OBSTETRIC FISTULA

Mrs GERAGHTY (Torrens) (15:35): Today I want to speak about a serious women's health issue that I believe I have actually raised before in the house, but it came to my attention again during a trip to Ethiopia. The problem I am talking about is obstetric fistula. Like many health problems in African countries and other developing nations, it is a condition which, thankfully, I do not think happens very often at all to Western women. It is something that women in Western countries no longer have to endure.

Put simply—and I think it is worth describing it, as unpleasant as it is—obstetric fistula is a rupture between the vagina and the bowel or bladder and the outside of the body. It occurs as a result of untreated protracted or obstructed labour. The fistula causes embarrassing body leakages and accompanying bad odours.

Obstructed labour globally affects about 5 per cent of women. In the West medical treatment can overcome the problem, but in other parts of the world women have to endure the labour and the after effects. Six in 10 women in developing countries give birth without medical assistance from a midwife or doctor. Estimates from the World Health Organization suggest that about 2 million women worldwide have untreated obstetric fistula, with 100,000 new cases each year.

The personal and social impact of this condition can be dire. To take Ethiopia as an example, women with obstetric fistula are often abandoned by their husbands and ostracised from their communities because they can no longer give birth. The condition stigmatises women, isolates them from family communities and further impoverishes its sufferers. Ethiopian society places a high value on having many children. Many sufferers incur the condition in younger years, and with few hospital doctors and poor transport, they can be burdened with the dreadful physical and social consequences for the rest of their lives. Unfortunately, life expectancy for some of these Ethiopian women is only about 41 years of age.

Fistula can be cured by surgery, after which there is a good chance of a full recovery, and the cost can be now as low as $450 for the surgery and post-operative care. Two Australians feature in the story of treating this condition in Ethiopia. In 1974, Dr Catherine Hamlin from Australia and her husband, Dr Reginald Hamlin from New Zealand, established a fistula hospital in Addis Ababa. Today the hospital offers free fistula repair surgery to approximately 2,500 women every year and also houses 50 long-term patients. The hospital is a world leader in treatment, rehabilitation and prevention and now has three small hospitals operating in rural areas, but it has no public funding and relies on donations to keep this vital treatment going.

The hospital is helping many women, but this appalling condition is still a major health problem for millions of women. In 2003 the United Nations Population Fund and partners launched a global campaign to end fistula, with the goal of making fistula rare all over the globe, not just in Western countries. The campaign is aimed at prevention as well as treatment. It also raises awareness of the problem among policymakers and communities, to try to break down the stigma attached to the condition.

The campaign is undertaken in more than 40 countries in Africa and Asia and in 2010 the United Nations Secretary General called for $750 million to treat 3.5 million cases of obstetric fistula by 2015. When I visited the fistula hospital in Addis I was extremely proud of the condition of the hospital and the services that were being provided, but it was quite traumatic to see very young girls with this dreadful condition.

One young woman we saw was still a teenager and she was actually bent over and having to undergo physical treatment and physiotherapy to help straighten her body because of the dreadful leakage that comes with fistula. She had spent years curled up in a ball in a foetal position. It was just an amazing thing to see the work that was being done with her to help her be able to walk again, to go home and live a normal life and, hopefully, in the future to have more children without fistula.