“Living with fistula was a sad experience for me. However, I remain grateful that I was supported to go through the surgery and I was later reintegrated into society. Throughout the period, my husband was a source of hope and support as he never abandoned me,” remarked Massa Swarray, a fistula survivor, now serving as a fistula champion for Haikal Foundation.

Obstetric fistula is a devastating childbirth injury that often leaves women and girls with chronic medical problems and leads to depression, social isolation and deepening poverty. Around the world, an estimated two million women and girls live with the condition. Although it is almost entirely preventable, lack of access to quality sexual and reproductive health services is a contributing factor to obstetric fistula.

In Sierra Leone, UNFPA partners with Haikal Foundation and the Aberdeen Women’s Centre to screen women with suspected obstetric fistula, conduct surgeries to repair fistulas, and provide support to rehabilitate and reintegrate fistula survivors into their families and communities. The programme which is funded by the Government of Iceland also provides skills training to build livelihood opportunities for survivors and facilitate social reintegration.

On Thursday 8 December, a graduation ceremony was held in Bo to recognize 54 obstetric fistula survivors and champions who completed repair surgeries and benefitted from a rehabilitation programme to support social reintegration into their communities. The ceremony was led by Haikal Foundation, with support from UNFPA, the Ministry of Health and Sanitation, and the Government of Iceland.

Speaking at the event, UNFPA Representative Ms. Nadia Rasheed commended the Haikal Foundation for its achievements in supporting social reintegration of fistula survivors. Obstetric fistula, she noted, is one of the most devastating conditions faced by women and girls, exposing them to stigma and discrimination in their families and communities, leaving them isolated, and robbing them of opportunities for livelihoods and education.

“Obstetric fistula is a reflection of the shortcomings in our health systems. This is why it is important for us to work together to ensure that all pregnancies and births are safe, and that everyone has access to high quality healthcare,” Ms. Rasheed said. She further stated that the deeper root causes of fistula must be tackled at the community level, as fistula often occurs as a result of child marriage and adolescent pregnancy, emphasizing that “harmful practices like child marriage expose far too many girls and women to pregnancy and birth complications that risk their lives and result in fistulas.” She also applauded the Ministry of Health and Sanitation for prioritising efforts to improve maternal health and appreciated the support by the Government of Iceland to Sierra Leone’s efforts to end fistula by 2030.

Executive Director of Haikal Foundation, Haja Hawa Turay in her remarks said that the partnership between UNFPA and her organisation led to the graduation of the 54 survivors, who are now ready to return to their communities. She assured that her organisation will continue to support national efforts aimed at ending obstetric fistula through identification, rehabilitation and social reintegration efforts.

Making his remarks at the same event, Resident Minister, Southern Province, Mohamed E Alie said that the intervention by Haikal Foundation, UNFPA and other partners is complimenting national efforts to tackle maternal mortality. Government, he said, is committed to protecting the rights and dignity of women and girls. He called on a collective community approach to end child marriage so as to end obstetric fistula.

In his keynote remarks, the District Medical Officer, Bo district, Dr. Prince E. Masuba emphasised the role of communities in ending the condition, saying it requires collective efforts from ending child marriage, to the use of contraceptives, to ensuring pregnant women visit health facilities.

“Every pregnant woman should be attending a clinic regularly and have access to a skilled provider. Also as parents let us ensure that our girls attain the age of maturity before they become pregnant. There are so many contraceptives available to divert early pregnancies,” Dr. Masuba said.

The Paramount Chief of Kakua Chiefdom, Bo district, P.C. Prince Lapia Boima, along with other speakers including representatives from the district and city councils and traditional and religious leaders, also emphasised the need to end child marriage, enable access to sexual and reproductive health services, and ensure that pregnant women visit health facilities, in order to end fistula in line with the Sustainable Development Goals.

The ceremony was the 10th graduation hosted by Haikal Foundation and concluded with the distribution of certificates to fistula survivors along with an allocation of seed funding to support them in establishing livelihood opportunities as they return to their communities.