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Reproductive and Child Health

End Obstetric Fistula in Sylhet Division

Obs. Fistula is not just a medical issue but also a social issue. Obstetric fistula is one of the distressing pregnancy-related morbidity in Bangladesh, mostly occurs in marginalized living behind population. Sylhet division is at high risk of obstetric fistula due to its Pocket areas (teagardens, Haor) –early marriage, poverty, illiteracy, lack of awareness.

The DGHS with the support of UNFPA and CIPRB has been implementing the “End Obstetric Fistula Program” in Sylhet division (all four districts) since January 2019.

The General Objective of the research is to eliminate obstetric fistula in Sylhet division. The specific Objective of the research includes to identify all fistula cases at the facility level in Sylhet, to refer for better treatment to tertiary institutions, to ensure surgical operation of new fistula cases if needed, and to establish fistula management and rehabilitation.

The project coverage includes all 4 districts of Sylhet Division (Sylhet, Moulvibazar, Habiganj, Sunamganj). This project is implemented with the coordination of CS office. CIPRB provided technical support for project implementation, 4 functional fistula corners at 4 district hospitals and three District Coordinators of CIPRB work closely with the GoB.

Progress of fistula project

Progress and Highlights of fistula project

From January 2019 to December 2023, a total of 448 patients in Sylhet division were identified in the fistula corner of the four district hospitals concerned. Out of these 351 patients were referred to Sylhet Osmani Medical College Hospital, OGSB Hospital, Mums Hospital, Kumudini Hospital. 295 patients have already been operated out of which 235 have fully recovered and are leading normal lives. Rehabilitation of 179 fistula patients with various assistance (such as sewing machines, goats, cash, food items, various government allowances including VGD cards, old age allowance, disability allowance) in collaboration with Directorate of Women and Child Affairs, Directorate of Social Services, DGHS, DGFP, Local Govt. Arrangements have been made.

Fistula identification

Coordination of health and family planning department to identify the fistula cases. Continuing motivation of suspected cases and coordination. Total 448 confirmed cases (107 from haor, 34 teagardens) through home visit and networking

Fistula treatment and management

Establish referral linkage between the district hospital and fistula specialized hospital. A total of 351 patients referred from district hospital to OMCH- Sylhet, MAMMS, Kumudini hospital, OGSB hospital and 295 patients were operated and repaired.

Rehabilitation of fistula survivors

Effective coordination between health and other departments / stakeholders established to strengthen rehabilitation and reintegration support for the fistula survivors such as Women’s welfare, social welfare etc. A total of 179 patients received rehabilitation support through effective coordination.

Fistula free declaration in 26 teagardens

26 teagardens in Sylhet division were declared fistula free. A total of 12650 households were screened & 21 suspected obstetric fistula cases identified. 16 patients were diagnosed at district hospital & referred to tertiary level facilities in Dhaka. Ten were cured successfully already and returned to normal life. Six of the patients received different need-based rehabilitation support.

Awareness through billboard displayed in teagarden.

The billboard is playing an important role to prevent obstetric fistula by creating mass awareness in Sylhet division. Total 10 billboards on fistula were displayed in different selected 10 tea garden facilities in Sylhet division. These billboards were developed under guidance of the Civil Surgeon, Moulvibazar with support CIPRB and UNFPA Bangladesh. Fistula cases are identified due to awareness raising by billboards particularly in teagarden area in Sylhet division.

Celebrating International day to end Obstetric Fistula in Sylhet

In every year the international day to end Obstetric Fistula in Sylhet has been celebrated in Sylhet division. Colorful rally and District level sharing meeting held in all districts. Health camp- for fistula identification held at the fistula corner in all district hospitals. Advocacy meeting with the journalist and divisional meetings with different stakeholders held. Awareness sessions are held in teagardens and haor areas.