May 23rd is International Day to End Obstetric Fistula, a day to raise awareness about a little-known childbirth injury that occurs when a woman has obstructed labor but cannot access medical help. It leaves a woman incontinent and too often an outcast.
Even though obstructed labor occurs in approximately 5% of all child births worldwide, obstetric fistula has largely been eradicated in wealthy countries, thanks to the advent of the Cesarean section in the early 1900s.
Today, however, this condition continues to destroy women’s lives at an alarming rate in poor, rural regions of Africa and Asia, where all too often, women give birth without a skilled attendant present. Fistula affects approximately one million of the world’s most vulnerable women.
Sadly, very few people have heard of obstetric fistula. Bringing awareness to this tragically neglected injury is one of the biggest hurdles to helping women in need.
In low-income countries where fistula remains prevalent, women too often suffer in isolation, unaware that their condition is treatable. And in wealthier countries, kindhearted people who may want to help, can’t—simply because they have never heard of this devastating condition.
Obstetric fistula: One of humanity’s most disabling injuries with a cost-effective cure
For the woman does not have emergency obstetric care when she needs it—short of her death or the death of her baby—obstetric fistula is about the worst thing that can happen to her. Not only does it leave her unable to control her body’s wastes, leaking urine and or stool—but it leaves her humiliated.
A woman with fistula may face heavy stigma. Her smell too often drives away her husband, family, and friends. With little community understanding of fistula and its causes, she may live years in isolation and shame.
Thankfully, there is a cure! The condition is treatable with a single repair surgery that costs only $586 on average. This procedure can restore a woman’s continence and hope for the future.
Fistula Foundation, the organization I represent, is the global leader in fistula surgery. We provide more life-transforming surgeries to more women than any other organization in the world, including the United Nations and the US government. Since 2009 we’ve worked in 32 countries in Africa and Asia and provided more than 50,000 life-changing surgeries.
Each of these surgeries represents a woman whose life is changed forever—women like Mailess, a fistula patient our team in Zambia met earlier this year.
Meet Mailess, a fistula survivor from Zambia
After Mailess endured many hours of wrenching, complicated labor at home, she knew that she needed to see a doctor. However, the nearest health facility was many miles away, across harsh wilderness roads. In desperation, Mailess and her companions set out on foot. However, they were forced to wait for three hours to avoid a pride of lions they encountered along the way, feeding on an antelope carcass.

In the end, Mailess had to travel to three different facilities before she found a doctor who could help her. By that point, it was too late. Her baby was stillborn, and she began to leak urine uncontrollably.
Tragically, Mailess’s troubles were just beginning. Her husband divorced her, convinced that she would never be healed. No doctor was able to cure her incontinence. “I lost all hope I had for healing from this problem,” she said.
After ten years of living with obstetric fistula, Mailess finally received a phone call from her brother that changed her life. The hospital where her brother worked—St. Francis Hospital in Katete, Zambia—had just joined Fistula Foundation’s countrywide treatment network for obstetric fistula. He had seen it with his own eyes: women with her exact symptoms were being healed, thanks to highly trained doctors and nurses. Mailess could finally get the care she needed!
In February 2021, Mailess received life-changing fistula repair surgery at Fistula Foundation’s partner hospital—and for the first time in a decade, she is finally dry!
“I have seen a big change this time…[You] have helped us so well with the care and support you have given us.”
–Mailess, a Zambian fistula survivor, speaking to Fistula Foundation’s staff as she recovered from surgery at St. Francis Hospital
How to help women like Mailess
International Day to End Obstetric Fistula is coming up on May 23rd! To help women like Mailess, we encourage you to take two actions:
1. Spread the word about obstetric fistula to your family and friends! Share this page to your social media accounts on Facebook, Instagram or Twitter.
2. Give today to support fistula repair surgeries across Africa and Asia. One surgery costs only $586 on average, and can make a life-changing difference for women like Mailess.
This year, will you join us on May 23rd?