By Mir Afroz Zaman, POBNEWS24, Dhaka, Aug 16, 2022 : About 17,500 women suffer from obstetric fistula in Bangladesh. The rate of women affected by fistula is highest in Barisal and Dhaka divisions. On the other hand, the prevalence of this disease is high among the population with low income and low education level. These data have emerged in a study.
This study on the situation of fistula in Bangladesh was published in the online version last week by the famous UK-based public health and medical journal ‘The Lancet’.
11 researchers from Johns Hopkins University, University of North Carolina, Florida’s IAP World Services, United Kingdom-based Save the Children International, and International Humanitarian Research Center, Bangladesh (ICDDRB) were involved in the research.
According to the research article, this maternal illness in Bangladesh is on par with the African country of Ethiopia. However, the situation in Bangladesh is better than another African country, Nigeria. On the other hand, the rate of women suffering from fistula is much higher in Bangladesh than in neighboring Nepal.
Significant progress has been made in maternal health in Bangladesh. Between 1990 and 2015, global maternal mortality decreased by 2.3 percent per year. At the same time, maternal mortality in Bangladesh decreased by 4.7 percent.
With one maternal death, 20 to 30 mothers suffer from acute or chronic maternal illness. Among these, fistula is the most devastating disease. Fistula is the most debilitating of women. Fistula is considered a public health problem.
Obstetricians say, cause of fistula – delayed and obstructed labor. If labor is delayed and obstructed, the vaginal, urinary tract, and faecal tissues of the parturient are damaged. In some cases, the urethra joins the vagina, in some cases the vagina joins the anus, and in some cases the urine and the anus joins the vagina. There is no control over urination and defecation. Bad smell comes out of the body. The affected woman fell into helplessness. In this condition, women start avoiding people. As a result, he gradually became very lonely.
Fistula situation in Bangladesh
The last maternal mortality and health care survey in the country was conducted in 2016.
The survey had a question asking for fistula information. To confirm the validity of the data of the national survey, a survey was conducted in two upazilas of Sylhet between August 3 and December 9, 2016. The survey was conducted on 65 thousand 740 women aged 15 to 64 years.
In the survey, 67 women reported fistula. However, 19 out of 67 people can be confirmed to have a fistula in a health examination by a trained doctor. Researchers say that two-thirds of the fistulas that women talk about are not actually fistulas.
By combining the Bangladesh Maternal Mortality and Health Care Survey and survey and health examination data on women in two upazilas of Sylhet, researchers say that the estimated number of fistula patients in the country is 38 out of 100,000 women aged 15 to 49 years. As such, the estimated number of fistula patients among women of reproductive age (15-49 years) in the country is 13 thousand 376.
On the other hand, as estimated, 4 thousand 81 people are suffering from this disease among women aged 50 to 60 years. According to that, the estimated number of fistula patients among women aged 15 to 60 is 17 thousand 457.
To be done
Researchers say that even though the maternal mortality has decreased in the country, the burden of maternal health problems like fistula is very high. Only a few hundred fistula patients receive surgical treatment each year. Many women are not receiving treatment due to lack of trained surgeons, inadequate resources, lack of planning, lack of coordinators etc.
On the other hand, it appears that the incidence of fistula is high in two sections of the country. Again, due to lack of education, many women are not able to take the opportunity of treatment. The researchers said to pay more attention to these two issues.
Bangladesh government considers fistula as a health problem. Bangladesh is also working to achieve the set goal of eliminating fistula globally by 2030. However, many experts have doubts whether it will be possible to achieve this target within a certain period of time.
Public health specialist Abu Jamil Faisal has worked on fistula prevention, treatment and rehabilitation of fistula patients in Bangladesh for a long time. He told PoBNews24, “The estimated number of fistula patients that the researchers have found out is treatable.” For this, these patients should be found and taken to the hospital.
