The Sindh High Court (SHC) has directed an additional advocate general (AAG) to submit a list of all hospitals in the province where treatment for obstetric fistula is being provided to patients.
The court issued the orders on Wednesday while hearing a petition calling for the utilisation of funds for a national programme to control maternal deaths. The petitioners, including Dr Shershah Syed, submitted that around 5,000 women die during pregnancy in Sindh every year because of a lack of healthcare facilities in rural areas. They said there is a shortage of medical care facilities as well as trained staff to attend to the expecting mothers and handle deliveries.
According to the petitioners, the government had launched the Maternal and Newborn Child Health Programme many years ago, however, the funds allocated for the programme were never utilised. More than 1,500 fistula patients hail from the province where a majority of government hospitals do not provide fistula repair surgeries, they said, requesting that the provincial government be held accountable for the lack of timely and adequate treatment and violation of women’s rights to life and dignity as per the Constitution.
Obstetric fistula is a hole that develops between the birth canal and bladder or rectum usually during a prolonged labour or difficult delivery, and causes the uncontrolled leakage of urine or faeces or both.
The petitioners requested that the authorities be directed to ensure access to affordable treatment of obstetric fistula to all women in Sindh. They said the government should ensure that at least one qualified gynecologist in every district was trained and equipped to provide fistula repair surgery.
An SHC division bench headed by Justice Mohammad Ali Mazhar directed the provincial law officer to file comments, including details of hospitals in the province where fistula patients were being provided treatment and adjourned the hearing till June 12.
PPI adds: Eminent gynaecologists and social activists on Wednesday stressed the need for comprehensive training of midwives all over Pakistan to prevent women from developing obstetric fistula.
Addressing a joint press conference to mark International Day to End Obstetric Fistula at the Pakistan Medical Association (PMA), health experts called for a change in socio-cultural attitudes in society in order to reduce the maternal mortality rate as well as to prevent women from developing complications related to fistula.
Pakistan National Forum on Women Health Programme Officer Dr Sajjad Ahmed Siddiqui said an estimated 4,000 to 5,000 new fistula cases are being reported in Pakistan out of which only 500 to 600 patients are brought to treatment centres for surgeries while a number of cases remain undiagnosed due to a lack of awareness in society.
He said that many women and girls with fistula are shunned by their families and communities, adding that it is immoral that the poorest most vulnerable women and girls suffer needlessly from such a devastating condition.
Society of Obstetricians Gynaecologists of Pakistan representative Dr Nusrat Shah said an estimated 2 million women live with obstetric fistula in developing countries, most of whom develop the disease during their pregnancy because of unskilled birth attendants. She said major factors of such a high fistula rate are social and cultural issues like early marriages, poverty, lack of education, high fertility rate and poor heath infrastructure.
Dr Shah explained that obstetric fistula is preventable and in most cases treatable. She said midwives play an important role in developed countries as part of safe motherhood programmes and it is important to develop similar programmes in order to improve maternal and neonatal care in Pakistan. PMA Karachi General Secretary Dr Abdul Ghafoor Shoro, social activist Sheema Kermani, Dr Mirza Ali Azhar and others also spoke on the occasion.
