UNFPA Yemen: "I am reclaiming my health, my dignity, and my life": Women healing from obstetric fistula in Yemen

ADEN, Yemen  

"I lived in silence, hiding my pain from others, enduring my own gaze before enduring theirs," recalls Safiy, 28 years from Bajil District in Al Hudaydah Governorate. 

For five years, Safiy carried a pain she could neither understand nor explain. After severe complications during childbirth at a hospital in Bajil, she began experiencing faecal leakage—a condition that would force her to withdraw from from daily life.

Amina, 20 years, from Aden Governorate too, faced her own silent battle. Married at fifteen and pregnant nine months later, she had no access to antenatal care in her remote village. When labour came, it lasted three agonizing days with only a traditional birth attendant by her side. By the time she reached a hospital, her baby had died. An emergency cesarean section saved her life, but left her with an obstetric fistula—a devastating childbirth injury that would isolate her for a year and a half.

Safiy and Amina's stories reflect a harsh reality facing thousands of women across Yemen. Global estimates reveal that Yemen has the highest prevalence of obstetric fistula in the Arab States region—113 cases per 100,000 women as of 2020, compared to 86 per 100,000 across Arab States and 36 per 100,000 in Asia and the Pacific. 

Obstetric fistula—a hole between the birth canal and bladder or rectum caused by prolonged, obstructed labour without timely medical intervention—is both preventable and treatable. Yet in Yemen, a perfect storm of factors has made it a persistent crisis: early marriage and adolescent pregnancy, critically low rates of skilled birth attendance, and a healthcare system devastated by over a decade of conflict.

When Systems Collapse, Women Pay the Price

The conflict and humanitarian crisis have pushed Yemen's healthcare system to the brink. An estimated 19.4 million people lack access to basic healthcare, including reproductive health services.

Nearly half of all health facilities remain fully or partially functional, and only one in five of them provide maternal and newborn care. Almost half of all childbirths occur outside a health facility.

Nearly a quarter of pregnant women do not receive antenatal care, while only 3 in five women give birth with skilled assistance. 

For women like Safiy and Amina, the barriers to treatment are formidable: limited functional facilities with operating theatres and specialized fistula care, financial and transportation obstacles, weak referral systems in remote areas, and a severe shortage of trained fistula surgeons. Most devastating is the social stigma—the isolation and psychological trauma that discourage women from seeking care at all.

A Lifeline in Darkness

Safiy decided not to surrender. After being examined at a health facility in Al Huban, she was referred to a UNFPA-supported fistula treatment centre at Al Sadaqa Hospital in Aden.

"When the doctor told me about my condition, she said treatment was possible," Safiy remembers. "Those words alone gave me back my breath."

She underwent surgery successfully at no cost, and received financial support to cover the transportation. 

"I could not believe the pain that had accompanied me for five years could come to an end," she says. "Today, I am recovering step by step. I am reclaiming my health, my dignity, and my life."

Amina's path to healing followed a similar trajectory. When she learned about the fistula treatment centre she contacted the coordinator and traveled to Al Sadaqa Hospital. After successful surgery, her recovery began.

"The hospital not only treated my condition but restored my dignity and renewed my confidence in life," Amina says. "They gave me the chance for a new beginning.”

Building Back Better

UNFPA supports two dedicated obstetric fistula treatment centers in Yemen—at Al Sadaqa Hospital in Aden and Al Thawra Hospital in Sana'a—providing surgical repair, training midwives, supporting safe childbirth practices, and ensuring women with complications can access skilled care. 

Since 2023, nearly 300 obstetric fistula repair surgeries have been successfully completed at these two centres. 

Through partnerships with Ministry of Public Health and local organizations like Deem for Development Organization, UNFPA is working to strengthen referral systems, expand access to emergency obstetric care, and address the root causes that result in obstetric fistula. 

But the need far outweighs current capacity with steep funding cuts threating the suspension of UNFPA’s support to these two centres 

"Yes, my story is full of pain, but it is also full of hope,” recalls Safiy.

On the International Day to End Obstetric Fistula, that hope needs to transform into action. Obstetric fistula is preventable and treatable; ending it is within our reach.

#EndFistula 
#YemenCannotWait