UNFPA, the United Nations Population Fund, in partnership with the Darfur Regional Authority (DRA); celebrated the first ever International Fistula Day at the Friendship Hall in Khartoum. The event show cased advocacy efforts by all stakeholders including Fistula survivors, national and state governments, civil society networks, veteran and practicing medical professionals, midwives, donors and UN organizations.

The morning official ceremony was followed by a seminar in the afternoon during which four papers were presented by experts covering medical, social, human rights and religious aspects of Obstetric Fistula. At the end of the seminar, experts and participants came out with specific recommendations to better address Fistula in Sudan.

Fistula survivor Hanan Satti told her story about her suffering. She said following prolonged labour, she was diagnosed with Fistula. Besides the ordeal of constantly leaking urine, she talked about her psychological suffering and the mounted worries about the possibility of an unsuccessful operation. Six months later, Hanan had the surgery and fully recovered. She thanked Abu Fistula Centre and her supportive husband. Hanan said she had two children since the successful surgery.

Federal Minister of Health, Bahar Idris Abu Garda, addressed participants stressing that all recommendations of the seminar will be adopted and implemented in cooperation with all partners. "We are committed to work with all partners including governments, civil society, professionals, the UN and donors to implement all the recommendations," said Abu Garda.

Minister of Health Affairs, DRA, Osman Elbushra told participant that UNFPA is one of the major players in supporting health services in Darfur especially Fistula. "The commitment of all partners is necessary to improving primary health care services coverage in every village in order to end Fistula and the suffering of women," he said. Elbushra added that "We hope the meeting will come up with concrete recommendations and plan of action and that all partners commit to implementing them."

"We are here today to recognize and honor the work of all those who are committed to preventing and treating Fistula in Sudan," said Pamela Delargy, UNFPA Representative in Sudan.

She told participants that ten years ago, UNFPA launched the Global Campaign to End Fistula, comprising more than 80 international partner agencies, in addition to hundreds more at national and local levels. The campaign, she added, is now active on the ground in more than 50 countries in Africa, Asia, the Middle East and Latin America.

Delargy added that as a result of the global campaign, some progress has been made. Fistula has received increased attention in national and international agenda. New resources have been invested to improve medical care, train surgeons and health workers and fund units to carry out fistula repair. Education campaigns have alerted more women, families and communities to the importance of medical care during pregnancy and childbirth as well as the specialized surgery available to help them.

Pointing to the magnitude of the Fistula issue, she added that despite these efforts, the fight against fistula remains critically under-resourced. "While 20,000 women every year receive surgery to repair Fistula, it is not keeping pace with the 50,000 new cases annually," noted Delargy.

In response, added Delargy, the UN General Assembly designated May 23 as the first-ever International Day to End Obstetric Fistula, in a resolution that also underlined the importance of reproductive rights and ending exclusion, inequalities and child marriage to help eliminate Fistula.

"Sadly, thousands of Sudanese women suffer from Fistula and many do not even know that they can get treatment," said Delargy. She added that the causes of Fistula are mainly lack of access to Emergency Obstetric Care, childbearing at an early age, poor nutrition, and even some harmful traditional practices that persist in many areas of the country. "Unless we act together, there will be more cases. Sudan has been part of the global campaign to end fistula and today we are here to show support to accelerate that campaign," noted Delargy.

On UNFPA efforts to address Fistula in Sudan; Delargy told participants that UNFPA in collaboration with local, national and international partners has supported the work on Fistula in Sudan for a decade. This has included supporting the National Obstetrical Fistula Prevention and Management Center in Khartoum in addition to supporting the satellite Fistula centers in Kassala, El Fashir, Zalingy, Nyala and Geneina.

"We have supported the training of more than 200 health care providers on fistula prevention and management. We have also supported community awareness programming through media and outreach activities, covering more than 70% of population in the targeted states and UNFPA annual Fistula Treatment and rehabilitation campaigns reached hundreds of women in different parts of the country" said Delargy.

"More is waiting for us to do," pointed out Delargy. There is a an urgent need to encourage and support more effective programs including better reproductive health services, universal and equitable access to these services, and improved information to reduce the number of Fistula cases. "We urge development assistance players to make this a higher priority and help extend support to the poorest, most vulnerable and marginalized women, girls, and communities that are hardest to reach and most at risk," said Delargy.

"Since Fistula is common among the poor, social justice has to prevail," said Isam Ahmend Elbashir of the Islamic Fiquh Council - one of Sudan's top Fatwa bodies. He added that women need the right environment to develop and that can only be achieved through eradicating cultural, religious and health illiteracy among women.

Elbashir added that the society has to have the priorities right. "I'm calling on the wealthy to share their wealth for the benefit of all by making money available for health services and medical equipment.. there is a bigger reward in doing that," he added.

State Ministers of Health of the Darfur Regional Authority, West, North, South Darfur and Khartoum State were present at the event. Ministers of Social Welfare were also present at the event.

Khartoum State Health Minister Dr. Mamoun Humaida stressed the significance of training supporting health cadres such as nurses, midwives and other health cadres noting that in Sudan for every five medical graduates; only one nurse graduates.

Representative of civil society organizations, Eltiraifi Ahmed Karraminno reiterated civil society organizations' commitment to provide awareness-raising to communities, enhance primary health services and fundraising. "Today is a big day. The beginning of a national effort to fight Fistula through working with the UN and other partners," added Karraminno.

Among the recommendations that came out of the seminar is the need for political commitment to implement the seminar recommendations including a multi-year plan of action to be evaluated every year by all partners. Focus on training different levels of medical cadre was one of the recommendations together with awareness-raising at the community level.

Tokens of appreciation were presented at the event to those who dedicated hard work to the cause of ending Fistula in Sudan including professionals, decision-makers and UNFPA.