Obstetric Fistula (OF), in which a hole (fistula) develops between either the rectum and vagina or between the bladder and vagina, remains one of the most devastating complications of prolonged obstructed labour and accounts for 3% of severe childbirth related complications. In South Sudan, there is an estimated backlog of 60,000 cases waiting for surgical repair, of whom fewer than 1,000 have had surgical repair and treatment. Left untreated, OF puts the affected women in triple jeopardy. Often, they lose their babies at birth, experience debilitating condition, and later face unwavering stigma and social discrimination. Adolescent girls are particularly susceptible to obstructed labour because their pelvises are not fully developed. Unfortunately, South Sudan has a very high teenage pregnancy rate, estimated at 300/1,000 and an adolescent birth rate of 158/1000. It is anticipated that the prevalence may be higher given the poor socioeconomic profile and healthcare system, a situation which has been worsened by the ongoing humanitarian crisis.

UNFPA Response:

• UNFPA has been supporting obstetric fistula repair camps across the country for many years, with robust efforts being made to initiate routine fistula treatment at hospitals in the country.
• UNFPA works with the Ministry of Health and partners to support the training of OF surgical teams, comprising doctors, nurses and/ or midwives as part of the efforts for routine treatment of obstetric fistula. 
• UNFPA continue to support knowledge exchange through south-to-south cooperation and technical assistance with other countries and organizations including sponsoring one of the trained fistula surgeons to attend the International Society of Fistula Surgeons Conference in Maputo, Mozambique and collaboration with several international and faith-based organizations providing OF treatment and management in South Sudan 
• Supporting the development and implementation of the national obstetric fistula strategy and actively engage in the work of the National Obstetric Fistula Taskforce which continues to champion fistula prevention and response.