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The first-ever International Day to End Obstetric Fistula was jointly commemorated with the international Midwives Day at Villa Sultan in Mogadishu, Somalia, on 23 May 2013. The event was attended by dignitaries of the government of Somalia including Director General and Parliament Representatives, UN agencies, NGOs, Fistula survivors, Women Associations, Midwives and other partners. The day was marked by a series of colorful events focusing on with a variety of awareness creation and consultative platforms such as illustrative testimonials by fistula survivors, keynote speeches, cultural songs, poems, and plays under the theme "End the shame, end the isolation, and end fistula!"

Considered one of the most serious injuries caused by childbirth complications, obstetric fistula is a hole in the birth canal caused by prolonged, obstructed labour due to the lack of timely and adequate medical care. In most cases, the baby is either stillborn or dies within the first week of life, causing woman to suffer a painful, and long lasting physical and psycological trauma, a fistula-that renders her weak, sick, unproductive, shunned by society, and marginalized. Their families and communities often abandon them; further  throwing women and young girls into poverty and worsening their suffering and isolation from society.

Speaking on the occasion and particularily on this gruesome trauma so many Somali girls and women suffer from, Dr.Abdirizack Yusuf Ahmed, Directorate of Health representative, thanked the government and UNFPA for their concerted efforts to organize a remarkable event and remarked that many Somali women who develop fistula are stigmatized and suffer severe psychological, social and physical trauma. He said, ‘‘UNFPA in partnership with WAHA (Woman and Health Alliance) is a valued partner working with the Government to bring smile and restore hope to so many women suffering from fistula. We need the further collaboration of all to facilitate, encourage, refer and accompany women to deliver in health facilities to make a significant impact in the fight against obstetric fistula. This is a responsibility of all Somalis, he noted, including family heads, traditional and religious leaders, politicians and the rest of us.

Somalia's maternal mortality ratio stands at 1,044 deaths per 100,000 live births, making it one of the highest in the world and contributes to raising the regional and global averages for the indicator. Moreover, latest reproductive health situation analysis conducted by UNFPA in early 2009 concluded that more than 90% of women deliver at home as more than half are assisted by traditional birth attendants (TBAs). The number of maternal deaths is highest in countries where women are least likely to have access to a midwife, doctor or other trained professional during delivery.

Remarking on the occasion, Ms. Fatuma Muhumed, representing UNFPA South/Central Zone Office, urged all stakeholders to accept Fistula as a solid realty on the ground that needs an urgent, persistent and concerted effort to eradicate. ‘‘It is with us", she said, ‘‘in Mogadishu city alone, UNFPA has directly supported 238 women and girls to receive corrective surgical procedures to treat fistula in 2012. Let's end the shame, end isolation, end fistula!''

Maternal death can be prevented if all of us work together, she added, to give women access to family planning to avoid unintended pregnancies, avoid harmful traditional practices and facilitate the provision of skilled care at the time of birth. The World need midwives now more than ever!


Iftin Group was a joyful addition to the occasion as it entertained the guests by traditional songs, dance and plays all demonstrating the importance of midwives in saving the lives of pregnant women, mothers and their babies and the challenges they face from fistula and the daily challenges of living with it. Invited midwives also presented poems to the participants.




Faria Mohamed, 27, a fistula survivor and one of the Day's ambassadors from Afgowe area in Mogadishu told her story of pain and shame sustained from an obstetric fistula following the failed delivery of child. Her husband together with his family, decided for her to be attended by Traditional Birth Attendant (TBA) and the TBA failed to take her to a hospital. The result was a painful and life threatening two day labor. When her husband saw the extent of her injury with fistula, he left her alone. She lived with the debilitating effects of fistula for eight years until she underwent a successful surgery. Now her goal is to educate women and girls to avoid the post-delivery complications of fistula.


Fistula survivor at the age of 29, Asha Mohamed, was the other ambassador of the day. Unqualified midwife mishandled her by giving administering medicine that fastened the contraction process. As a result, she delivered a still baby and two day later her urine started leaking involuntarily as she lost control of her muscles. She was referred by a friend to Hanano Hospital in Mogadishu, where UNFPA in partnership with WAHA performed a  successful fistula surgery. Having recovered from her ailment, she has delivered her 9th baby successfully with the usual support of UNFPA at the same hospital.

Obstetric fistula has been virtually eliminated in industrialized nations, as it is preventable and, in most cases, surgically repairable. However, an estimated 2 to 3 million women and girls still live with the condition in the developing world, and more than 50,000 new cases are recorded each year. Over the last 10 years, UNFPA has directly supported more than 34,000 women and girls to receive surgical treatments for fistula-roughly one third of global repairs-including 7,000 women and girls in 2012 alone. Partner agencies have supported thousands more as part of the Campaign to End Fistula, which was launched in 2003 by UNFPA along with a wide range of partners. The Campaign is based on the three key strategies of prevention, treatment and social reintegration of survivors.