The Silence that Kills and the Right Denied
In a village not far from the city, yet far from the spotlight, a young woman named Aïssa is a mere shadow of her former self. Every day, the trickle of urine reminds her of the tragedy of her childbirth, a silent solitude that has cut her off from her community, her husband, and all dignity. Aïssa is one of the millions of faces hidden behind the term obstetric fistula. On May 23, 2025, the world will turn its attention to this undeniable injustice on the occasion of the International Day to End Obstetric Fistula, this year under the significant theme: “Her Health, Her Right: Shaping a Future Without Fistula.”
With only five years remaining until the “Africa without Obstetric Fistula by 2030” goal, it is urgent to deploy substantial resources. Obstetric fistula is not just a medical complication; it is a flagrant violation of women’s fundamental rights, a painful symptom of the deep inequalities that persist in our healthcare systems and societies. Its elimination is not a utopia, but a matter of justice, equity, and respect for human dignity.
Beyond the Numbers: The Faces of Suffering
Obstetric fistula is a debilitating injury, an abnormal perforation between the vagina and the bladder (vesicovaginal fistula) or the rectum (rectovaginal fistula), caused by prolonged and obstructed labor without timely access to emergency medical care, particularly a C-section. The constant pressure exerted by the baby’s head on the soft tissues of the pelvis deprives them of oxygen, leading to necrosis and perforation.
But beyond this clinical definition, fistula is a human catastrophe. The stigma that accompanies it is often worse than the physical pain. Affected women are frequently ostracized by their families, divorced, and isolated by their communities due to chronic incontinence and the resulting odor. They live a true “internal exile,” a social death that deprives them of economic opportunities, education, and any form of social life. The link between fistula, *poverty, and *vulnerability is inseparable: the most impoverished women, those living in rural areas without access to adequate health infrastructure, are the most affected.
10 Important Things to Know About Obstetric Fistula
To Better Understand the Scale of the Challenge and the Urgency of Action
To combat fistula, it is essential to understand this condition. Here are 10 important facts that break down the wall of ignorance:
- Obstetric fistula is a specific category of fistula that results from childbirth complications, but women can be affected by multiple types of fistulas with varied causes (surgery, radiotherapy, inflammatory diseases, infections, etc.). All these fistulas require accurate diagnosis and appropriate medical or surgical management.
- A childbirth injury: Obstetric fistula is a direct and serious complication of childbirth, resulting from the absence of timely emergency obstetric care.
- It is entirely preventable: Universal access to skilled midwives and emergency obstetric care (like C-sections) can prevent almost all cases.
- It is curable: Most fistulas can be surgically repaired by specialized medical teams, with very high success rates (95% according to UNFPA).
- An indicator of inequality: Its persistence is a direct reflection of unequal access to maternal healthcare and failing health systems in impoverished regions of the world.
- Millions of women affected: According to WHO and UNFPA, over 2 million women in sub-Saharan Africa, Asia, and Latin America live with untreated fistula.
- Impact on dignity and human rights: Beyond incontinence, fistula leads to social isolation, shame, depression, and the violation of fundamental rights to health, education, and a life free from discrimination.
- The human and economic cost: The repercussions of fistula are not limited to the individual; they affect families, communities, and hinder overall socioeconomic development.
- The importance of social reintegration: Surgery is an important first step, but psychosocial support, rehabilitation, and economic reintegration are essential for complete and lasting healing.
- A global call to action: Its elimination requires strong political commitment, adequate funding, strengthening of health systems, and continuous community awareness.
The 2025 Theme: “Her Health, Her Right,” A Cry for Justice
This year’s theme, “*Her Health, Her Right: Shaping a Future Without Fistula,” reaffirms a fundamental truth: health is not a privilege, but an *inalienable human right. Obstetric fistula embodies the denial of this right for millions of women. It highlights the systemic failures that prevent women from accessing essential care, condemning many to a life of suffering and marginalization.
The elimination of fistula is intrinsically linked to the United Nations’ *Sustainable Development Goals (SDGs), particularly *SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). Achieving these goals means ensuring that every woman has the right to a safe pregnancy and childbirth. The education of young girls and their empowerment are also key factors, as an informed and educated woman is more likely to access the care she needs.
Shaping a Future Without Fistula: Solutions and Hopes
The eradication of obstetric fistula is an achievable goal. Solutions exist and require collective commitment:
- Prevention first and foremost: Massive investment in primary healthcare systems is urgent. This includes the training and deployment of skilled midwives in rural areas, improvement of health infrastructure, and universal access to family planning and quality emergency obstetric services. Educating young girls and boys to delay early pregnancies also plays a major preventive role.
- Access to care and surgery: It is imperative to support and fund active screening campaigns, ensure access to free and quality surgical interventions for all affected women, and develop specialized referral centers.
- Reintegration and support: Healing does not stop at surgery. Psychosocial support programs, rehabilitation, vocational training, and access to microcredit are essential for survivors to regain their dignity, economic independence, and their place within their community. Organizations like the United Nations Population Fund (UNFPA) are at the forefront of these efforts, collaborating with governments and local partners.
A Call for Solidarity and Collective Action
The International Day to End Obstetric Fistula 2025 is not just a day of commemoration. It is an urgent call to action, a reminder that the silent suffering of millions of women is a preventable and unjust tragedy. Obstetric fistula is not an inevitability. It is a wound of inequality and poverty, a scar of indifference.
Each of us has a role to play. By informing ourselves, raising awareness among those around us, supporting organizations working on the ground, and challenging our decision-makers, we can contribute to building a future where no woman will be abandoned to the shame and pain of fistula. A future where her health will truly be her right, and where every woman will have the chance to shape a life full of dignity and hope.
So, on May 23, let us remember Aïssa and all those who, like her, live a nightmare after giving life and are waiting for the world to act. Fistula can be eliminated. Let’s make this right a reality for all.