ON THE ROAD TO RECOVERY

Only a few countries with recently established obstetric fistula programmes can claim results as impressive as the ones in Côte d’Ivoire, specialists agreed during a recent meeting in New York. With a population of 20.8 million and high maternal mortality ratio, the country faces a complex set of maternal health challenges, especially in terms of morbidities like obstetric fistula.

Amenan, Therese and Silue are some of the fistula survivors who advocate for the end of obstetric fistula in Cote d'Ivoire. Photo: UNFPA Cote d'Ivoire.

According to Dr. Edith Boni Ouattara, UNFPA (United Nations Population Fund) Reproductive Health Programme Specialist in Côte d’Ivoire, the participation of the Ministry of Health has been crucial in achieving results, especially with the adoption of a three-year national plan (2009-2012) on fistula. “This kind of ownership is crucial if we want to advance our work in the country,” she explained.

Another important factor for the programme’s success has been the work with fistula survivors, who are active as ambassadors for the fight against fistula in their communities and at the national level. “They give their testimonies and sensitize the public about obstetric fistula through media interviews, national conferences and local meetings,” said Dr. Boni Ouattara.

“I think this was something people simply didn’t talk about before we started our work in 2007. When the campaign was launched in the country, there was little mobilization. The priority then was the western portion of Côte d’Ivoire, where fistula cases were more evident. Today we receive cases from all regions,” she commented.

“When we see these women who are now free of fistula, we rejoice with the results. It comforts us and tells us how necessary and how important our work is. We are giving these women their lives back,” Dr. Boni Ouattara celebrates. 

In 2010, the programme aims to expand its work in the country, rehabilitating more obstetric fistula centres. However, insufficient funds are one of the biggest challenges.

Although UNFPA has been able to provide medical and surgical kits to three fistula centres in Côte d’Ivoire, train more than 160 health providers, and work to strengthen capacity at country and community levels, the number of fistula patients treated so far – 460 women since 2007 – is low  compared with the backlog of fistula cases in the country. “We want to do more,” said Dr. Boni Ouattara.

“However, the availability of specialized services for fistula treatment, sufficient and qualified professionals, and ways to socially reintegrate women marginalized by society all require resources. The needs are immense and the funds are scarce, making it more difficult to expand the activities,” she added.

The programme in Côte d’Ivoire is currently being supported by the Inner Wheel Club Service and various other foundations, like Fondation Orange and Fondation OMAIS. It also counts with support from the Embassy of Israel, the African Development Bank, the Bank of Africa, and the Japanese Cooperation, all of which helped upgrade some of the fistula centres, like adding surgery rooms that will be used to repair fistulae.