Fistula Foundation

Fistula Foundation

Fistula Foundation is the global leader in treating obstetric fistula, a devastating childbirth injury that leaves women incontinent, humiliated, and often shunned by their communities. In addition to covering direct surgery costs, Fistula Foundation also supports training surgeons, equipping facilities, grassroots community outreach, and holistic post-surgery reintegration.

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surgeries funded by 2021

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The problem: obstetric fistula

Obstetric fistula is one of the most devastating and serious childbirth injuries. It most commonly occurs in poor, rural areas in Africa and Asia where women have limited access to emergency obstetric care, such as C-section. When a woman experiences a prolonged, obstructed labor under these conditions, she will likely be in excruciating pain for days. The constant pressure of the baby’s head on the pelvis restricts blood flow to the soft tissue between the mother’s vagina and her bladder or rectum, leaving holes known as “fistulae.” These holes cause incontinence.

Unable to control her urine and/or feces, a woman will often also suffer from chronic infections and pain. What’s more, with too little community understanding of fistula and its causes, a woman can be blamed for her condition and shunned by her neighbors and family.

Each year between 50,000 to 100,000 women worldwide are affected by this wrenching condition. [1]

Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula — but fewer than 20,000 corrective surgeries occur annually.
Fistula Foundation patients in Kenya.

The solution: cost-effective, restorative surgery

An obstetric fistula can only be treated with corrective surgery. If the operation is performed by a skilled surgeon, a woman with fistula can very often return to a normal life, with her continence and hope restored. However, due to stigma,lack of awareness, poverty, and inadequate healthcare systems, field experts estimate fewer than 20,000 procedures take place annually. [2]

Aggregated data from Fistula Foundation’s current partners shows that it typically only costs US$598 to provide a woman in Africa or Asia with life-changing fistula repair surgery and rehabilitation services — less than a single night’s stay in most hospitals in the United States. [3] (Actual surgical costs vary depending on the local economies and healthcare infrastructure where partners work. The costs for more complicated surgeries, such as treating dual vaginal and rectal fistula, can be greater.) The global success rate for fistula repair surgeries is approximately 86%. [4]

Fistula most commonly occurs to women in their twenties, in countries where the average lifespan is approximately 65 years—meaning a one-time surgical intervention can restore 40+ years of health. Without access to care, fistula survivors are forced to live with this devastating injury for the rest of their lives. 

A life-changing fistula repair surgery and rehabilitation services cost US$598 — less than one night’s stay in most hospitals in the US.
A fistula surgery in progress at a Madagascar hospital funded by Fistula Foundation

How Fistula Foundation works

Fistula Foundation is the global leader in fistula treatment, funding more surgeries than any other organization, including the US government. Their work supports one goal: to provide as many life-changing fistula surgeries as possible. More than 80% of funds raised by Fistula Foundation go directly to supporting programs.

Fistula Foundation’s strategy builds sustainable in-country capacity by covering the cost of surgery, surgeon and nurse training, medical equipment and post-surgery rehabilitationFistula Foundation partners closely with local doctors and nurses, who are best positioned to understand the cultural nuances of how to implement effective programs.

Grants are invitation only.  Potential partners go through a rigorous review process, including external reference checks of local doctors’ reputations, fistula surgery skills, and certification. Grant recipients receive funds in stages and are required to provide regular, detailed reports. Site visits are also conducted regularly, both to build a closer relationship between Fistula Foundation staff and their partners on the ground, as well as to help ensure funds are used appropriately.

Dr. Denis Mukwege smiling
Fistula Foundation’s longest-term partner is 2018 Nobel Peace Prize recipient, Dr. Denis Mukwege of Panzi Hospital.

In 2014, Fistula Foundation launched an innovative countrywide treatment network program in Kenya, with the potential to end fistula across the country in a generation. Its integrated network allows surgeons, outreach workers, and hospitals to share resources and information to effectively treat more Kenyan women than ever before. The program was so successful, Fistula Foundation deployed the same countrywide treatment model to Zambia in 2017. Both programs are thriving, and the organization looks forward to expanding its Fistula Treatment Network into more countries.

What makes Fistula Foundation so effective


Obstetric fistula can be cured by a surgery that costs an estimated US$598. The suffering and health burden averted is comparable to the most cost-effective health interventions, such as vaccines and bed nets. [5]

Dramatic impact

The Institute for Health Metrics and Evaluations estimated in 2017 that the burden of living with obstetric fistula is comparable to living with terminal cancer, and double the burden of blindness. [6]

Fistula Foundation’s accountability

Fistula Foundation vets potential partners through a careful review process that involves the Foundation’s Program Development staff, Board of Directors, and Grants Review Committee. They also rely on expert input from two senior fistula surgeons who advise its staff and board. Surgeons and hospitals receiving funding are required to provide quarterly progress reports detailing their project activities and costs, surgical outcomes, and any challenges encountered. Fistula Foundation releases funds once a partner’s report has been reviewed and approved.

Since 2005, Fistula Foundation has met the Better Business Bureau’s standards in all 20 categories of accountability, earning their seal of accreditation. [7] A breakdown of expenditures, tax returns, audits, and annual reports is available on Fistula Foundation’s website. [8]

Recognition for Fistula Foundation

Fistula Foundation is a GuideStar Platinum Participant — the highest rating that is awarded to nonprofits — and since 2006, Charity Navigator has awarded Fistula Foundation four stars, a rating given to only 1% of charities. Additionally, Fistula Foundation has been named a top-rated charity by both Charity Watch and GreatNonprofits. [9] [10] [11] [12]

GiveWell, the sector’s most rigorous voice on effective giving (and one of our charity evaluators), states that: “Fistula Foundation may be in the range of cost-effectiveness of our current top charities.” [13]

Frequently Asked Questions

The majority of Fistula Foundation’s program spending is directed to fistula repair surgeries, including pre-operative care, surgery, and post-operative care and rehabilitation. They also support certified surgeon training, equipment and facilities, patient transportation to the hospital, and grassroots community outreach and fistula education.

They do both. In Kenya and Zambia, their comprehensive countrywide network programs are run by Fistula Foundation staff on the ground. For other programs, like Dr. Mukwege’s Panzi Hospital in DRC, they provide a grant to fund the hospital’s fistula efforts.

Fistula Foundation has supported an increasing number of surgeries every year, except for 2020 when their surgery total declined by 17% due to the effects of the Covid-19 pandemic. They currently fund over 8,000 surgeries per year, and by the end of 2021, Fistula Foundation will have supported over 60,000 life-changing surgeries.

Fistula Foundation works with local hospitals and medical staff, including several award-winning surgeons and leaders in fistula treatment. Their longest-term partner is 2018 Nobel Peace Prize recipient Dr. Denis Mukwege of Panzi Hospital. New potential partners go through a rigorous vetting process to ensure their care is relevant, respectful, and effective in their communities.

While Fistula Foundation strives to cooperate with local governments, countries with the weakest healthcare infrastructure often also have weak governmental funding oversight. In the United States, Fistula Foundation collaborates with US government-funded projects when possible. However, they recognize that contractual obligations can hamper the ability to deliver high-quality care in a timely and efficient manner. Fistula Foundation focuses its fundraising strategy on the generosity of private donors to deliver the best care possible, quickly and effectively.

We recommend Fistula Foundation based on research by our founder, Peter Singer. In his book, The Life You Can Save, obstetric fistula surgeries are used as an example of an intervention that clearly provides profound benefits at a modest cost. Peter consulted experts in the field who recommended Fistula Foundation as a model organization.

You are currently on The Life You Can Save Australia’s website. The Life You Can Save Australia Limited (ABN 90 623 716 370) is a Public Benevolent Institution endorsed as a Deductible Gift Recipient by the Australian Taxation Office. 

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