Preventable surgical injuries haunt Pakistani women

UNFPA links fistula risk to obstructed labour and poor maternal care

KARACHI: Pakistan continues to face a silent but devastating maternal health challenge, as experts warn that obstetric fistula — a preventable childbirth injury — still threatens thousands of women, particularly teenage girls and those lacking access to safe maternity care.

In a statement issued on the International Day to End Obstetric Fistula, Dr Luay Shabaneh, UNFPA Representative in Pakistan, said fistula remained one of the most severe childbirth-related injuries, often leaving women incontinent, socially isolated, and emotionally traumatised.

He stressed that the condition was both preventable and treatable, and called for sustained investment in maternal healthcare, surgical safety, and rehabilitation services across Pakistan.

According to the statement, nearly 70 per cent of fistula cases in Pakistan are linked to surgical injuries, medically termed iatrogenic fistula, highlighting concerns over the quality and safety of obstetric and gynaecological procedures.

The statement noted that prolonged obstructed labour, lack of emergency obstetric care, and inadequate surgical training continue to place women at risk, particularly in underserved areas.

To tackle the growing challenge, the United Nations Population Fund established a Regional Centre of Excellence for fistula care, training and innovation at Koohi Goth Hospital in Karachi. The facility has emerged as a national referral hub for fistula repair and surgeon training.

The centre aims to provide treatment to around 800 fistula survivors annually and reports a 96 per cent surgical success rate. Beyond surgery, the programme also offers psychosocial support, literacy and vocational training to help survivors reintegrate into society, according to the press release.

The hospital has additionally hosted regional training programmes for surgeons from Bangladesh, Nepal and Afghanistan, positioning Pakistan as a regional leader in fistula treatment and surgical training.

UNFPA stated that more than 5,000 competency-based trainings have so far been conducted in Pakistan, alongside the development of a network of 23 specialised surgeons supported by trained nurses and anaesthetists.

Globally, an estimated 500,000 women and girls are living with obstetric fistula. UNFPA said over 153,000 fistula repair surgeries had been supported worldwide between 2003 and 2025.

Dr Shabaneh emphasised that ending fistula was not only a matter of women’s dignity and rights, but also an economic necessity, as untreated fistula contributes to major productivity losses worldwide.

Meanwhile, the Pakistan National Forum on Women’s Health, in collaboration with Fistula Foundation, UNFPA, PMA, Midwifery Association of Pakistan and Tehrike-Niswan, is organising a press conference at the Karachi Press Club on May 23 as part of activities marking the International Day to End Obstetric Fistula.

Experts and health advocates, including Dr Sajjad Ahmed Siddiqui, Dr Abdul Ghafoor Shoro, Dr Muhammad Ismail Memon, Dr Sana Ashfaq, Raffat Jan, Sheema Kermani, Dr Sonia Naqvi, Golden Mulilo and Renuka Swami, are expected to address the conference.

--IV News Desk

Photos courtesy: Koohi Goth Hospital, Karachi