Who is Doing What About Fistula?

Major Support Provided By

Izumi Foundation KavliFondet Norad Provictimis

UNDP started The Campaign to End Fistula in December 2003. Two young Australian doctors established The Addis Ababa Fistula Hospital in Ethiopia, where they dedicated their careers to operating on women with fistula. They also started training surgeons and even non-surgeons in these techniques. Though her husband has passed away, Dr. Catherine Hamlin is still deeply committed at more than 80 years of age.

  • Several governments and non-governmental organizations (NGOs) have for years tried to alleviate the problem by training surgeons and even non-physician women to do corrective surgery for obstetric fistula. Ethiopia, Niger, Tanzania, and Uganda, are some countries where efforts are made to treat fistulous women.

WHO is hoping to gather surgeons who do obstetric fistula repair, and seek consensus on what might be the best surgical technique to use in various fistula situations. In recent years there has been increased funding for research into causes of maternal death in developing countries, and into obstetric fistula. The Bill and Melinda Gates Foundation was a major source of funding through a 2001 – 2005 grant. Articles on maternal death and obstetric fistula were published in The Lancet, a prestigious journal, in its January 3, 2004 issue, and research is increasingly being publish elsewhere too. The CDC has had a medical epidemiologist working full-time on maternal mortality.

Until recently, nobody has undertaken to deal with obstetric fistula by systematically using disease eradication approaches. Yet, HDI’s Rapid Fistula Prevention Project (HDI-RFP) is achieving promising results in a large pilot project covering a multiethnic mostly nomadic population of 100.000 who live across 4.560 square kilometers (3.059 square miles) of semiarid, almost roadless terrain in Niger. That’s a country where one in seven women sooner or later dies in childbirth, the worst such statistic in the world.

  • It should be possible to eliminated obstetric fistula in Africa, Asia and elsewhere, as has been done in Europe and North America, although fistula is not biologically eradicable.