Reproductive Health Problems in the World: Obstetric Fistula: Background Information and Responses

RS21773 -- Reproductive Health Problems in the World: Obstetric Fistula: Background Information and Responses

March 17, 2004

Summary

Obstetric fistula has gained increased attention in the 108th Congress when a number of briefings were held to discuss the impact of this debilitating condition on millions of women. Additionally, H.Con.Res. 447 and H.R. 3810, were introduced to recognize the effects of the affliction, and to reserve a portion of the U.S. contribution to the United Nations Population Fund (UNFPA) for fistula prevention and repair. Finally, P.L. 108-199, 2004 Omnibus Appropriations, provides $1 million to the International Medical Corps to expand its fistula repair services in Sierra Leone. It also supports the establishment of airborne medical transport services in Africa to fly medical personnel, supplies, and anti-retro viral therapies to rural areas on a regular schedule.

It is estimated that at least 2 million women and girls suffer from this affliction worldwide. Fistula occurs from prolonged labor, particularly when labor lasts two days or more. When a woman or girl is unable to push the baby out, the pressure from the baby's head can interrupt blood flow to tissues in the pelvic area. Ultimately, the woman passes the baby after it dies, as the decomposed body is smaller than the live one. After pushing for a number of days a hole develops in the tissue between the vagina and bladder (and at times the rectum), causing incontinence. Fistula survivors can also suffer nerve damage, which can make walking difficult. Women with this condition are stigmatized and usually shunned, due to their strong odor. Some are abandoned by their husbands on whom they are financially dependent, and are forced to leave their homes. Many live a life of solitude. Those who are cast out often resort to begging, and in some cases sex work. This report will discuss the prevalence of this condition, the impact that the condition has on affected girls and women, and describe efforts of USAID and other organizations to raise awareness, prevent, and treat fistula.