Who is Doing What About Fistula?

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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 94 years of age (in 2017).

  • 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, Nigeria, Tanzania, and Uganda, are some countries where efforts are made to treat fistulous women.

WHO is working 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 has increasingly been published elsewhere too. The CDC has had a medical epidemiologist working full-time on maternal mortality.

Understandably, the Campaign to End Fistula has in actuality focussed largely on extending the woefully inadequate availability of surgery for those who already have obstetric fistula.

15 years in, HDI is arguably the only group focussed with laser-sharp focus on preventing these tragedies. HDI is the first to be dealing with obstetric fistula by systematically applying disease eradication approaches. Yet, HDI’s Rapid Fistula Prevention Project is achieving promising results in an expanded pilot project covering a multiethnic mostly nomadic population of now more than 300 000 who live across 8 878 square kilometers (3 478 square miles, 170 sq. miles more than Rhode Island and Delaware combined) of semiarid, almost roadless terrain in Niger. That’s a country where 1 in 7 young girls would sooner or later die in childbirth, the worst such statistic in the world, now improved to 1 in 15.

As Niger and HDI have shown:

  • 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

For more information about Obstetric Fistula check out Resources.

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