This week, the international aid world will convene in New York City during the United Nations General Assembly to discuss data, procedures, progress or perhaps lack thereof. But it’s important to remember that behind all of these facts and figures are women like Shefali*.

At age 20, Shefali was a happy wife and mother of a beautiful son. Like most women, when she became pregnant with her second child she was excited about expanding her family. She went into labor at home alone, without access to a skilled birth attendant, as do more than two thirds of women in Bangladesh. After enduring a day of excruciating labor she felt that something was wrong. She knew that her baby had already died inside her womb. Her husband took her to the hospital where the stillborn baby removed, but this was just the beginning of Shefali’s suffering.

Not long after, Shefali began to leak urine: days of obstructed labor had caused an obstetric fistula, an injury that caused her to become incontinent.

Photo Credit: HOPE Foundation for Women & Children of Bangladesh
Photo Credit: HOPE Foundation for Women & Children of Bangladesh

Obstetric fistula is a terrible injury happening to some of the poorest women in the world. As in Shefali’s case, it occurs when a woman’s labor becomes obstructed and constant pressure from the fetus causes tissue to die. As a result, a small hole is created that causes the woman to become incontinent. The smell of her incontinence often spurs a woman’s husband to leave and community to abandon her – and even worse, she often thinks it’s her fault, believing she’s cursed. Her child usually does not survive.

The most shocking part? The surgery that can completely transform a woman’s life costs as little as $450 and often takes less than an hour to complete. Yet there are women like Shefali with fistula today who have lived with this condition for decades because they do not know treatment is available or because they cannot afford to access it.

Recently, Shefali heard about the free obstetric fistula repair services offered by HOPE Hospital for Women and Children of Bangladesh, a Fistula Foundation partner. She arrived at the hospital in Cox’s Bazar for treatment, eager for the surgery that would finally cure her and allow her to once again walk with pride through her village, free from the burden of obstetric fistula.

Obstetric fistula used to be common in the developed world until the early part of the 20th century – in fact, a fistula hospital once stood on the site of today’s Waldorf Astoria Hotel in New York – but thanks to the widespread availability of emergency obstetric care and emergency interventions like C-sections, fistula is now extremely rare in the U.S. and other industrialized nations. But, in places like rural Bangladesh, where Shefali gave birth, there is too often no medical help available if something goes wrong during labor.

Today, Shefali is 40 years old. She suffered with obstetric fistula for 20 years, without any idea that her devastating childbirth injury could be treated through surgery. We know there are at least one million more women like her, who suffer from untreated fistula, and too many of those women have suffered for years.

Shefali’s life was transformed because true partners worked together: Fistula Foundation’s generous donors paid for the surgery she received through skilled hands from our trusted partners at HOPE Hospital. This week, as we all reflect on achievements made and significant work that remains to be done, let us pause for a moment and think about the individuals behind these spreadsheets and data points, and about the collaboration and partnership required of all of us to treat the one million women just like her who are still in need of help.

This post is written by Kate Grant, CEO of Fistula Foundation, a nonprofit that works to treat the childbirth injury obstetric fistula by funding treatment, surgeon training, and equipment that enables providers to give the very best quality of care to women who are suffering. To learn more, visit or join the organization on Facebook or @Fistula_Fdtn on Twitter.

*Name changed to protect patient privacy.

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