Girls’ Globe values the voices of the incredible organizations in our network. Over the next year, Girls’ Globe will continue to highlight the amazing work of these organizations and what they are doing to improve the health and well-being of women and children around the world. Last week, in honor of the International Day to End Obstetric Fistula we “sat down” with CEO of The Fistula Foundation, Kate Grant. Read the interview below and learn more about the they are doing to improve the the health of women around the world.
1. Earlier this week the G4 Alliance launched globally at the WHA in Geneva, Switzerland – an alliance in place to improve access to care in Surgery, Obstetrics, Trauma and Anaesthesia. What does this alliance hope to achieve and how is Fistula Foundation involved?
The goal of the G4 Alliance is to advocate for neglected surgical patients (i.e. those in low-resource countries) and to provide a collective voice for increasing access to safe, essential and timely surgical, obstetric, trauma and anesthesia care as part of universal health coverage. The numbers are staggering: Over two billion people lack access to basic surgical services worldwide with less than 4% of all operations being delivered to the world’s poorest countries. In fact, Africa has roughly 1% of the number of surgeons in the U.S. (Abdullah 2015). We know that far too few women in the developing world have access to timely obstetric surgery – that is why fistulas occur – and after the fact they face challenges in accessing the necessary surgery to repair their bodies which have broken by childbirth. Fistula Foundation is dedicated to ending that suffering through free, safe, and high-quality surgeries, which is why we are a proud member of the G4 Alliance and its vision to make sure all patients have access to the surgical care they need.
2. Saturday marked, the International Day to End Obstetric Fistula. Can you explain why it is so important to specifically invest in ending obstetric fistula and not just maternal health services in general?
New York Times columnist Nick Kristof has referred to women with fistulas as “ the lepers of the 21st century, among the most voiceless and shunned people on earth.” Obstetric fistula may not be the ‘sexiest’ issue out there, but as the most devastating of all childbirth injuries, it is one that deserves targeted attention and investment. Not only is a woman left incontinent and unable to control her bodily wastes, but 9 times out of 10 her baby does not survive and she is abandoned by her husband and ostracized from her community because they cannot stand her smell. Fistula is truly a symbol of global inequality and indeed should not exist. The cure is a surgery which, on average, takes 1 hour and costs $450. Doesn’t seem like much, but this 1 hour and $450 completely transform a woman’s life!
3. Are there any specific concerns or challenges that the community working towards ending fistula is currently facing?
There are a few specific challenges we face in ending fistula completely. One of the biggest challenges is a global shortage of trained surgeons. Because fistula has been nearly eradicated in high-income countries, it is no longer a relevant field of specialized training for most surgeons. The Fistula Foundation funds training programs led by international experts in nearly all of the countries in which we work. Surgeons are trained through the standard competency program developed by the International Federation of Gynecology and Obstetrics (FIGO), and we support them following their training to make sure they have the necessary resources to put their skills into practice.
Another big challenge is lack of awareness. Again, because fistula has been nearly eradicated in high-income countries, many people are simply unaware that the problem exists. It is a humiliating and isolating condition that affects the poorest and most vulnerable women in low-resource countries, many of whom don’t even know that treatment is available or are too ashamed to come forward. We fund outreach programs to help raise awareness in rural communities and identify these women who are too often hidden and ostracized from society.
4. How can the international community help to end Obstetric Fistula as a part of the post-2015 agenda.
The only way to truly end fistula is to treat existing cases while at the same time preventing new ones from occurring. In order to do that, every pregnancy and delivery must be safe – this means improving women’s access to pre-natal care and emergency obstetric services. ALL women need access to emergency obstetric care, regardless of which part of the world they come from. About half of the women who give birth in Africa each year do not have access to the emergency care they need, so that is really the key to any agenda focused on ending fistula.
Until the time comes where every pregnancy and delivery is safe, raising awareness is one of the most important factors in helping to end obstetric fistula. The issue has slowly started to creep onto the international agenda in a variety of forms, such as the Global Fistula Map we co-funded with Direct Relief and UNFPA, and the United Nations Campaign to End Fistula. In fact, in December 2014, a UN resolution was passed to intensify efforts to end fistula. Efforts like these help keep fistula on the radar – let’s keep up the momentum!
5. Can you share any news about the progress to end Obstetric Fistula?
The good news is maternal mortality rates have dropped dramatically and more women are delivering their babies with a skilled attendant present than ever before. The path to ending fistula is a long one, but we are making steady progress. Fistula Foundation has now funded more than 14,000 surgeries across 30 countries, meaning more women in more places have been able to access surgery than ever before. More surgeons are being trained than ever before as well, increasing the international capacity to reduce the global backlog of patients.
Our Action on Fistula program, a three-year, $2M initiative funded by Astellas Pharma EMEA designed to make a lasting impact on fistula treatment in Kenya, also shows promise in accelerating the progress to end fistula. It is the largest and most well-funded single program we have ever undertaken in any of the countries where we work, and we believe has the potential to be a roadmap for comprehensive fistula treatment in other countries and regions. Based on its success, we are working to establish treatment networks throughout Africa and south Asia in order to help surgeons collaborate better and ensure that women have access to timely, quality surgery.
6. How can our readers and audience get involved to help end Obstetric Fistula?
There are many ways to get involved! Become a fistula ambassador in your community or school by joining our Circle of Friends program and putting on an event. Play the game Half the Sky on Facebook, inspired by the book-turned-documentary, Half the Sky: Turning Oppression into Opportunity for Women Worldwide by Nick Kristof and Sheryl WuDunn. The game allows players to complete quests based on themes from the book that unlock real-world donations to Fistula Foundation and the surgeries we provide! Another great example is Allie Pape, a supporter recently used an opportunity on an email lottery called The Listserve to raise $2,500 and counting for Fistula Foundation. You can read more about her story on my Huffington Post page.
As we know, obstetric fistula is often a ‘hidden’ condition that far too few people know about. Follow us on Twitter at @Fistula_Fdtn and be sure to tweet us using the hashtags #EndFistula and #FistulaDay and let us know what YOU are doing to help end fistula and raise awareness. Or, make a donation in honor of someone you love, or take our #nopresentspledge, a pledge you can take multiple times a year to let friends and family know that instead of gifts, you’d prefer they make a donation in your name to give the gift of health to a woman in need instead.