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Global Fistula Care Map Aims to Expand Treatment

A new effort hopes to connect new mothers suffering from fistula in developing countries with the medical care they need.
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There are many dire medical problems that the first world has the luxury of not worrying much about. Such as obstetric fistula, which tears a hole inside the birth canal. It’s one of the most devastating birth injuries a woman can sustain, but treatable. But that’s often not the case for much of the developing world.

There are between 50,000-100,000 cases of obstetric fistula each year worldwide. In 2010, only an estimated 14,000 were treated. Obstetric fistula causes 8 percent of all maternal deaths and, when it’s not fatal, leads to constant incontinence and shame. As we explained as part of a 2010 report by Lindsey Pollaczek from an international meeting on fistula, (“Dispatch from Dakar: Gathered to Fight Fistula”) women who develop the condition are often abandoned by their husbands, rejected by their communities, and forced to live in isolation.

The result of inadequate facilities and personnel in the developing world, fistula disproportionately affects young, poor women. In an effort to coordinate prevention and treatment of fistula across the globe, targeting outside help where it can do the most good, a Global Fistula Care Map displays more than 150 health facilities that provide fistula repair in 40 countries across Africa, Southeast Asia, and the Middle East. The map, more than a year in the making, was developed by the nonprofit Direct Relief International; partners on the project included the Fistula Foundation and the United Nations Population Fund. (Thomas Tighe, the director of DRI, sits on Miller-McCune’s editorial advisory committee.)



The interactive map shows, for example, that Ethiopia, with a population of nearly 83 million, has seven private facilities compared to only one government-run facility with an onsite fistula surgeon. The opposite trend is true in the Ivory Coast, where there are four government-run facilities and no private nonprofits.

“Documenting where treatment is available is critical to providing care, raising resources, and restoring the health and dignity of women and girls living with fistula,” Gillian Slinger, the United Nations Population Fund coordinator of the Campaign to End Fistula, was quoted in a release announcing the map.

A simple surgery, when available, can cure 90 percent of obstetric fistula patients. “If we know where service gaps are,” Slinger said, “we can then better steer activities forward, to get help to all those who need it.”

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