In Kenya, an initiative by the Fistula Foundation is making fast progress toward its goal of treating 1,200 women who suffer from the life-altering condition.
Through its Action on Fistula Program, 582 women have received reconstructive surgery in just over a year of launching the three-year effort.
Fistula is caused primarily by prolonged obstructive labor. It often occurs in developing countries where many women give birth at home without access to a medical attendant or the ability to have a C-section to deliver the baby.
Lindsey Pollaczek, the program director for Action on Fistula in Nairobi, says as a result, “after a prolonged period of being in labor, the woman can develop a fistula – which is a hole in the birth canal that causes chronic incontinence.”
“In over 90 percent of the cases the child is stillborn, and then she’s also left with this devastating physical injury which leaves her incontinent -- which is also an incredibly psychologically damaging challenge because of the stigma and the smell that goes along with the incontinence."
While the condition has been eradicated in most developed countries, the United Nations Population Fund estimates that 3,000 new cases occur every year in Kenya, with approximately one to two fistulas for every 1,000 deliveries.
Many stricken women think they did something wrong or are cursed – and are sometimes socially isolated from their communities and family for years.
“Many women end up being divorced from their husbands once they develop a fistula because they’re not able to have sexual relations. [Sometimes], the husband might run away or abandon them,” said Pollaczek.
She said the program to repair fistulas has three primary components: treatment, training and outreach. The Fistula Foundation has worked with the International Federation of Gynecology and Obstetrics (FIGO) to certify its first credited training center in Kenya.
"That’s based in Eldoret at the Gynocare Fistula Center, [where] we’ve now trained three Kenyan surgeons, newly trained in fistula surgery, and providing them with ongoing support through the duration of the program ,” says Pollaczek.
The initiative also involves community outreach to raise awareness about fistula and to let women suffering from the condition to know that it is treatable.
This reduces stigma, allowing women to feel more comfortable in seeking treatment.
Pollaczek says the Action on Fistula program in Kenya has exceeded the foundation's expectations and with continued help from partner Astellas Pharma EMEA, they will attempt to to duplicate the model beyond East Africa.
“We’re really looking at taking this to maybe places in southern Africa as well as Asia. We have a great team that’s sort of putting our heads together and seeing where we can go next,” said Pollaczek.