Fistula is a hole that develops between the birth canal and one or more of a woman's internal organs. While it is almost always preventable, fistula is all too common in the developing world, where it is estimated to affect more than 2 million girls and women.

Consequences of fistula are life altering: For women with obstetric fistula, the baby usually dies during labor and the mother is left with chronic incontinence, often leading to isolation from family and community life, and neglect or abandonment by male partners. Without surgical repair, a woman's prospects for work or family support are greatly diminished, and she is often left to rely on charity. These problems are compounded in cases of traumatic fistula, which is caused by rape or sexual violence. In these cases, women face greater psychological trauma and increased vulnerability to HIV or other sexually transmitted infections.

In up to 90% of cases, the fistula can be surgically repaired. Through the Fistula Care project, the largest U.S. government-funded effort to date dedicated to treating and preventing fistula, EngenderHealth works to restore dignity to women with fistula and to prevent other women from developing the condition. Our activities include:

 
Treating Fistula

• Increasing the number of providers able to surgically repair fistula  
• Upgrading medical equipment and supplies at health facilities to ensure high-quality care for women receiving surgical repair for fistula
• Improving providers' skills in counseling fistula clients
• Supporting women as the re-enter family and community life

Preventing Fistula

• Upgrading emergency obstetric care to prevent obstetric fistula
• Increasing awareness at the community level about how to prevent fistula and the importance of maternal health care
• Improving access to family planning
• Advocating policy changes that tackle the root causes of obstetric fistula, such as delays in accessing emergency obstetric care
• Promoting gender equity and reducing violence against women

For nearly a decade, EngenderHealth has partnered with institutions and surgical teams to facilitate more than 20,000 fistula repair surgeries, transforming the lives of women and their families in 15 countries across Africa and Asia. These surgeries have been possible with support from USAID and other generous donors. Currently, we have fistula activities in 12 countries in partnership with other international organizations, local nongovernmental organizations, faith-based organizations, public sector clinics, and national working groups on safe motherhood.