Fistula, a hole between the birth canal and one or more of a woman’s internal organs, is almost always preventable, yet it is all too common in the developing world, where it affects over 2 million girls and women.

Consequences of fistula are life altering: For women with obstetric fistula, the baby usually dies 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 if sexual violence results in a traumatic fistula, because there is 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 effort to date dedicated to treating and preventing fistula (funded by the U.S. Agency for International Development), EngenderHealth works to restore dignity to women with fistula and to prevent other women from getting the injury. 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 reenter family and community life

 
Preventing Fistula

• Upgrading emergency obstetric care to prevent obstetric fistula cases
• 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 root causes of obstetric fistula, such as the delay accessing emergency obstetric care

Currently, we have fistula activities in 11 countries in partnership with other international organizations, local nongovernmental organizations, faith-based organizations, public sector clinics, and national working groups on safe motherhood.