According to the 2010 Sudan Household Survey (SHS) South Darfur holds the highest Maternal Mortality Ratio (MMR) in Sudan - indicating an equally high level of maternal morbidities. One of the most severe maternal morbidities is obstetric fistula; a child birth complication caused by prolonged, obstructed labour without timely medical intervention.

The State of Maternal Health

The high level of maternal mortality and morbidity is a direct reflection of poor maternal health services; the armed conflict in South Darfur impacts the availability and accessibility of maternal health services for pregnant women in the area. It also comes as a direct consequence of delayed referral of cases of obstructed labor to the nearest health facilities offering comprehensive emergency obstetric care, including caesarian section.

In most cases the babies are stillborn.

Furthermore, poor maternal health outcomes are linked to a range of traditional and cultural barriers. Harmful traditional practices such as child marriage and early pregnancy seriously influence the state of maternal health in South Darfur.

Silent Suffering of Obstetric Fistula

In most cases, women suffering from obstetric fistula, end up being rejected by their husbands and ostracized by their communities. Without a solution in sight those women are forced to withdraw from most of their normal productive life within their community - and leave behind their aspirations for motherhood.

The only solution to obstetric fistula, once it has occurred, is surgical repair by well trained and specialized surgeons. Due to the limited availability and accessibility of maternal health services, the backlog of obstetric fistula cases is expected to be high in South Darfur.

Expanding treatment availability

In order to respond to the situation, UNFPA Sudan has in partnership with Darfur Regional Authority supported the establishment of a surgical fistula repair center in South Darfur which was completed last year.

Furthermore, UNFPA Sudan has supported Nyala Teaching Hospital, the main referral hospital in South Darfur, through renovation and rehabilitation of the Obstetrics and Gynecology Department - as well as the Fistula Centre through provision of equipment and supplies in order to ensure access to quality comprehensive maternal and new-born services in south Darfur.

In February 2014 UNFPA in cooperation with the State Ministry of Health, supported a fistula repair campaign, where a total of 33 women were successfully treated ranging from early twenties up to the seventies.

However, successful repairs are not always the end of the journey to reconstructing the lives of obstetric fistula patients as most of the patients have been rejected by their husbands and families, and some isolated and stigmatized by their communities. To reintegrate patients into these communities and assist them in returning to live productive lives, UNFPA Sudan in partnership with State Ministry of Social Welfare organize training for the women repaired from obstetric fistula in income generation skills to enable them to independently sustain their own livelihood on the road towards reconstructing their lives.