Working Together to Prevent and Treat Fistula

Fistula Hospital, Addis Ababa

Good morning.

It is a pleasure to be here at the Addis Ababa Fistula Hospital. It is an honour to be here with the hospital’s founder, Catherine Hamlin, and all of the staff and patients.

Dr. Hamlin and her late husband, Reginald, chose to dedicate their lives to the treatment of fistula. The Addis Ababa Fistula Hospital is remarkable evidence of this inspiring and long-lasting dedication. I say long-lasting because this year marks the hospital’s 30th anniversary. Congratulations.

Since you first opened its doors back in 1974, the Addis Ababa Fistula Hospital has served as a model for standards of care. But just as importantly, it has served as a model of hope.

Before this hospital opened, young women with fistula had nowhere to go. They were left alone, often shunned and abandoned, and left with little hope for a better life. Since the girls were hidden away, the condition itself was hidden.

Dr. Hamlin has worked tirelessly to bring attention to the hidden condition of fistula. I say hidden because it affects some of the most marginalized members of the population – poor, young, illiterate women in remote regions.

In fact, the continued existence of fistula is evidence of the failure of health care systems to provide a continuum of vital maternal health care, and the failure to provide girls with education and economic opportunities so that they do not become mothers during their childhood.

During the past three decades, this hospital and its dedicated staff have restored the hope and dignity of 24,000 women by providing them with loving care and first-rate treatment. It is impossible to put into words what this facility has meant to each and every one of the patients who have passed through these doors. Because many of the nurses are ex-patients, the care they provide is full of understanding and concern.

But the impact of this hospital extends beyond the individuals who receive treatment.

The Addis Ababa Fistula Hospital shows us what is possible and how to do it.

Over the years, the hospital has trained more than 100 doctors from over 20 countries in fistula surgical repair and treatment.

Inspired by the work of this hospital, UNFPA, the United Nations Population Fund, launched a Global Campaign to End Fistula, in 2003. The campaign is designed to increase awareness of the issue and to bring prevention and treatment services to other places and people in need.

We know the needs are great. There are an estimated 2 million women suffering from fistula, who need treatment. Every year, between 50,000 and 100,000 women are newly afflicted with the condition. These numbers are based on young women who are able to get to a hospital for treatment—many more suffer in silence.

But this does not have to be the case. The long-term goal of the global campaign is to make fistula as rare in Africa and Asia as it is today in industrialized countries.

I am happy to report that the Campaign to End Fistula is now working in over 23 countries in Africa and South Asia to ensure women’s rights to adequate medical care and safe delivery, and to a life of dignity.

The Campaign emphasizes the necessity of a comprehensive approach, by raising awareness at all levels—from communities to policy makers—determining needs and supporting implementation of national strategies. The goal of the strategies is simple: to prevent and treat obstetric fistula.

Working together with partners, the Fistula Campaign is gaining ground.

Uganda has completed an in-depth assessment of the situation and will soon begin implementing its national plan to prevent and treat fistula, with funding from the Bill and Melinda Gates Foundation.

In Zambia, the Campaign is supporting the fistula repair unit at Monze Mission Hospital. Initial efforts have already started to make a significant contribution to raising awareness of the problem, increasing referrals and improving the situation of the repair unit.

In Mali, the Campaign has been upgrading and expanding the capacity of a hospital to provide fistula treatment. A national strategy for fistula was recently drafted with partners, and implementation is expected to begin this spring.

In Sudan, a national fistula campaign was launched this past December, with the slogan, ‘We MUST Care’.

In Bangladesh, a needs assessment has been completed and UNFPA is supporting the development of a Fistula Repair Centre at Dhaka Medical College. Done in collaboration with the Government, it is our hope that the Repair Centre will serve as a regional centre of excellence for both provision of repair services and training in treatment, much like the Addis Ababa Fistula Hospital.

A major part of the Campaign is to train doctors in fistula surgery and this would not be possible without the help of Dr. Hamlin’s experienced team. Last October, surgeons from this hospital travelled to Bangladesh to train 20 local doctors and nurses. They conducted some 40 operations, together with visiting surgeons from Australia. These Bangladeshi doctors will now be able to treat countless women and UNFPA is grateful for your support and expertise.

I would like to conclude by saying that all of this work and the Campaign to End Fistula would not have been possible without the pioneering work of you, Dr. Hamlin, and your husband. You have led the way and for that we are truly grateful.

It is our hope that we will continue to work together and to raise funds for this hospital and other facilities so that fistula survivors can receive the treatment they need and that new cases will become fewer and fewer.

Thank you and God bless all of you.