Experts to gather in Uganda to recognize advancements made in prevention, treatment of fistula

Government officials, representatives of nongovernmental organizations, doctors, and health care providers from around the world will gather in Uganda this week to recognize the advancements made in the prevention and treatment of fistula, a devastating childbirth injury. Global and local leaders from EngenderHealth, the U.S. Agency for International Development (USAID), and Fistula Care, a program led by EngenderHealth and funded by USAID since 2007, will share lessons learned and chart the way forward toward achieving a fistula-free generation.

Obstetric fistula, a hole that develops between the birth canal and one or more of a woman's internal organs, is caused by obstructed labor without access to timely and skilled medical care, such as cesarean section. Women living with fistula uncontrollably and continuously leak urine and/or feces. An estimated 2 million girls and women in Africa and Asia are living with fistula, with approximately 50,000 new cases annually.

"Together, with local governments, regional health care organizations, faith-based groups, and other partners, EngenderHealth and USAID have made significant progress toward transforming the health and lives of women living with fistula, as well as addressing barriers that lead to fistula in the first place," said Dr. Ariel Pablos-Mendez, Assistant Administrator of Global Health at USAID.

USAID, EngenderHealth, and other partners have improved access to and quality of fistula care—both prevention and treatment—at 57 health facilities in 15 countries across Africa and Asia. USAID has funded more than 30,000 fistula repair surgeries, most of which have been through Fistula Care. Also, Fistula Care has trained more than 33,000 individuals, including surgeons, nurses, and health care and community outreach workers, on fistula prevention, surgical repair, and care, thereby creating a sustained network that can provide ongoing treatment for the enormous backlog of women living with fistula and awaiting surgery.

Fistula Care has been a driving force in increasing the evidence about ways in which to standardize fistula care, including prevention services, surgical techniques, and counseling, which can have a huge impact on women's health. For example, Fistula Care collaborated with the World Health Organization (WHO) on a randomized controlled trial on a procedure that could potentially reduce the occurrence of complications and the length of the hospital stay required after surgery.

"We have the ability to make fistula as rare in Africa and Asia as it is in the Americas and Europe today. With continued investment and attention, we can accomplish our ultimate goal of achieving a fistula-free generation for women, families, and communities around the world," says Pamela W. Barnes, President and CEO of EngenderHealth. 

To date, through EngenderHealth, USAID, and local partners, Fistula Care has also:

  • Partnered with international and local organizations in Africa and Asia to set up operating rooms, train surgical teams, deliver medical equipment, and establish policies, standards, guidelines, training tools, and monitoring systems.
  • Advocated for policy changes to tackle root causes of fistula, including family planning, early marriage, and poor access to emergency obstetric care.
  • Implemented local solutions to raise community awareness about fistula prevention and treatment and to reduce maternal morbidity and mortality.



  1. ron tolls ron tolls United States says:

    For some 2,000,000 women living in the shadows with fistulae, all attempts to alleviate their misery are laudable, but huge obstacles remain:  poverty, women’s' rights, access to care, trained specialists, and above all child marriage.  Just this morning there was an outcry from all over the world to punish an eight year olds’ husband, a middle aged man, and family who arranged the marriage in Yemen because on her wedding night she received severe internal injuries, lacerations to her genitalia, profound bleeding and death.  In much of the Middle East child marriage has been accepted for centuries.  It is encouraging to see comments from Kuwait and Dubai calling for change.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
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