Aden, Yemen – “I have seen women who arrived at the hospital in despair, walk away with hope in their eyes," tells Dr Iqbal Naji, one of the first and amongst only two national obstetric fistula surgeons in Yemen.
An obstetric fistula is a serious birth complication resulting from prolonged, obstructed labor. Without proper medical care, long and difficult births can cause a hole between the birth canal and the bladder or rectum – or both – resulting in a fistula.
Fistula’s not only cause women to leak urine or feces uncontrollably, 90 percent of women who develop a fistula also deliver a stillborn baby. Obstetric fistulas cause women both physical and psychological trauma that can last a lifetime if untreated.
Yet, fistula is almost entirely preventable.
Building the skills to help women
Dr. Iqbal’s journey began in 1995 when she graduated from medical school and started working as a general practitioner at Al-Sadaqa Hospital in Aden Governorate. It was during this time that she witnessed firsthand the silent suffering of women with obstetric fistula; they were often abandoned and stigmatized. Their pain and isolation moved her, sparking a determination to find a way to help.
In 2012, a turning point came when Dr. Iqbal was selected for a UNFPA-supported training on fistula repair surgery by an international expert. Here she learnt the intricate techniques needed to restore not just physical health but also emotional well-being.
Two years later, in 2014, she performed the first-ever fistula repair surgery in Aden. A moment that would change the trajectory of her career and the lives of countless women.
Determined to expand her expertise, with the support of UNFPA, Dr. Iqbal pursued advanced training at the Hamlin Fistula Hospital in Ethiopia in 2014 and at Community Based Rehabilitation Tanzania Hospital in Tanzania in 2019. These experiences deepened her knowledge and strengthened her commitment to tackling the stigma and suffering endured by women with obstetric fistulas in Yemen.
Giving a new chance for women with fistulas
Today, Dr. Iqbal has performed over 200 surgical repairs with a 90 percent success rate.
Dr. Iqbal faced many obstacles along the way. There was limited medical supplies, resources and a lot of skepticism from her colleagues who warned her that that successful fistula repairs were too difficult to achieve in Yemen. But she never gave up.
I was told this specialty was too difficult, that success was rare. But today, when I receive messages from the women I have treated, I know I made the right choice," says Dr. Iqbal with pride.
Dr. Iqbal's hands do more than perform surgeries—they restore hope, rebuild lives, and break the cycle of suffering; and for Dr. Iqbal, that is the greatest reward of all.
Funding cuts threaten years of progress in treatment and care
In Yemen, women are at increased risk of developing obstetric fistulas during childbirth due to limited or no access to reproductive health services, affecting over five million women of childbearing age in 2025, including the lack of skilled birth attendants during childbirth. Six out of ten births in Yemen take place without a skilled birth attendant.
Rising levels of malnutrition, particularly among pregnant women, and alarming rates of child marriage, resulting from the conflict also stand to increase the risk of obstetric fistulas for women in Yemen.
UNFPA, has been working to treat and eliminate obstetric fistula in Yemen even prior to the conflict, by training midwives to help mothers safely deliver their babies and by reaching survivors of fistula with care. UNFPA also provides strategic vision, technical guidance and support, medical supplies, training, in addition to promoting community awareness of what obstetric fistula is and how it can be treated.
UNFPA has established two fistula treatment centres at Al Sadaqa Hospital in Aden and Al Thawra Hospital in Sana'a Goverorates. These centres provide free surgical treatment and care to over 100 fistula patients each year.
However, with deep funding cuts to UNFPA's response in Yemen, these services are now at risk of closure; threating to rolling back years of progress and efforts of health professionals like Dr. Iqbal Naji, who work tirelessly to restore hope for women across Yemen.
