“The persistence of fistula is a result of human rights denied and a reflection of human rights abuse,” Babatunde Osotimehin, Executive Director of the UN Population Fund (UNFPA), said in his message marking the first-ever International Day to End Obstetric Fistula.

“It reflects chronic health inequities and health-care system constraints, as well as wider challenges, such as gender and socio-economic inequality, child marriage and early child bearing, all of which can undermine the lives of women and girls and interfere with their enjoyment of their basic human rights.”

An estimated three million women and girls, nearly all in developing countries, are affected with another 50,000 to 100,000 new cases developing each year, according to figures cited by UNFPA and the UN World Health Organization (WHO).

An obstetric fistula is a hole in the birth canal caused by the baby’s head pushing against the mother’s pelvic bone during contractions, often without adequate medical care during prolonged labour. The hole forms between a woman’s vagina and her bladder or rectum, causing her to leak bodily fluids.

The newborn rarely survives, if it is born live, and renders the woman incapable of having more children. Shunned by their families and communities, women with fistula are often poor and marginalized.

According to UNFPA, women and girls with obstetric fistula are usually poor, often illiterate, with limited access to health services, including maternal and reproductive health care.

“In an age of rapid globalization in which mobile and e-technologies have changed the face of human communications and revolutionized the frontiers of science and medicine, it is unconscionable that the poorest, most vulnerable women and girls continue to suffer needlessly from this scourge,” Mr. Osotimehin said.

Reconstructive surgery to fix the condition cost around $400 according to the global Campaign to End Fistula, which UNFPA leads and coordinates with a wide range of partners. The campaign is based on three key strategies of prevention, treatment and social integration.

Over the past decade, the agency provided support to more than 50 countries, resulting in fistula treatment and care for some 34,000 women and the training of thousands of health-care personnel in prevention and management.

“We are training more health workers close to where people live so that they don’t have to travel long distances before they get the service,” Mr. Osotimehin told UN Radio. “We don’t have to have a midwife that is super-qualified. You can actually train a cadre of staff over a short period of time to be able to deliver good quality service under supervision.”

Where prevention is not possible, treatment is more often an option. In Mozambique, 16-year-old Essita Mulhanga underwent surgery to repair her fistula.

In a 2012 report, Secretary-General Ban Ki-moon urged dramatically intensified political and financial mobilization to accelerate progress towards ending obstetric fistula.

He called for at least $750 million to treat all cases of obstetric fistula by 2015, the deadline for the eight anti-poverty targets known as the Millennium Development Goals (MDGs) towards which the UN is boosting efforts in its “1,000 days of action” campaign.

“This is part of our broader effort to reach the Millennium Development Goals and mobilize partners in the Every Woman, Every Child initiative,” Mr. Ban said today in his message on the Day.

“The benefits reverberate far beyond the women who are directly affected, extending to children who will be raised by healthy mothers and communities that benefit from their contributions.”

In his report, Mr. Ban noted three interventions that have the most important and immediate impact on maternal death and disability: family planning; attendance during childbirth by skilled health personnel, such as a midwife; and emergency obstetric care, in particular Caesarean sections.

Early marriage is also an issue with adolescent girls particularly at risk for obstetric fistula at a much higher rate than women in their twenties.

Highlighting the importance of the International Day to End Obstetric Fistula to raise awareness of the condition, Mr. Ban said: “The more understanding and action we generate today, the more we can look forward to a future where obstetric fistula is virtually unknown because it is virtually non-existent.”

The World Health Organization (WHO) is emphasizing the importance of people taking steps to improve their health by calling on adults to measure their blood pressure on World Health Day, which will be observed on Sunday.

“Our aim today is to make people aware of the need to know their blood pressure, to take high blood pressure seriously, and then to take control,” said WHO Director-General Margaret Chan.

World Health Day is observed on 7 April every year to mark the anniversary of the founding of WHO in 1948 and each year a theme is selected that highlights a priority area of concern for the agency. This year’s theme “Measure your blood pressure, reduce your risk” focuses on preventing hypertension in people over 25 years of age.

Hypertension is one of the most important contributors to heart disease and stroke – which together make up the world’s number one cause of premature death and disability. It is most prevalent in Africa, where it affects up to 46 per cent of adults.

High blood pressure also contributes to nearly 9.4 million deaths from cardiovascular disease each year and increases the risk of conditions such as kidney failure and blindness.

People can take simple measures to reduce the risk of hypertension such as consuming less salt, eating a balanced diet, engaging in regular physical activity, avoiding tobacco use and avoiding harmful use of alcohol. These actions, along with the measurement of blood pressure, also save individuals and governments time and money, WHO says.

“Early detection of high blood pressure and lowering heart attack and stroke risk is clearly far less expensive for individuals and governments than heart surgery, stroke care, dialysis, and other interventions that may be needed later if high blood pressure is left unchecked and uncontrolled,” said the Acting Director of the WHO Department for Management of Non-communicable Diseases, Shanthi Mendis.

“Most of the time there are no symptoms until you get complications, and this means that people have to know their numbers.” Ms. Mendis underlined that people over the age of 40 in particular must make an effort to get their blood pressure taken, as it tends to go up gradually.

WHO’s campaign to encourage people to measure their blood pressure is a response to the UN Declaration on Non-communicable Diseases, which was adopted by Heads of State and Government in September 2011. The Declaration commits countries to make greater efforts to promote public awareness campaigns to further the prevention and control of non-communicable diseases such as heart disease and stroke, cancers, diabetes, and chronic respiratory diseases.

The call to action, which comes on the eve of World Water Day, aims to focus on improving hygiene, changing social norms, better managing human waste and waste-water, and, by 2025, completely eliminating the practice of open defecation, which perpetuates the vicious cycle of disease and entrenched poverty.

“I am determined to energize action that will lead to results,” said Eliasson. “I am calling on all actors – government, civil society, business and international organizations – to commit to measurable action and to mobilize the resources to rapidly increase access to basic sanitation.

“Let’s face it – this is a problem that people do not like to talk about. But it goes to the heart of ensuring good health, a clean environment and fundamental human dignity for billions of people – and achieving the Millennium Development Goals. With just over a thousand days for action before the 2015 MDG deadline, we have a unique window of opportunity to deliver a generational change.”

The MDG target to halve the proportion of people without access to sanitation has helped to raise the profile of the issue, and 1.8 billion people gained access to improved sanitation since 1990, but there is still far to go, notes a news release on the new initiative. Meanwhile, the MDG target to halve the proportion of people without access to improved sources of water has already been met.

Of the world’s seven billion people, six billion have mobile phones. However, only 4.5 billion have access to toilets or latrines – meaning that 2.5 billion people, mostly in rural areas, do not have proper sanitation. In addition, 1.1 billion people still defecate in the open.

The countries where open defecation is most widely practiced are the same countries with the highest numbers of under-five child deaths, high levels of under-nutrition and poverty, and large wealth disparities.

“We strongly support this effort to increase the focus on sanitation,” said the Deputy Executive Director of the UN Children’s Fund (UNICEF), Martin Mogwanja, who noted that ending open defecation will contribute to a 36 per cent reduction in diarrhoea, which kills three quarters of a million children under five each year.

“We can reduce the cases of diarrhoea in children under five by a third simply by expanding the access of communities to sanitation and eliminating open defecation,” he told reporters at the launch of the call to action at UN Headquarters. “In fact, diarrhoea is the second largest killer of children under five in the developing world and this is caused largely by poor sanitation and inadequate hygiene.”

Mogwanja said he witnessed personally the impact of open defecation in both development and humanitarian contexts when he worked in Pakistan. A total sanitation project was developed there for the flood-affected areas, together with non-governmental and government partners. In less than two years, over six million people gained access to toilets and are now living in open defecation-free communities.

“But the effort succeeded not by building latrines; it succeeded by getting people to recognize and to talk about the problem,” he stated.

The private sector also played an important part in this transformation, he said, by engaging in sanitation marketing activities, and developing a supply chain which ensured that people had access to the right products in the right place at the right time.

“And it worked,” Mogwanja stated, noting that with the direct support of UNICEF and its partners, over 25 million people in over 44,000 communities now live in open defecation-free environments.

“This can also improve the safety of women and girls, who are often targeted when they are alone outdoors. And providing safe and private toilets may also help girls to stay in school which we know can increase their future earnings and help break the cycle of poverty.”

The call to action will not set up any new structures or funding mechanisms, but focus on generating action at the community level – one community at a time.

In a new report, “Childhood Under Fire,” launched to mark two years of violence in Syria, Save the Children details the impact of the conflict on children, showing that many are struggling to find enough to eat; are living in barns, parks and caves; are unable to go to school with teachers having fled and schools being attacked; and that damage to sanitation systems is forcing some children to defecate in the street.

Citing new research carried out amongst refugee children by Bahcesehir University in Turkey, the report also reveals the extent to which children have been directly targeted in the war, with one in three children reporting having been hit, kicked or shot at.

Combined with the breakdown of society in parts of the country and more than three million people displaced, the conflict has led to the collapse of childhood for millions of youngsters.

“Childhood under Fire” details how some young boys are being used by armed groups as porters, runners and human shields, bringing them close to the frontline, while some girls are being married off early to ‘protect’ them from a widely-perceived threat of sexual violence.

.”For millions of Syrian children, the innocence of childhood has been replaced by the cruel realities of trying to survive this vicious war,” said Carolyn Miles, president and CEO of Save the Children. “Many are now living out in the open, struggling to find enough to eat, without the right medicine if they become sick or injured. As society has broken down, in the worst cases, hunger, homelessness and terror have replaced school for some of these young people. We cannot allow this to continue unchecked; the lives of too many children are at stake. ”

The research by the Bahcesehir University also reveals the extent to which children have been affected by war, with nearly one third of children surveyed saying that they had been separated from members of their families due to the conflict. Three quarters of those surveyed had experienced the death of a close friend or family member. Many are showing signs of emotional difficulties as they struggle to come to terms with their experiences.

Save the Children, which is providing humanitarian relief in Syria and neighboring countries, is calling for all parties to the conflict to allow unfettered, safe access to populations in need and to ensure that everything is done to bring the fighting to an end.

There are some 170,000 Sudanese refugees currently in South Sudan, according to the UN High Commissioner for Refugees (UNHCR), with more arriving from Sudan’s South Kordofan and Blue Nile states every day after fleeing conflict and food shortages.

UNHCR will begin distributing more soap, jerry cans and blankets to over 8,200 families with children under the age of five in the Yida camp in South Sudan’s Unity state, where health workers first saw a significant hike in death rates among refugee children in late June and early July.

“We are targeting the most vulnerable refugees in the camp to improve sanitization and minimize the risk of respiratory infections in these households. The distribution of other supplies such as plastic sheeting and buckets will continue throughout the month,” UNHCR spokesperson Melissa Fleming told reporters in Geneva.

In the last three weeks, mortality and morbidity rates have stabilized and even decreased, as aid agencies took urgent action to address the root causes, she added.

UNHCR has so far dug two out of the six additional boreholes that will double the supply of potable water in Yida. Drainage systems are being improved at all seven water points to reduce the risk of contamination and water-borne diseases from standing water, and community latrines are being built to meet the needs of the growing population.

“Nonetheless, the challenges remain daunting in Yida,” said Fleming. “This remote border camp now hosts some 60,000 refugees from Sudan’s South Kordofan state, a four-fold increase since April. Children form more than a quarter of this population.”

She said that most refugees have been arriving in a very weak state – exhausted, dehydrated and malnourished. The rainy season has exacerbated the situation, bringing seasonal diseases to an already fragile population.

“The rains have also flooded nearby roads and turned Yida into a virtual island. Airlifts are now the only way to get life-saving aid into the camp,” Fleming noted.

UNHCR is now planning to airlift an additional 8,500 plastic sheets and 15,000 mosquito nets for immediate distribution to the new arrivals. Many are currently sleeping under poorly-thatched roofs, which increase the risk of respiratory illnesses and malaria particularly among children under five.

Meanwhile in Upper Nile state, one in three children is believed to be malnourished in Batil camp, UNHCR reported. Common health problems in this camp of 35,000 refugees include watery diarrhoea, respiratory tract infections and increasingly, malaria.

To address the high malnutrition rates, aid agencies started a blanket food distribution across the camp last Sunday, followed by a therapeutic supplementary feeding program to help children recover from moderate acute malnutrition. In addition, some 12 per cent of children under five are receiving treatment for severe acute malnutrition.

In total, Batil has five clinics for health and nutrition treatments, and 20 oral rehydration points throughout the camp. The health agencies have set up surveillance and response mechanisms for possible outbreaks of diarrhoeal and other diseases.

UNHCR noted that it has only received $47.5 million out of the $186 million it needs to meet the urgent needs of the Sudanese refugees in South Sudan.