First Lady Calls For Strong Commitment To Eliminate Obstetric Fistulas

The First Lady, Marieme Fadel Dah, participated, Tuesday via videoconference, in the meeting of the initiative for the elimination of obstetric fistulas in West and Central Africa.

The First Ladies of Niger, Comoros, Chad, and Sierra Leone, as well as the regional directors of the United Nations Population Fund in Africa, also participate in this initiative organized under the slogan: “A strong and broad partnership that is essential for the elimination of obstetric fistulas in West and Central Africa”.

In her speech, the First Lady called for participation, alongside governments, the United Nations Population Fund, and other partners, to implement the National Strategy for the Elimination of obstetric fistulas.

She underlined the interest of devoting efforts to support all initiatives that contribute to the elimination of this disease, by fighting against early marriage, by taking care of women who are affected by it at different levels of the health pyramid, by ensuring girls’ access to education and women to childbirth-related services by qualified doctors and facilitating their access to birth spacing programs, as well as combating violence against women and girls.

Here is the full text of the First Lady’s speech:

“Excellency Madam Malika Issoufou, First Lady of Niger;

Excellencies First Ladies,

Dear Sisters from Burkina Faso, Chad, Gambia, and Sierra Leone,

I would like to thank all the organizations involved in the preparation and implementation of this excellent initiative and to express my pride in being part of it.

You will allow me to start with a confession that is quite embarrassing for me: before the invitation of my very dear sister Malika, I did not know the extent of this phenomenon and it is by learning for this meeting that I grasped the seriousness and the underlying suffering.

I almost had tears in my eyes. And yet, it is not hard to prevent. Obstetric fistula is indeed a major public health problem and a social tragedy for the victims, who are mainly the most vulnerable, destitute girls and women, living in the most isolated localities, with very limited access to quality health services. So as not to repeat what others will develop better than me, I will focus on the extent of the problem in Mauritania and the challenges we face. In addition to population growth and poor access to reproductive health / family planning services, the aggravating factors in Mauritania are:

– the high prevalence of marriage at an early age: 15.6% before 15 years and 35.2% before 18 years (MICS 2015),

-unmet need for family planning / birth spacing (33.6%,

– early and close pregnancies and the low rate of assisted deliveries (64.4%),

-the high number of female genital mutilation: 66.6% among women and 53.2% among girls,

-the low level of girls’ education: 62% in primary school (MICS 2015), 41% in secondary school and 21% in higher education.

However, since the launch of the national campaign in 2003, Mauritania has developed and implemented several programs and strategies to fight against obstetric fistula:

-development of a national strategy for the elimination of obstetric fistula (2020-2025),

-the adoption of a fatwa by religious leaders against female genital mutilation,

-the creation of a regional center of excellence (ENSSS) for clinical mentoring of midwives to strengthen continuing education and promote the provision of quality reproductive health services,

-the strengthening of surgical management and the offer of repair surgery to 635 women with fistulas,

-integration of obstetric fistula in indigent diseases with access to free care including the socioeconomic reintegration of women treated and cured of obstetric fistula.

Despite this progress, it should be noted that obstetric fistula remains a challenge in Mauritania:

– each year an additional number of 150 to 300 women increase the number of obstetric fistula carriers, with a cumulative gap (2003 to 2021) of 2,700 to 5,400 cases,

– every week, 16 women die while giving birth (582 maternal deaths per 100,000 live births).

The results obtained to date remain modest compared to the new additional cases. The urgency to eliminate obstetric fistula is well established.

Therefore, we must all be engaged alongside our governments and the United Nations Population Fund, and other partners in the implementation of the national strategy for the elimination of obstetric fistula. We should also be dedicated to supporting all initiatives that participate in the elimination of obstetric fistula, namely: the fight against early marriage, support at all levels of the health pyramid, girls’ access to education, women’s access to assisted delivery services by qualified personnel, women’s access to family planning / birth spacing and the end of violence against women and girls.

Finally, I cannot end without thanking you for this opportunity which will allow us, as First Ladies, to influence the policies of our respective States, to mobilize national financial resources to end obstetric fistula and ensure that women and girls can contribute freely and with their full potential to the development of Mauritania and all of Africa.

Thank you”.

The videoconference was followed live, from Nouakchott by the Minister of Social Affairs, Children, and Family, Ms. Naha Mint Haroune Ould Cheikh Sidiya, the Secretary General of the Ministry of Health, Ms. Ba Halima Yahya, the representative of the United Nations Population Fund and executives from the departments of Health and Social Affairs.