposi et des Infections Opportunistes (GHESKIO) to enhance the access to quality reproductive health services for youngsters of reproductive age in metropolitan areas of Port-au-Prince, Jacmel, South and Northwest regions. Since 12 January 2010, GHESKIO began providing humanitarian assistance and emergency care to persons affected by the earthquake, who were installed in a camp near the institution.
both in terms of the number of countries working in this area and the level of engagement of the survivors; and Conducted an external, mid-term review of the UNFPA components within the Campaign, led by a team from Health Research for Action (HERA) & the International Center for Reproductive Health (ICRH) that assessed national
programmatic efforts and regional/global support to national programmes (see page 7).
Olympian brightens fistula ward
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Bangladesh’s seven year campaign of advocacy, awareness-raising, and capacity building will culminate with a new center for fistula treatment, slated to open in late 2010. Built with funds from the Government of Bangladesh and support from UNFPA, the center will be based on the premises of a public hospital in Dhaka and is expected to facilitate treatment of approximately 800 obstetric fistula patients annually. Dr. Hashina Begum, Assistant Representative in UNFPA Bangladesh, says needs assessment data from six out of the country’s 64 districts point to at least 71,000 obstetric fistula cases nationwide. She notes, “This center will provide treatment and also act as a referral facility for all the districts.” The center’s primary focus will be providing surgical procedures along with pre- and post-surgery counseling. Staff will also work in close collaboration with a nearby rehabilitation facility for obstetric fistula survivors recovering from surgery. Young girl undergoes treatment in the fistula ward. Photo: UNFPA Tanzania.
Olympic medalist and UNFPA Goodwill Ambassador Yuko Arimori toured an obstetric fistula ward in Dar-Es-Salaam, Tanzania, in February 2010, commending the work on fistula treatment. Ms. Arimori, who made history as Japan’s first Olympic medalist for Women’s Marathon, offered her highest praise for the quality of services provided by Comprehensive Community-Based Rehabilitation in Tanzania (CCBRT), a recipient of UNFPA support. Her visit underscored the endurance test that defines this nation’s efforts to combat fistula. “Estimates point at 1,200 new cases of obstetric fistula annually in Tanzania, or approximately two percent of cases worldwide,” said Dr. Julitta Onabanjo, UNFPA Representative in Tanzania, which is among the 10 countries with the highest number of maternal deaths in the world. Dr. Onabanjo noted, “Because they are often ostracized by their families and communities, women with fistula may be isolated, often for many years. Sadly, most women with the condition do not know that treatment is available, or they cannot afford it.”
Fistula survivor and advocate Ms. Sultana Begum now teaches her skills to other women. Photo: UNFPA Bangladesh.
In 2009, Comprehensive Community-Based Rehabilitation in Tanzania performed 160 fistula surgeries and facilitated the successful treatment of another 30 women at hospitals in northern Tanzania.
For Bangladesh, the center will serve as the newest benchmark in a remarkable evolution towards maternal health. As recently as 2003, women with obstetric fistula were condemned to suffer in silence, without a single program or public forum to address their needs. Since then, Campaign
Magazine brings VIPs out for fistula
initiatives have enabled some 2,050 fistula patients to receive surgical
The media has long played a critical role in the efforts to raise awareness for fistula. In November 2009, ELLE Belgium took their support a step further, marking its sixth anniversary with a VIP event honoring the Global Campaign to End Fistula. More than one thousand of Belgium’s media, fashion and arts elite turned out to celebrate and to view a special exhibition of UNFPA’s awareness campaign images, curated by RKCR/Young and Rubicam UK.
treatment in Bangladesh with an average of 300 patients treated per year.
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Dr. Hashina cites progress on several key fronts, including an increased capacity of professionals, greater access to quality health care, and enhanced assistance facilitating social reintegration of obstetric fistula survivors. “The survivors work as Community Fistula Advocates (CFAs) after treatment,” Dr. Hashina explains. Altogether, 35 fistula advocates are providing counseling on maternal health to prevent obstetric fistula and promote reproductive health in villages and communities. “Previously there was silence about fistula,” she notes. “Women didn’t talk about it. Now the advocates interact and initiate the discussion, encouraging obstetric fistula patients to look for help.”
Freedom from fistula
Powerful women Freetown, Sierra Leone
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A new short film produced in Liberia, “Freedom from Fistula”, is adding more voices of fistula survivors to the fight against this devastating child-bearing injury. Produced in 2008 by Lisa Russell of Governess Films in association with the Ministry of Health and Social Welfare, Republic of Liberia and UNFPA, the film offers an overview of the Campaign to End Fistula workings in the country. “In a nation still recovering from an 11-year civil war, it was inspiring to film such a progressive programme prioritizing women’s health,” stated Emmy-award winning filmmaker Lisa Russell. “The Liberia Fistula programme gives testament to the dedication of Liberia’s government and health care workers dedicated to rehabilitating this beautiful country.” Although it’s proved challenging to estimate the prevalence of obstetric fistula in Liberia, the issue is clearly a priority. The striking scenes of Liberian women and girls in their quest for treatment and a new life shows that raising Sallay stands in the center with village chief and local midwife.
awareness about the problem is a key component to end fistula in the country. “As we improve knowledge about fistula, we can break the cycle of poor
Sierra Leone has one of the highest maternal mortality rates in the world.
maternal health and stigma associated with women living with obstetric fistula,”
Some 30 per cent of the deaths are caused by obstructed labour, and
explained the national fistula programme manager in Liberia, Dr. John Mulbah.
although there are no official estimates on obstetric fistula in Sierra Leone, specialists agree that the figures are high. The urgent need for awareness-raising, strengthened health care and for
Another priority is country capacity development. Before the initiative, medical doctors would come from abroad to perform surgical interventions. Now, most providers are from Liberia and a central outreach team led by Dr.
cultural changes to enhance maternal health in the country is best exempli-
Mulbah goes from county to county to operate and train providers. As part
fied by Sallay Jusu, a 45-year-old woman from the district of Moibayeima in
of this strategy, fistula management and treatment have been included in
the eastern part of Sierra Leone, who lived with obstetric fistula for 25 years.
the curricula of the only medical school in the country.
Ms. Jusu’s story is as compelling as her background — she is of the Mendes ethnic group and a traditional chief in her own district. However, in a land not well-accustomed to female leadership, not all clans in Sierra Leone accept women leaders. Regardless, she uses her unusual prominence to spread the word and mobilize society against obstetric fistula. It doesn’t come as a surprise that Ms. Jusu didn’t know why she was leaking after giving birth at the age of 20. Poor access to information and health care, particularly for young people, high illiteracy rates among women and limited information are some of the major challenges in tackling maternal health problems in Sierra Leone. She initially thought it was a punishment for her sins. Since there are serious taboos in the country about leaking women, all related to sexual behavior, Ms. Jusu suffered in silence for more than two decades to avoid discrimination. Husbands usually divorce their wives when they learn they have the condition, and women are then even more stigmatized. UNFPA National Programme Manager for Reproductive Health in Sierra
Finda, 23, was treated from fistula. Photo: Lisa Russell/Governess Films.
The results achieved in the last three years since the programme was
Leone, Dr. Jarrie Kabba-Kebbay, explains that these deeply entrenched cultural
launched are impressive, including the steady increase in the number of
barriers not only prevent women from seeking help but also hinder efforts to
patients treated: from around 150 in 2007 to almost 200 in 2009, with an
prevent new cases. “Women can’t access information or health care. More-
average success rate of 81 per cent.
over, there is limited male involvement in the use of reproductive health and an almost complete male dominance in decision-making,” she said.
Working at the community level to sensitize residents about the importance of timely referral and access for women with pregnancy complications
“We live in a society in which women are not empowered to make their
to specialized health services is another cornerstone of the programme.
own decisions. Their husbands or other family members decide on whether
A major step is to reintegrate fistula survivors back into society after
to deliver in the health facilities or not.”
treatment, as their communities often reject them. “It’s critical to empower them and to work with the community so that survivors are accepted back,”
said the UNFPA Assistant Representative in Liberia, Dr. Philderald Pratt.
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More than one hundred maternal health practitioners from across Africa
eliminating fistula globally through prevention and curative activities in partnership with member countries’ societies. The organization held its first conference in Addis Ababa, Ethiopia, in 2008. Renowned fistula surgeon Dr. Kees Waaldijk currently serves as President.
and Asia sent a unanimous message at the Second Conference of the International Society of Fistula Surgeons (ISOFS): strengthening prevention and health care delivery is paramount to eliminate obstetric fistula. This imperative was eloquently outlined in the opening speech by Dr. Bashir M. Isaak, who heads the Division of Reproductive Health of Kenya’s Ministry of Public Health. He declared, “We cannot treat ourselves out of obstetric fistula. There must be renewed effort in strengthening safe motherhood.” The conference held November 25-27 in Nairobi, Kenya, covered topics ranging from the role of community midwives to the effectiveness of social reintegration and community partnerships. Organized in collaboration with the African Medical and Research Foundation (AMREF), the event hosted a diverse assembly of government ministries, medical professionals, and delegates from civil organizations and academic institutions. As an annual summit of health care providers and activists from some of the world’s most affected nations, ISOFS provides a valuable forum to share key lessons from their work on the front lines of obstetric fistula. “By sharing your experiences, you have given many women hope,” said the Conference Chair, Dr. Asante Sana. “Each participant goes home with a basket full of ideas. It’s my hope that these ideas will be translated to
MDG good practices
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As part of the Millennium Development Goal (MDG) + 10 efforts, the United Nations Development Group MDG Policy Network has developed a publication on MDG Good Practices with examples of each Millennium Development Goal and efforts to make progress toward the achievement of corresponding targets. The publication will be released in 2010. The Campaign to End Fistula promising case example was included in the chapter addressing MDG5, the goal focused on improving maternal health and increasing universal access to reproductive health. The Campaign case emphasizes its innovative and comprehensive approach, which combines programmatic, technical and advocacy interventions. It argues the “scalability” of the programme is facilitated by mainstreaming the issue of obstetric fistula in country sexual and reproductive health plans, and capacity strengthening at country and regional levels for obstetric fistula training, treatment and rehabilitation services. The case reports on the three key strategic intervention points of prevention, treatment and reintegration – emphasizing the results achieved to date (at the close of the 5th year of the global Campaign).
actions towards restoration of women’s dignity.” Ms. Batula Abdi, UNFPA Kenya Reproductive Health Programme Officer,
highlighted several measures identified as critical, including: • Community involvement in prevention and treatment efforts, • Generating evidence in what works better in the area of clinical
management and social integration, • Strengthening health care systems to provide obstetrical emergency
care, and • Harnessing community midwives to effectively communicate
prevention strategies. ISOFS, originally led by Dr. Catherine Hamlin, co-founder of the Addis Ababa Fistula Hospital and a pioneer in fistula surgery, is committed to
“Outcast no more”
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In March 2009, CNN World Report broadcast “Outcast No More,” a UNFPA-produced documentary on obstetric fistula survivors in Afghanistan’s remote Badakshan province. The video follows the story of two fistula survivors and the UNFPA-trained doctor who performed their successful surgeries. Currently available on YouTube and the UNFPA Online Video Channel, the video has since received more than 50 requests for broadcasting throughout the world.
Fistula at ECOSOC
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Fistula survivor and activist Sarah Omega Kidangasi joined singer/ actress and Campaign celebrity spokesperson, Natalie Imbruglia to call for action on maternal health and obstetric fistula at the High Level Segment of the Economic and Social Council (ECOSOC) meeting of the United Nations in July 2009. Addressing 400 attending ministers of health, foreign affairs and ambassadors at the ECOSOC High-Level Segment, Ms. Imbruglia detailed the sobering statistics: that every minute a woman dies needlessly in pregnancy or childbirth, and that for every woman who dies, 20-30 women suffer from obstetric fistula or other devastating birth injuries. Ms. Kidangasi gave a powerful account of her own struggle with this preventable condition. “Night and day for twelve years, my life was continually put on the verge,” she recalled. “With uncontrolled leaking of urine, foul smell, stigma, isolation, pain and rejection, it was like dying every day.” Ms. Kidangasi testimony and strong presence helped raise the profile of maternal health within the context of the meeting, exemplifying the importance of empowering fistula survivors.
Portraits of war Geneva, Switzerland
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Campaign mid-term review An external, mid-term review of the global Campaign to End Fistula was conducted in 2009. The review assessed eight country level programmes, as well as global and regional support provided to countries.
The evaluation, led by a team from Health Research for Action
(HERA) & the International Center for Reproductive Health (ICRH), had two main objectives:
Assess the relevance, effectiveness and efficiency of the current strategies and approaches for national fistula programming.
Assess the coordination, management and support from UNFPA’s global and regional levels to national level efforts.
Series of pictures depicts the challenges faced by Congolese women. Photo: UNFPA Geneva.
It was a comprehensive evaluation focusing on the UNFPA supported
Following the success in the United States, “Congo/Women Portraits of War:
elements of the Campaign. The major findings were reported in
The Democratic Republic of Congo” recently premiered in Europe with mas-
10 volumes: eight country-related, one summarizing the country
sive attendance. The critically acclaimed photography exhibition features
findings and one focusing on global and regional level activities.
images by award winning photographers Lynsey Addario, Ron Haviv, Marcus Bleasdale and James Nachtwey. The European launch event, carried out in the United Nations Palais in Geneva, marked the start of the exhibition’s European tour and commemo-
Some of the major findings of the evaluation include:
awareness building and service development. It has been a catalyst
rated both International Women’s Day (8 March) and the 15th anniversary
to mobilise countries towards addressing fistula prevention,
of the adoption of the Beijing Declaration and Platform for Action.
treatment and care;
According to Adele Kagarabi, provincial commissioner, advisor to the
Within UNFPA the internal coordination and management mechanisms
government of South Kivu and strong advocate for an end to violence
for the Campaign contributed not only to increased coordination and
against women, “the awareness-raising campaigns that we implement at
ownership of activities but also to greater knowledge of obstetric
national and local level together with UNFPA and other partners help to
fistula, both inside the organization and with external audiences;
make people aware of the problem and about their rights.” “As you walk between the poignant portraits of this exhibition, I hope
The Campaign to End Fistula has achieved a lot in terms of
The global advocacy and awareness raising activities have been a key
you will each think of one thing you can personally do to help women in
contributor to greater visibility and knowledge of the fistula problem
the DRC,” she said and ended on a note of hope, pointing out that since
at global and national levels, as well as resource mobilisation for
2004 UNFPA-supported programmes had brought health and legal help to
fistula programmes both within and outside UNFPA;
thousands of survivors.
It is essential to increase integration of fistula prevention, treatment
The exhibit features both photographs and essays documenting the
and care into UNFPA country programmes and into national
bravery of women and their families through the recent atrocities they
reproductive health programmes.
endured in the Democratic Republic of Congo: the violent passage from dictatorship to democracy, ongoing economic crises, ethnic struggles and
Since integration carries the risk that the achievements of the Campaign in creating public awareness and political support may gradually be lost,
all kinds of violence.
it is necessary to maintain the specific focus on advocacy, monitoring
These challenges have been accompanied by the nearly total collapse
and technical assistance at the global, regional and national levels.
of the health system and an almost complete absence of both general and reproductive health care, and the common occurrence of rape and extreme sexual violence against women and girls of all ages with devastating
consequences — obstetric and traumatic fistula among them. For those who
approaches in fistula-related programming used to date and increase
survived, support was often unavailable.
understanding of how the Campaign approach, with multiple strategies
The exhibit, organized by the Art Works Projects (Art and Design for Human
The findings contribute to the evidence base about effectiveness of
undertaken simultaneously at national, regional and global levels has
Rights) and the Ellen Stone Belic Institute for the Study of Women and Gender
assisted in advancing the programme.
in the Arts and Media, Columbia College in Chicago, was funded by UNFPA,
Humanity United, and Leadership donors of the Ellen Stone Belic Institute.
and donors in 2010, providing important guidance for the future of
Results and recommendations will be disseminated to partners
the Campaign. The countries surveyed were: Bangladesh, DRC, Niger,
Nigeria (in-depth assessments) and Kenya, Pakistan, Sudan, and Tanzania (desk reviews).
The global conference Women Deliver is expected to draw thousands of committed advocates for global sexual and reproductive health to Washington DC from June 7-9. Building upon the historic success of the inaugural conference in 2007, this event will give platform to a dynamic international slate of speakers and panelists to address core themes of Maternal and Newborn Health, Health of Women and Girls, Family Planning, and Culture. In this spirit of inclusiveness, Women Deliver 2010 will send a strong, clear message to the worldâ€™s nations: that maternal and reproductive health is a global priority.
Inadequate sexual and reproductive care accounts for an estimated one-third of the global burden of illness and early death among women of reproductive age. The Maternal Health Advocates Panel, organized by UNFPA, will address the human scale of this staggering statistic, from the perspective of champions journeying from different countries around the world. The panel will give voice to these heroes who work bravely and tirelessly to effect lasting social change in their communities, and beyond. Each panelist will share the story of her own struggle with reproductive health issues (including obstetric fistula, adolescent pregnancy, and HIV/AIDS) and the frequently corresponding stigma associated with these conditions. Through their commitment and passion, these women transformed personal challenges into a catalyst for positive change within their community. The Panel seeks to facilitate increased, equitable access to the global stage for these advocates, advancing development by respecting their rights to engage in dialogue about decisions affecting their lives and lives of others with similar stories and circumstances. It will also provide a rare forum for peer exchange of skills and lessons learned with other advocates. Leading by example, these champions will lend their voices to the call for investment in the worldâ€™s women.
Why the Campaign? Over 300 million women worldwide suffer from complications of pregnancy and delivery. For every woman who dies, at least 20 experience a maternal morbidity, including obstetric fistula. Obstetric fistula is a preventable and treatable childbearing injury that leaves women incontinent, ashamed and often isolated from their communities. There are at least 2 million women living with obstetric fistula in the developing world and up to 100,000 new cases occur each year. In 2003, UNFPA and its global partners united to launch the Campaign to End Fistula. Since then, the Campaign is now present in 47 countries, raising over US$37 million toward the goal of eliminating fistula by the year 2015. The Campaign, with its many partners around the world, focuses on three key areas: preventing fistula, treating affected women, and supporting women as they recover from surgery and rebuild their lives.
For more information or to learn how you can help, please visit: endfistula.org.
Caribbean Campaign to End Fistula Countries
UNFPA Campaign to End Fistula
220 E. 42nd Street, New York, NY 10017 email: firstname.lastname@example.org dispatch is a biannual newsletter highlighing developments in the Campaign to End Fistula Editorial Process: Etienne Franca Design and Printing: Prographics, Inc. Contributors: Leyla Alyanak, Hashina Begum, Michel Brun, Nicole Carta, Jacqueline Daldin, Luc De Bernis, Christian Del Sol, Triana Dorazio, Katherine Gifford, Calixte Hessou, Katja Iversen, Janet Jensen, Jarrie Kabba-Kebbay, Dimitry Leger, Cecile Mazzacurati, Geoffrey Okumu, Amanda Patterson, Friederike Paul, Sehar Raja, Kate Ramsey, Lisa Russell, Julie Weber, Anne Wittenberg. Campaign Donors (since 2003) Americans for UNFPA Arab Gulf Programme for UN Development Organizations Bill & Melinda Gates Foundation through EngenderHealth European Voice Government of Australia Government of Austria Government of Canada Government of Finland Government of Iceland Government of Ireland Government of Japan (through the UN Trust Fund for Human Security) Government of Luxembourg Government of New Zealand Government of the Netherlands Government of Norway Government of Poland Government of the Republic of Korea Government of Spain Government of Sweden Government of Switzerland Johnson & Johnson Kingdom of Spain, Autonomous Community of Catalunya One by One United Nations Foundation Virgin Unite Women's Missionary Society of the African Methodist Episcopal Church Zonta International UNFPA wishes to acknowledge with gratitude the multi-donor support generated towards strengthening and improving Maternal Health in the world. Our appreciation is also extended to the many partners and individual donors for their collaboration and support to the Campaign to End Fistula since its inception.