Intersection of Human Rights and Health Care

This post was written with Ulla E. Müller, the President and CEO of EngenderHealth.

This week we gathered with global leaders at Women Deliver, a global conference focused on accelerating the health, rights and well-being of women and girls around the world. As can be attested by the tens of thousands of women and girls worldwide who have received surgical repairs for devastating conditions like fistula, it is utterly impossible to transform the lives of women without access to essential reproductive health services. Obstetric fistula is a severe, yet entirely preventable condition caused by obstructed labor without access to timely, emergency obstetric care. Virtually eradicated in the U.S. and Europe more than a hundred years ago, its mere existence is an indication that existing health systems are failing women and girls. In the Democratic Republic of Congo, fistula is all too common, and the women are often stigmatized and face discrimination from family, community and society. In Eastern Congo specifically, women live in constant fear of gender based violence and rape, which has turned women's bodies into the battlefield for much of the last two decades. Rape devastates the body and soul. It is an act that dehumanizes and steals a woman's self-worth and her physical and psychological health. When deployed as a strategy of control over land, over resources, or over an entire population, it is a cheap, effective way to destabilize entire families and communities. One of the possible consequences of rape is traumatic fistula - where an injury creates an abnormal opening resulting in constant, uncontrollable leakage of urine and/or feces. At Panzi Hospital, we have, with the support of organizations like EngenderHealth, treated tens of thousands of women and girls who required fistula and other gynecological surgeries to regain control over their bodily functions. It is this type of carefully strategized surgical intervention combined with preventative and holistic services like family planning, psychosocial care, literacy, numeracy, and vocational training which are catalysts for transforming women's lives, both in the short- and long- term. May 23 is International Day to End Obstetric Fistula--an important day to highlight the need to take a holistic approach to end fistula and other maternal morbidities. We call for increased access to quality reproductive health care, safe surgery and anesthesia environments, and integrated, woman-focused healthcare programs to both address the backlog of women currently living with fistula, as well as prevent new cases from occurring. This means building stronger health systems and trained surgical teams; training more nurses and midwives and giving them the materials and support they need to do their work well, improving prenatal, postnatal and emergency obstetric care from skilled clinicians; as well as raising community awareness on the causes and treatments of obstetric fistula in order to help remove the stigma surrounding the condition so that more women can seek treatment without fear of reprisal. We also must ensure that fistula prevention and treatment services are sustainable, well done and accessible at lower level facilities. Access to preventative services like family planning also remains one of the most affordable and effective ways to improve maternal health. Family planning can bring transformative change to the global and local community. We must not remain silent as the women and girls we love-the mothers, sisters, wives, daughters, friends, colleagues and peers in our community-are denied their basic right to health, their position in our society, their access to education, their access to economic opportunity, resources or support, if we hope to create sustainable social and economic development. We have the knowledge and tools to prevent and treat fistula and other devastating maternal injuries. After more than a decade of concerted effort by governments, health institutions, and international and local organizations, momentum is building to achieve a fistula-free generation in our lifetime. It is possible and we must mobilize to end fistula, end violence against girls and women, and deliver on our promise to women and girls. Dr. Denis Mukwege is the Founder, Medical Director, and President of the Panzi Hospital and Foundations and appeared on the 2016 Time 100 list.