The Fistula Foundation

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The Fistula Foundation

• February 28, 2008
• Kate Grant
• Fistula Foundation, Executive Director
• American College of Nurse-Midwives

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Agenda

• Understanding Obstetric Fistula
• Maternal Health in developing countries
• Obstetric Fistula prevalence
• Fistula Hospital History a Legacy of Healing
• A Future of Hope expansion plans
• Fistula Foundations role
• Whats ahead for the Foundation

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• Obstetric Fistula is the single most dramatic
  aftermath of neglected childbirth.
• --World Health Organization

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Obstetric Fistula

• Obstetric fistula is a childbirth injury
  resulting from unrelieved, obstructed labor that
  cuts off blood supply to pelvic tissue.
• It leaves women incontinent physically and
  socially ostracized.
• UNFPA estimates 2 million women in developing
  countries suffer from untreated fistulas.
• Largely eradicated in developed countries in late
  19th century with use of c-sections and forceps
  deliveries.

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Lifetime Maternal Morality Risk

• For an American woman in the U.S. the lifetime
  risk of death due to pregnancy and childbirth is
  just
• 1 in 2800

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Lifetime Maternal Morality Risk

• For an African woman the lifetime risk of dying
  due to pregnancy or childbirth is
• 1 in 16

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For want of a Dr. or Midwife

• United States
• Population 300 million
• Women of reproductive age 71.8 million
• Ob-Gyns 19,180
• Ratio 1 to 3,743
• Lifetime births avg. 2
• Ethiopia
• Population 75 million
• Women of reproductive age 14.9 million
• Ob-Gyns 93
• Ratio 1 to 160,215
• Lifetime births avg. 5 - 6

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Obstetric care a rarity in poor countries

• In Ethiopia, only 1 in 100 of the poorest women
  (bottom 10 by income) give birth with a trained
  birth attendant.
• Even with richest 10 only 1 in 4 have an
  attendant
• In the U.S. 99 of births occur with a trained
  attendant, usually a Dr. to help a laboring
  woman.

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Causes of Maternal Mortality
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The Fistula Hospital in Ethiopia
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The Pioneering Fistula Hospital

• The Addis Ababa Fistula Hospital is the only
  facility in the world exclusively dedicated to
  treating fistula. It serves as a center of
  excellence, offering training and pioneering
  surgical techniques and methods of physical and
  psychosocial rehabilitation for women.
• --United Nations Population Fund (UNFPA)

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A Legacy of Healing

• AAFH founded in 1974 by Doctors Reg and Catherine
  Hamlin.
• Treated nearly 30,000 women free of charge.
• Trained Doctors from all over the world.
• Recognized as the global center of excellence for
  fistula surgery and treatment.
• Supported by donors from the U.S., Australia, the
  UK, and elsewhere.

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Restoring Dignity

• Over 90 of patients are cured.
• Receive physical therapy, psycho-social help,
  even a new dress when they leave.
• Former patients return to their villages and most
  can have more babies.

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Joy Village for long-term care

• For patients requiring long-term care and those
  who cannot return to village life, the AAFH built
  Desta Mender (Joy Village in Amharic).
• Here patients can live after surgery and continue
  physio-therapy.
• They work in the village and do micro-enterprise
  projects.

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A Future of Hope

• The Hospital is rapidly expanding its treatment
  capacity.
• Building 5 new mini-hospitals throughout
  Ethiopia.
• When completed they will enable over 4000 women
  to be treated yearly, up nearly 3-fold from
  current capacity of approximately 1400.
• 3 are open, 4th opens this May, 5th set to open
  in 2009.

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Expanding Prevention Efforts

• New Hospitals provide opportunity to increase
  emergency obstetric care.
• Radio and TV broadcasts to raise awareness.
• Hamlin Midwifery College opened in January 2008
• Obstacle trained providers of emergency
  obstetric care very limited. Continent-wide
  problem medical brain drain.

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Fistula Foundation - background

• Fistula Foundation was founded in 2000.
• The only organization in the U.S. dedicated to
  supporting the Fistula Hospital in Ethiopia.
• Incorporated in the State of California as a
  registered Nonprofit.
• Initial Governing Board had 5 members, built up
  to current Board of 13 members.
• Started with all volunteer support, but now has
  two FT, two PT employees, plus dedicated
  volunteers.
• Headquartered in Santa Clara, California

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Fistula Foundations Mission

• The Fistula Foundation is dedicated to restoring
  health and dignity to women with obstetric
  fistula and to helping prevent this tragic injury
  through support of the Hamlin Fistula Hospitals
  in Ethiopia.

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Fistula Foundations role

• Raise awareness
• Open hearts and minds
• Provide financial support to help enable the
  Fistula Hospitals inspiring work and expansion
• Say thank-you

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Fundraising Programs
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Publicizing the Hospitals inspiring work

• Website
• Initial point-of-contact for most FF donors
• Receive approx. 10 of funds through web
• Newsletter sign-up
• Information requests
• Newsletters and mail updates
• To date, we estimate over 100K mail-pieces to
  donors
• Quarterly newsletters

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Whats Ahead for the Foundation

• New media opportunities
• Congressional Hearing
• Documentary

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Please join us

• If you want to go fast, go alone,
• but if you want to go far, go with others.
• ---African Proverb