Fistula Research and Training Center

Koohi Goth hospital is one of the few large and well-equipped facilities in Pakistan which specialize in treating obstetric fistula and detaching women from the stigma which the condition brings with it.

The hospital treats more than a thousand patients out of a total of about 5,000 reported cases. This condition remains one of the most under-reported health problems of women. A lot of women with this condition lose bladder control and are disturbed by the odour that emanates from them.

Patients come to the hospital from areas where even basic health facilities are hard to find such as, Badin, Quetta, Peshawar and Thari Mirwah. Besides treatment, Koohi hospital also has a rehabilitation centre for its patients who are often admitted to the hospital for months.

What is an obstetric fistula ?

Obstetric fistula is one of the most devastating and serious of all childbirth injuries.

It happens because most mothers in poor countries give birth without any medical help. Many of these are young girls. Complications from pregnancy and childbirth are among the leading causes of death and disability for women of reproductive age in these places. Obstetric fistula was largely eliminated in the United States in the latter part of the 19th century and early 20th century with improved obstetric care in general and the use of Caesarian-sections in particular to relieve obstructed labor.

After enduring days of agony due to obstructed labor, a woman’s body is literally broken by childbirth. During labor contractions, the baby’s head is constantly pushing against the mother’s pelvic bone — causing tissue to die due to lack of blood flow to this area. All of that pushing creates a hole, or in medical terms a “fistula”, between the birth passage and an internal organ such as the bladder or rectum. A woman cannot hold her urine or, sometimes, fecal matter.

Her baby is unlikely to survive. If she survives, a woman with fistula is likely to be rejected by her husband because of her inability to bear more children and her foul smell. She will be shunned by her community and forced to live an isolated existence. These women suffer profound psychological trauma resulting from their loss of dignity and social standing, in addition to suffering constantly from their physical internal injury.

Why Do We Work in Pakistan? 

According to data from the United Nations Population Fund (UNFPA) and Pakistan National Forum on Women’s Health, it is estimated that 3,500 known cases of obstetric fistula occur annually in the rural areas and urban slums of Pakistan. Identifying patients has been difficult because many women live in severe poverty in areas that are difficult to reach. Furthermore, women suffering from obstetric fistula are unaware that they are suffering from a medical problem for which treatment is available. Additionally, our partners in Pakistan have found it difficult to provide treatment for women suffering from obstetric fistula because many in-country surgeons lack the motivation to repair fistulas as it is not a financially lucrative surgery for them.

The numbers are Shocking. Approximately 4,000 to 5,000 new obstetric fistulas cases are reported every year in Pakistan due to socio-cultural issues like early marriages, poverty and lack of education,

Right now, hundreds of thousands of women are suffering from this heartbreaking, treatable childbirth injury because they are too poor to afford corrective surgery, which costs about $450.

Worldwide, this number keeps growing bigger. Each year approximately 30,000 – 50,000 women develop this childbirth injury. The international capacity to treat fistula patients has been estimated at just over 14,000 a year — less than half the amount of new women who develop a fistula each year. Surgeons would describe this as an enormous backlog of untreated patients. There is clearly an overwhelming need for treating far more women.



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