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More than just a "surgical repair": fulfilling the promise of ICPD for women in rural Zambia

30 June 2019

Mkushi, Central Province: Pregnancy and childbirth should be among the happiest moments in a woman’s life. Sadly, this is not the case for thousands of women in Zambia, where an estimated 33,400 women and young girls have suffered from Fistula, one of the serious injuries that can occur during childbirth.

The story of Nangoma* typifies the stories of these women and young girls.

Back in 1994, Nangoma* was in labor for two days in her home village in Central Province. After the second day, her family took her to a clinic near her village. Her baby did not survive and she developed an obstetric fistula. Her husband left, and soon after, so did her hope.

At the clinic, the doctor told her she had fistula and referred her to the District Hospital to get treatment. But instead, she decided to return back to her home village with her husband and mother. Her husband ended up running away and they’ve never seen each other since. Nangoma* lived with the devastating effects of fistula for more than 25 years before she was finally able to get help.  

The ICPD held in Cairo in 1994 placed individual dignity and human rights at the very heart of sustainable development. In this regard, UNFPA reaffirms its commitment to putting the furthest behind first and to ending fistula within a generation - Ms. Gift Malunga, UNFPA Representative.

The Fistula had left Nangoma* socially isolated – she wouldn’t even visit friends or relatives. She was always washing her clothes and forced to bathe several times a day, because if she didn’t bathe, she couldn’t sit with family and friends. “Everywhere I sat, I left a mark, and people would always gossip about my condition. I was helpless and could not do anything about it. My life was miserable” says Namgoma.

In May 2019, through community outreach programmes, Nangoma* was able to access the help she desperately needed at Mkushi General Hospital, where the Ministry of Health with support from UNFPA was undertaking a Fistula Repair Camp. The doctor at the hospital explained to her about the life-transforming surgery she would undergo, and Nangoma* was eager to have it. 


LEFT: Nangoma* (R) shares a joyful moment with UNFPA Zambia Representative (L) after a successful fistula repair surgery.
RIGHT: WHO and UNFPA Representatives (L and R) pose for a happy photo with one of many women who underwent successful fistula repair surgeries at Mkushi District Hospital in Central Province, as part of the 2019 safe motherhood week commemoration

For over a decade, the Government of Zambia, in collaboration with partners such as UNFPA, has invested in over 2,300 life-transforming surgeries, to heal the physical and psychological wounds of Fistula survivors. However, Fistula repair services are not enough. In Zambia, UNFPA and partners continue to draw the attention of policymakers, communities and individuals, to key actions and investments required to ensure all women and girls are able to access key components of safe motherhood – before, during and after pregnancy.

Speaking during the official launch of the safe motherhood week held in May 2019 alongside the fistula repair camp, UNFPA Zambia Representative underscored that "the International Conference on Population and Development (ICPD) held in Cairo in 1994 placed individual dignity and human rights at the very heart of sustainable development, and continues to guide UNFPA’s global goals aimed at ending preventable maternal death, ending unmet need for family planning, and ending gender-based violence and harmful practices. UNFPA reaffirms its commitment to putting the furthest behind first; to ensuring human rights, well-being and dignity for all; and to ending fistula within a generation" Ms. Malunga said.