Addressing the devastating impact of obstetric fistula through government programmes, UNFPA support, and community efforts to help women rebuild their lives and regain their dignity

As the sun dips over the fields of a remote village in Sunamganj in Bangladesh, 37-year-old Rokia Begum gathers eggs from her small poultry farm. Each egg feels like a promise—a symbol of the life she’s rebuilt. Not long ago, Rokia couldn’t have imagined such a moment.

For years, Rokia, mother of six,  lived in silence and shame, struggling with obstetric fistula, a childbirth injury caused by prolonged, obstructed labour without timely medical intervention. The condition left her incontinent, leading to constant leakage of urine or faeces, which made even simple daily tasks unbearable. “I couldn’t go anywhere without fear,” she recalls. The persistent odour and physical discomfort drove her into isolation. Her husband abandoned her, neighbours avoided her, and she became invisible in her community.

Rokia’s story is shared by thousands of women across Bangladesh, where an estimated 20,000 women live with obstetric fistula. In rural areas, more than 35% of births still occur at home without skilled attendants. Child marriage and adolescent pregnancy exacerbate the issue, as young girls face a higher risk of obstructed labour. Despite progress in maternal healthcare, many women lack access to emergency obstetric care, leaving them vulnerable to this preventable condition.

Women with fistula often endure profound stigma and isolation, believing their condition is untreatable. “I thought this was my fate,” Rokia admits. For women like her, a lack of awareness and accessible healthcare facilities creates a cycle of suffering and silence.

Rokia’s life changed when a community health worker visited her village as part of the government’s programme to end obstetric fistula. Thanks to training under the UNFPA-supported ‘Global Campaign to End Fistula,’ the community health worker was equipped to identify Rokia’s symptoms and guide her to specialized care at a Fistula Corner. Encouraged by her family and local leaders, Rokia took a leap of faith and sought help.