Women sit in the Vesico Vaginal Fistula Ward of a hospital in Freetown, Sierra Leone.The Globe and Mail
Canada has spoken in generalities about supporting maternal and child health, and its intention to make this issue a priority at the upcoming G8 summit. But Prime Minister Stephen Harper has not yet announced a specific and meaningful program that would assist the poorest, least educated and most marginalized women in the developing world.
Mr. Harper can show real leadership by championing the United Nations Population Fund's campaign to end fistula - and divert attention away from critics who have spoken out against his controversial decision not to fund abortion programs.
Of the many debilitating health problems that expectant mothers in poor countries face, obstetric fistula may well be the one with the most profound consequences. Few in Canada have heard of this unglamorous problem because it doesn't exist in the developed world.
But in Afghanistan, Mali, Ethiopia and other parts of Asia and Africa, two million women suffer from this wholly preventable and treatable condition. After hours, sometimes days, of obstructed labour, the woman suffers a serious tear, often her baby dies, and she is left with chronic incontinence, and the terrible social stigma that results from this.
The tear occurs due to the pressure of a baby's head against the mother's pelvis cutting off blood supply to the tissues in the region, leaving the mother with a hole between her vagina and one or more internal organs. Often the woman is abandoned by her husband, who blames her for what has happened.
In Canada, a Caesarian section saves a woman from this pain and indignity. In sub-Saharan Africa and South Asia, however, more than half of all births still take place without trained birth attendants. The rates of young marriage and child marriage are also high, which contributes to the problem because women's pelvises aren't properly developed for childbirth.
Obstetric fistula can be closed with surgery, which costs about $300. However, the annual worldwide capacity to treat fistula is only about 6,500 repair surgeries.
So the best-case scenario is not to get to the point of being in danger of this condition, whose root cause is poverty. That means delaying pregnancy, practising family planning and getting access to proper obstetric care - issues that were highlighted this week at the Women Deliver conference in Washington, D.C., held in advance of the G8 summit.
The UN Fund's $25-million campaign, now under way in 47 countries, has helped to train local health-care professionals, educate villagers and fund repair surgery. But tens of thousands more women still suffer. In 2004, Ottawa contributed $250,000 to the campaign. Canada could do much, much more to build on this shifting momentum, and lead the global effort to restore dignity to the lives of these women and to help make childbirth safe.