IN THIS ISSUE
Preventing obstetric fistula
Fistula Foundation honors Oprah
Abeba’s story
Special donor "changes" a girl's life
Got Questions? We've Got Answers!
Have a question about obstetric fistula? Don't know who to ask? Ask the experts! Send us your questions about fistula and related issues and we'll work with a team of fistula sugeons, public health professionals and other experts to answer them for you. Look for answers to your questions in the next issue of Transformations.
Submit your questions by email to:
gotquestions@fistulafoundation.org
Or send questions by mail to:
Got Questions
The Fistula Foundation
42 Broadway, 18th Floor
New York, NY 10004
New CEO at Fistula Hospital
We are pleased to announce that Mark Bennett has been selected as the new CEO of the Addis Ababa Fistula Hospital in Ethiopia.
Mr. Bennett, a native of Australia, served for six years as program coordinator for Refuge Egypt, a Cairo-based organization catering to Sudanese and other African refugees and asylum seekers.
In 2003, Mr. Bennett was promoted to Diocesan Development Director of the Episcopal Church in Egypt. After a brief stay in Australia, he will be joining the Addis Ababa Fistula Hospital team in May 2005.
A letter from Dr. Allan Rosenfield
February 2005
New York City
Dear Friends,
We in the Public Health field view the increased awareness of obstetric fistula, and its impact on women in the developing world, as a major contribution of the Addis Ababa Fistula Hospital.
In 2004, Dr. Catherine Hamlin of the Fistula Hospital was recognized by the American Medical Association, the Global Health Council, and the United Nations Population Fund (UNFPA). Recently Dr. (Sr.) Ann Ward, a veteran fistula surgeon working in Nigeria, was honored with the Distinguished Community Award by the International Federation of Obstetrics and Gynecology (FIGO). Organizations including UNFPA, Engender Health, and Columbia University Mailman School of Public Health's Averting Maternal Death and Disability (AMDD) have committed time and resources toward the international effort to treat and prevent obstetric fistula.
The world is becoming aware of the dedicated fistula surgeons around the world who have been repairing fistulae with care and dedication, but with minimal resources. It is widely understood that broad awareness of an issue can lead to increased funding and improved political will. As friends of the Fistula Foundation, you can make a difference by educating yourselves and sharing your knowledge with others.
In this issue of our newsletter, we have included an article about fistula prevention. I hope you find it informative and that it helps you to better understand the challenges we face and the difference we can make.
Sincerely,
Allan Rosenfield
Dean, Mailman School of Public Health, Columbia University
Board Member, The Fistula Foundation
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New York City, 1872:
Emily came from a wealthy family. At 23, she was well-educated, happily married, and ready to start a family. After a trouble-free pregnancy, she started her labor at home, as many women of her era did. After fifteen hours of unsuccessful labor, it became clear that she would not deliver naturally. Her husband and her mother accompanied her to the hospital, where, over the next several days, her ordeal continued. Though in the end she survived, she not only lost her baby, but also suffered a terrible injury, a fistula, which left her incontinent and ashamed.
In 19th century America, Emily's experience was not uncommon. But by the turn of the century, when cesarean sections were widely available, fistulas had ceased to exist in the developed world. Today, more than 100 years later, in poor countries where quality medical care is inaccessible or unavailable, obstetric fistula continues to debilitate more than 100,000 women every year. More than 500,000 women die from childbirth-related complications. While it is important to treat those women who have suffered a fistula, it is equally important that efforts are made to prevent fistulas ... and save lives. The only certain way to prevent a fistula is to ensure that all women have timely access to safe, affordable obstetric care.
According to Lynn Freedman, Director of Averting Maternal Death and Disability (AMDD) at Columbia University's Mailman School of Public Health, "Functioning, responsive health systems play a unique role in reducing poverty and promoting democratic development. They are an essential prerequisite for addressing maternal and child health in a sustainable way." Only such functioning, responsive health systems can make fistulas as obsolete in the rest of the world as they are today in America.
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| A woman and her child await the nurse at a clinic in rural Ethiopia. Under Fistula Hospital's new prevention program, health professionals will use such visits to educate women about safe childbirth. | ||
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Shaleece Haas, co-founder of the Fistula Foundation explains, "Child marriage and FGM are very serious issues, but the truth is that if these practices were eliminated tomorrow, women would still get fistulas. Obstructed labor affects women of all ages and if they can't get a c-section when they need it, they are likely develop a fistula ... if they survive."
Fistula prevention is a complicated endeavor that begins with functioning healthcare systems. In Ethiopia, a country twice the size of Texas with a population of 72 million people, there are only 52 obstetrician-gynecologists registered with the Ministry of Health, and most of them work in private practice in the capital city, Addis Ababa.
To say that more facilities are needed is an understatement, but capacity building is only part of the solution. More than just facilities, the health system requires better-trained staff, more efficient and effective management, and adequate supplies and medications. At the same time, pregnant women and their families need to be educated about the necessity of seeking care before, during, and after labor.
To this end, the Fistula Foundation is allocating funds to increase and improve prevention efforts in Ethiopia. Fistula Foundation grantee Addis Ababa Fistula Hospital has begun a comprehensive program to prevent obstetric fistula, beginning with the establishment of five satellite fistula centers across Ethiopia. These centers will provide free emergency obstetric care to women in need and will serve as the headquarters of regional fistula awareness programs. Awareness projects include showing educational videos in local communities, broadcasting health education messages via radio, producing dramas, and organizing workshops for policy makers and community leaders. The goal of these programs is to ensure that expecting mothers don't delay in seeking care when they experience an obstructed labor. With continued focus on prevention, the Fistula Foundation's vision of the future looks like this:
Gelemso Village, Ethiopia, 2020:
Tshai came from a wealthy family. At 23, she was well-educated, happily married, and ready to start a family. After a trouble-free pregnancy, she started her labor in a well-equipped hospital, as many women of her era did. When her labor became obstructed, a skilled surgeon performed a cesarean section and delivered Tshai of a beautiful, healthy baby. She would forever remember the birth of her child as one of the most splendid moments of her life.
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Donor Profile is one of the regular features
in Fistula Foundation publications. Every month on our website, and in each newsletter, we feature a donor who has found a creative way to help the women of Fistula Hospital make the journey from despair to dignity.
Kinsey Oglesby Fayetteville, NC, USA Last summer I watched the Oprah Show featuring the heart-gripping video about fistula patients in Ethiopia. As the story of their horror unfolded, I knew I had to act. First I showed the video to my family. After watching, we all agreed to help the fistula patients instead of exchanging Christmas gifts. I also sent a letter out to over 80 friends and family members to spread the word. My goal was to help at least five girls by the end of the year. 
Next I hosted a brunch for 12 women. We watched the video and each lady left with a jar to collect their pocket change. On the jar lid I wrote, "Change
a Girl's Life." One of the women who attended the brunch organized auctions,
fundraising meals, cleaned houses, sold exercise equipment and more. Her
efforts generated over $2,500.
After the brunch ladies collected their savings, I had a sack full of coins to deliver to the bank. I waited in the bank for 30 minutes to deposit the funds. The folks around me were impatient about the wait. But I only had joy. Because, unlike the fistula girls, I was standing there in clean, dry clothes. I was not leaking a horrible discharge and feeling like a public disgrace. Their daily horror overshadows our petty grievances. I'm overjoyed that our fundraising efforts generated more than $6,000 for the important work of the Fistula Foundation. Thank God for Oprah, who exposed this issue. She made me aware of the need, and in turn I am becoming a voice for the fistula girls. Return to top |
One Woman’s Story is one of the regular features
in Fistula Foundation publications. Every month on our website, and in each newsletter, we feature the story of a woman who has made the journey to Fistula Hospital. This is Abeba’s story—in her own words.
Abeba Zerehun, age 18 Southern Region, Ethiopia 
I studied in school until 7th grade. I helped my mother at home with housework, and then I got married when I was 15. I met my husband for the first time on my wedding day. My parents chose him for me. I felt sad that I had to quit my education, but otherwise I liked my husband. He was a good man.
I got pregnant one year later. My labor started at three in the afternoon and my husband and my mother were with me. A traditional doctor told me to go to the hospital. They operated to take out the baby, but it was dead. After the baby died, my husband married another woman. My friends were there to help me in the village. When I came to Fistula Hospital, I was very happy. I knew this was the place where I would get cured. It has been 15 days since my operation and now I am dry. I want to go back home and continue my education. I want to study and I want to become a doctor like the doctors here and help girls like me who have this problem. When I go back to my village, I will tell other women to go immediately to a hospital so that they won't have a problem with their labor. Most people don't know that a hospital can help them, but if they knew, they'd go. Return to top |
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The Fistula Foundation Honors Oprah Winfrey for Inspiring Philanthropy
If you are a woman born in the United States, you are automatically one of the luckiest women in the world. ~Oprah Winfrey On January 13, 2004, a studio audience gathered in Chicago, Illinois to watch Oprah Winfrey perform her magic, as she does every time she takes the stage to film another episode of The Oprah Winfrey Show. On this cold winter morning, more than 250 fans waited to be informed and inspired by Oprah herself, but none were prepared for the story they were about to hear. Wild cheering greeted Oprah as she emerged and announced, "Here is one of the most extraordinary women you will ever meet. You need to know her." She was talking about Dr. Catherine Hamlin, founder of Addis Ababa Fistula Hospital. For the next hour, Dr. Hamlin shared the stories of women devastated by obstetric fistula, and her own story of 40 years spent treating childbirth injuries in Ethiopia. By the end of the taping, there was not a dry eye in the room. Oprah left her audience with this thought: "After hearing Dr. Hamlin's story today, I hope you will look inside yourself and find out what you can do to make a difference."
The 3,000-square-foot center is comprised of two buildings featuring classrooms and specialized clinical facilities. Hospital administrators indicate that the centre will greatly improve the quality of care for the 1,200 patients who are treated at Fistula Hospital each year. Highlights of the new center include: - A classroom where new nursing aides will learn patient care and nursing skills. This classroom will also be used for daily literacy classes, which have outgrown current hospital facilities. - A private counseling room where those patients with the most serious injuries can be taught to care for their own needs in a quiet and confidential environment. - A clinic for urodynamic testing, which will help medical staff to assess the condition of a patient's bladder and address the needs of those with stress incontinence. On December 12, 2004, Oprah Winfrey fulfilled her on-air promise of visiting the Addis Ababa Fistula Hospital for an event celebrating the center's completion. Accompanied by two viewer guests, Oprah attended the unveiling of the center bearing her name and charmed the patients and distinguished visitors by wearing the Ethiopian dress given to her for the occasion. At the ceremony, Oprah quoted her grandmother, who used to say, "To whom much is given, much is expected." The generous donors who made this project possible have more than fulfilled their promise, and to them the Fistula Foundation is deeply grateful. Return to top |
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