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 is estimated to afflict more than 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 it is traumatic fistula, caused by rape or sexual violence. In these cases, 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 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 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

• 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
• Promoting gender equity and reducing violence against women

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.