Obstetric fistula or vesico-vaginal fistula is a treatable tragedy and a frightening disease in which due to obstructed labour and childbirth complications a women develops incontinence of urine and sometimes feces, she becomes a constant source of infection and is surrounded in bad smell. As a result these women are driven out of their homes, divorced or subjected to a social boycott. Eventually being an outcast, they become a burden on the family and community and this illness has its social and psychiatric repercussions and a gloomy outcome. It is a disease of poverty, ignorance and lack of education. The patients usually tend to conceal their illness and most of them report for a medical advice when nothing much can be done at a primary care level. Due to lack of resources the patients fail to seek medical advice in larger cities with adequate surgical facilities and support, hence majority of them end up in leading a life like a leper. Reliable data on obstetric fistula are hard to come by because of the stigma associated with the condition.
Describing it as the most devastating of all pregnancy related disabilities, the United Nations Population Fund (UNFPA) says obstetric fistula affects an estimated 50,000 to 100,000 women around the world every year and is particularly common in sub-Saharan Africa, where populations face challenges to obtaining quality health care.
Fistula repair and a permanent solution is a difficult surgical procedure and due to poor follow up and recurrence of infection and other underlying reasons, the rate of recurrence is rather high. It is time consuming and a low priority in terms of financial returns for the surgeons, hence the patients face added hardship when such complication arise and they are put at the end of a never ending que of waiting list.
FIMA (Federation of Islamic Medical Associations) doctors felt the intensity of plight of victims of obstetric fistula while working in the remote area of Darfur-Sudan in 2007 and 2008. In 2009 FIMA formally started the Save-Dignity project headed by Prof. Dr. Iqbal Khan (presently Vice Chancellor of al Shifa University, Islamabad). The FIMA team made initial surveys and assessment with the help of SIMA (Sudanese IMA) and save dignity camps were held subsequently in Darfur and Khartoum. A camp was held in Afghanistan in 2014. IMA Nigeria also conducted the Fistula camps in July 2016 in conjunction with the 33rd FIMA council meeting in Abuja, Nigeria and camps were held in the Niger state. Her highness Lady Aisha Buhari, the first lady of Nigeria acted as the patron to these camps.
A group of urologists, surgeons and anesthesiologists from UK, South Africa and Australia sat early this year and planned to continue and further augment the past experience in this particular area of fistula repair in target areas which predominantly includes poor Muslim communities and under developed African countries. Dr. Afzal Kahloon, a dynamic Muslim urologist from Australia acted as the key person to organize a fistula repair camp. The Tanga region in Tanzania was selected and Dr. Mwimbe Juma, President of Sunshine Muslim Volunteers offered to act as the local coordinator. It took long to make the essential arrangements including registration of the foreign doctors, ground facilities, patient registration, boarding, travel and lodging arrangements etc. A sum of
US $ 35000 was required and the project had already exhausted its reserves in the previous camps and Dr Afzal had to start from a dime in his hand; Alhamdolillah the finances were generated in the stipulated period, rather they exceeded the pledged amount which reflects the high spirits of the team members.
The journey till end was not uneventful, it had difficult times, depressing moments and of course heights of personal and professional satisfaction and a feeling of gratitude as if something positive was contributed towards alleviation of the misery of destitute. This endeavor was solely focused to seek the pleasure of Allah almighty and to serve the people in suffering and an attempt to reduce the pain of those in agony. As per Marryum Kahlon, the young energetic liaison officer of the camp: This camp has certainly been an eye opener for us all. The under resourced conditions doctors work under, the extreme poverty patients face and the inaccessibility of areas of need combine to make a difficult working environment. We have been very fortunate to make a small impact on the community as a whole and a very large impact in the lives of individual patients.
We are looking forward to reviewing our efforts once back on home soil and evaluating how we can best utilise our resources, both time and money, in the future to make an even greater impact.
According to a recent statement issued by the office of UN Secretary General Ban ki Moon there are 2 million sufferers of Obstetrical fistula presently worldwide. UNFPA has supported more than 70,000 fistula repair surgeries for women and girls in need, and Campaign partners have enabled many more to receive treatment. As we talk about ending polio, HIV/AIDS, female genital mutilation and so many other forms of suffering, so must we commit to stepping up our efforts to end fistula, once and for all. This means heeding the call of the 2030 Agenda for Sustainable Development to leave no one behind, especially those most neglected, invisible and powerless, including the women and girls living with fistula. May Allah SWT accept the little contribution made by our doctors in Sudan, Afghanistan, Nigeria and now in Tanzania; FIMA pledge to continue its projects including FIMA Save Vision, Save Smile and Save Dignity. FIMA council has approved the FIMA Save Heart project in its 33rd Council Meeting held in Abuja, Nigeria.
Dr. Tanveer Zubairi
President, FIMA
