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A woman wearing a Fistula Foundation shirt stands in a doorway and smiles.
By
Deanna Neiers
Photo Credit
Fistula Foundation

Speaking from personal experience, being a new mom is tough. Your body has gone through so much and yet you have this little baby relying on you for comfort and nourishment at all hours of the day and night. Some women, including myself, are left with permanent damage to their bodies following childbirth, ranging from mild discomfort to debilitating pain. 

I was fortunate enough to have access to a surgery that provided me relief. Many women, especially in low-income countries, aren’t so lucky. When a mother has a prolonged, obstructed labor but doesn’t have access to emergency medical care, such as a C-section, an obstetric fistula can occur. Today, at least one million women in Africa and Asia needlessly suffer from untreated obstetric fistula. 

Fistula Foundation is committed to helping these women by focusing exclusively on delivering fistula repair surgery because of its enormous impact. The Foundation was established in 2000 as an all volunteer organization to support the pioneering Addis Ababa Fistula Hospital in Ethiopia. By 2009, it had already expanded its reach, and the organization has since provided surgeries in 32 countries in Africa and Asia.

Here are five things you need to know about obstetric fistula:

1. Obstetric fistula is a childbirth injury that leaves a woman incontinent. (Content warning: This section contains a detailed description of childbirth trauma; if you are not comfortable with this topic, we suggest you move to section two.)

Even as a woman, I had never heard of a fistula before, so let’s start by learning what it is. During a difficult and prolonged labor, the mother’s contractions continually push the baby’s head against her pelvis. Soft tissues caught between the baby’s head and her pelvic bone become compressed, restricting the normal flow of blood. Without adequate blood supply, sections of tissue soon die, leaving holes – known as “fistulae” – between the mother’s vagina and her bladder or rectum. It is these holes that cause incontinence, meaning that the woman will uncontrollably leak urine, stool, or sometimes both, for the rest of her life.

Obstetric fistula most commonly occurs in poor, rural areas of Africa and Asia where the women affected live in dirt-floor dwellings and lack access to running water and incontinence pads. This leaves them prone to chronic infections and pain, and thus they are often shunned by their families and communities.

Furthermore, obstetric fistula usually occurs in a woman’s first pregnancy, often when she is in her teens or early twenties, setting her up for a lifetime of suffering.  

2. For every woman who receives fistula surgery, an estimated 50 more go without.

For women who have unfortunately experienced obstetric fistula, a brief surgery costing just under $600 on average is their only hope for relief. Fistula Foundation is dedicated to reaching as many women as possible because for every one fistula surgery performed, an estimated 50 other women in need go without. 

Why is this? Obstetric fistula is most common in poor, rural regions of Asia and Africa where fewer than 6 out of 10 women give birth with a medical professional present. Just as they are often unable to access a C-section or other emergency procedures that could prevent this condition in the first place, they are also unable to access the surgery to correct it. 

3. There are three main barriers to fistula treatment: stigma and lack of awareness, poverty, and inadequate health care systems.

Fistula Foundation exists to remove all barriers to treatment, so that every woman can have access to high-quality fistula care.

Stigma and lack of awareness among patients, the medical community and potential donors alike make up one of the biggest barriers to treatment. Affected women often live in rural communities where information on this condition is lacking – some might not even be aware they are suffering from a known, treatable condition. Too often, they are ridiculed by neighbors and shunned by their families, so they hide themselves in shame. This is why Fistula Foundation addresses community education and outreach. 

Poverty is another important barrier to treatment. The cost of fistula surgery and rehabilitation is out of reach for nearly all fistula patients. Additionally, too few hospitals in Africa and Asia offer fistula surgery. This means that most women must travel long distances for help, adding to the total cost of care. Public transportation can also be difficult for a woman with obstetric fistula, because of her incontinence.

Finally, inadequate health care systems pose a big challenge to getting women the help they need. A lack of trained fistula surgeons has long been a barrier to scaling up fistula treatment. Fistula repair surgeries are difficult to perform and require special training – there are just not enough surgeons to meet the need. Another challenge is that many women live in countries where it is not culturally acceptable for female patients to be treated by male physicians. Female surgeons are already scarce, let alone female surgeons who have been trained to treat obstetric fistula. 

4. Fistula Foundation is the global leader in fistula surgeries, providing more surgeries than any other organization.

Fistula Foundation works to end the suffering caused by obstetric fistula because the organization believes that no woman should endure a life of misery simply for trying to bring a child into the world. The organization’s strategy is to first identify local surgical teams in Africa and Asia that are already successfully treating women with fistula, and then work with them to amplify their efforts. The charity partners with the very best hospitals and doctors who are trusted by the communities they serve and are working in areas with the greatest need.

Currently, the charity’s partners have performed more than 50,000 fistula repair surgeries.

Fistula Foundation listens closely to its partners and responds quickly to empower them to do more. Their grants support a combination of the following areas: cost of surgery, surgeon training, facilities, outreach and reintegration (helping women rejoin their communities post-surgery). 

5. Fistula Foundation has a proven plan to end obstetric fistula on a country-by-country basis.

Fistula Foundation’s pathbreaking model invests in treatment centers across a single country – enabling it to secure countrywide coverage. As a result, it can draw down a country’s backlog of fistula cases and reach women in previously unreachable places. 

This countywide model was piloted in Kenya in 2014, and expanded to a second country, Zambia, in 2017. Both programs are thriving, and Fistula Foundation is eager to expand to even more countries as financial support will allow.  

This innovative model consists of four elements:   

Reaching every woman: A robust community outreach program equips local health workers with the resources they need to educate communities and refer patients to the nearest treatment center. Additional strategies include radio announcements, community events and a nationwide hotline.

More hospitals, more capacity: Fistula Foundation is continually working with its partners to expand its network of well-equipped hospitals and trained surgeons. With more facilities in more places, women won’t need to travel long distances or be placed on a waitlist for surgery.

Surgeon and nurse training: A certified training program increases the number of qualified surgeons and nurses available to help women in need of fistula surgery and care.
 
Her new future: The final element helps women rejoin society. Fistula Foundation provides job skills training, legal assistance and reproductive care to help women get back on their feet.  
 

A female doctor and her patient laugh together in a hospital room.
Fistula Foundation

 
Now that you have learned about obstetric fistula and have heard more about Fistula Foundation’s work, here are ways that you can help: 

  • Get informed. Visit Fistula Foundation’s website and sign up for the organization’s newsletter.
  • Virtual campaign events. Host a virtual Lunch and Learn or team meeting featuring Fistula Foundation staff and hear inspiring stories of women whose lives have been transformed.
  • Workplace giving. Support Fistula Foundation through your workplace giving campaign.    
  • Matching gifts. If your organization doesn’t run a workplace giving campaign, you can check if they offer a matching gift opportunity on Fistula Foundation's website.
  • Share. Educate others about obstetric fistula and inform them how they can help.

An obstetric fistula is a horrible thing for a woman to have to endure. Thankfully, Fistula Foundation is working tirelessly to end the suffering. Learn more on our website or email us for more information on how to make Fistula Foundation part of your employee engagement strategy.


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Deanna Neiers

Deanna Neiers

Deanna Neiers is the director of the northeast and central regions at Global Impact, and leads corporate and charity partnership efforts in her regions.  She is passionate about the organization’s alliance of international nonprofits and loves inspiring employees to donate to them.  She also loves to travel, eat out and explore the city.  Though born in the Midwest, Deanna has lived in New York City for the past 17 years which has earned her the title of an “official” New Yorker.  She and her husband frequently ponder one important decision—should they raise their two young children as Cubs fans or Yankees fans?  Only time will tell.  

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