Obstetric fistula: life shattering but preventable.

• Author: Beattie, Jessica Bankes

Imagine a world without obstetric fistula. The result of an obstructed childbearing labour that sometimes lasts for days without access to timely medical attention, obstetric fistula has a devastating impact on the lives of women. During labour, the continuous pressure of the baby's head against the soft tissues of the mother's pelvis causes fistula or a hole between the woman's vagina and either her bladder or rectum, which leaves her chronically leaking urine, excrement or both.

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The consequences are life shattering; in most cases the baby dies. Unable to control the constant trickle of bodily fluids, the mother is abandoned by her husband and shunned by the community because of the terrible odor and stigma associated with her condition. Without treatment, her prospects for work and normal family life, including childbearing, are greatly diminished. Filled with shame, she is relegated literally to the outskirts of her community and left to live in isolation.

Virtually non-existent in industrialized countries, obstetric fistula occurs primarily in poor areas of Africa, Asia and some Arab States. The World Health Organization has estimated that there are more than 2 million women and girls, some as young as 12, in developing countries suffering from it, with 50,000 to 100,000 new cases occurring each year. Yet, the condition is completely preventable and reparable. According to the United Nations Population Fund (UNFPA), "the success rate of fistula repair for experienced surgeons can be as high as 90 per cent. After successful treatment, most women can resume full lives". Sadly, many living with the condition either are unable to afford or access treatment or do not realize that treatment is available.

In January 2004, American television personality Oprah Winfrey dedicated an entire hour of her show to this little known, devastating childbirth injury. Heidi Breeze-Harris of Seattle, Washington, was among millions who tuned in that day. Three months pregnant at the time, she was deeply shocked by what she saw and heard and was so moved that by the end of the hour she felt compelled to help. Learning that the cost of reparative treatment for one woman is $300, she thought: "I've got that! This is an astronomical sum of money for these women, but it's so little by our standards, especially relative to the absolute devastation for the women left untreated."

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Tired of quietly lamenting the fact that...