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Kabul 1 June 2016–On the commemoration of the International Day to End Obstetric Fistula (OF) Ministry of Public Health (MoPH), Afghanistan Society of Obstetricians and Gynecologists (AFSOG) and UNFPA – United Nations Population Fund together and in one voice agreed that:

“It is a grave injustice that in the 21st century, in Afghanistan women still suffer from obstetric fistula. Obstetric Fistula is a devastating condition that affects the poorest, most vulnerable and marginalized women and girls due to poor access of women during delivery to Emergency Obstetric care, socioeconomic and gender inequality, frequent births and early marriage. This is the time to work together and put shoulder to the wheel with MoPH, AFSOG and UNFPA and other government and non-government partners to “end fistula within a generation”.

Obstetric Fistula, the hidden tragedy - is one of the most serious pregnancy and birth related injuries/disabilities that results in a hole in the birth canal caused by prolonged obstructed labor in the absence of timely and adequate medical care. In addition to being an injury, OF is a devastating social and personal harm to the women affected, since continuous leakage of urine or feaces or both causes the woman to be marginalized and ostracized.

Malalai Maternity Hospital is one of the two health facilities in the country that provide surgical repairs  for Obstetric Fistula. The Obstetric Fistula Center in Malalai Maternity Hospital was established in 2007 with UNFPA financial and technical support. The OF Center provides surgical repairs services to 150 fistula patients each year. The center has recently been complimented by the establishment of areintegration ward, with financial support of UNFPA and the Islamic Development Bank.

The reintegration ward helps fistula patients regain their personal and social life, reintegrate in their families and communities and also become potential advocates for other women who suffer the same disability. These women will also advocate for the change of behaviors that are the main causes of fistula, such as; child marriage and early and/or frequent childbearing with no space between births.

UNFPA also trained around 150 health workers from different parts of the country in diagnosis and referral of OF cases.

Around the world 800 women die, daily, from complications related to pregnancy. For every woman that dies, 20 or more are injured or disabled, and most of these cases happen in developing countries such as Afghanistan. According to the Prevalence of Obstetric Fistula among Women of Reproductive Age study conducted in 2011 in six provinces of Afghanistan, the prevalence of obstetric fistula was estimated to be 4 cases per 1000 reproductive age women.

Eliminating fistula is a social and a rights issue and should therefore be integrated into the national-level targets and plans for achieving the sustainable development goals. Ending OF through other interventions, in addition to surgical repairs, require that all Afghan women have access to quality reproductive health and family planning services and prevention of early/child marriage and pregnancy.