A Devastating – but Preventable – Condition
Obstetric fistula is one of the most severe and traumatic childbirth injuries affecting women and girls worldwide. It results in devastating health complications and strips affected individuals of their dignity, rights, and quality of life.
According to estimates from international organizations, including the World Health Organization, several million women and girls worldwide live with untreated obstetric fistula. Approximately 50,000 to 100,000 new cases emerge each year, predominantly in sub-Saharan Africa, Asia, the Arab region, Latin America, and the Caribbean.
Eritrea’s Enduring Commitment
Like many nations in sub-Saharan Africa, Eritrea continues to grapple with obstetric fistula. Recent local estimates suggest the condition affects approximately 0.34 per 1,000 women, with a higher prevalence among females under 18. Additionally, obstructed labor contributes significantly to maternal mortality, which stood at 184 per 100,000 live births in 2019. Many fistula cases in Eritrea also result in stillbirths, compounding the tragedy faced by affected women.
Despite various challenges, Eritrea has demonstrated a strong, enduring commitment to eliminating obstetric fistula through implementing a comprehensive, multi-pronged approach.
The Ministry of Health (MoH), in close collaboration with local and international partners, provides free fistula repair services, transportation coverage, and a robust rehabilitation program. Central to these efforts is the National Fistula Diagnosis and Treatment Center (NFDTC), located in Mendefera, which offers free diagnosis, treatment, post-surgical care, and accommodation for patients nationwide. Over the years, the center, staffed by locals and receiving support from developmental partners, has achieved a high success rate in fistula repair, allowing survivors to regain their health, dignity, and independence.
Rehabilitation and Community Reintegration
Eritrea’s comprehensive approach has gone beyond medical treatment, and the country prioritizes fistula survivors’ psychological, economic, and social rehabilitation. Regular follow-ups ensure that patients do not develop recurring injuries. Additionally, survivors receive counselling, financial support, and vocational training, which helps them reintegrate into their communities and achieve self-sufficiency. Community engagement initiatives are also in place to reduce stigma and raise awareness about the importance of antenatal care and skilled delivery services. Crucially, reducing stigma and discrimination against survivors helps to restore dignity, encourages seeking treatment, supports mental health, fosters community reintegration, and empowers women – ultimately ensuring that they regain independence, opportunities, and a better quality of life.
Preventive Measures and Broader Health Initiatives
As with its general approach and strategy to overall health and well-being, Eritrea’s efforts to combat obstetric fistula focus heavily on prevention. This reduces risks, enhances early intervention, promotes better maternal health, and minimizes long-term physical and emotional consequences. For one, the country has implemented stringent laws and enforcement measures prohibiting harmful traditional practices, such as FGM/C and child marriage. Public awareness campaigns and media initiatives educate communities about the dangers of these practices and emphasize the importance of reproductive health.
Furthermore, Eritrea’s broader healthcare improvements have also played a critical role in reducing obstetric fistula. The government has expanded access to healthcare services, significantly increasing the number of doctors, nurses, and midwives. Greater efforts have been made to deploy healthcare professionals to rural and underserved areas. Today, over 80 percent of Eritrea’s population lives within a 10-kilometer radius of a healthcare facility, and more than 70 percent within a 5-kilometer radius. As a result, the proportion of births attended by skilled health personnel has risen dramatically, while antenatal care coverage has similarly improved, with 98 percent of pregnant women attending at least one antenatal visit.
A Future Free from Obstetric Fistula
Eritrea’s unwavering commitment to eliminating obstetric fistula is yielding positive results. Through a combination of prevention, treatment, and rehabilitation strategies, the country is not only addressing the immediate needs of affected women but also working to eradicate the condition entirely. By continuing to invest in maternal health, enforcing protective laws, and fostering community engagement, Eritrea is paving the way for a future where no woman or girl suffers from this preventable condition.
While challenges remain, the progress achieved to date is encouraging and underscores the power of a holistic, sustained, and compassionate approach to public health.