An Interview with Kate Grant

Girls' Globe

Last week, in honor of the International Day to End Obstetric Fistula, Girls’ Globe “sat down” for an interview with CEO of Fistula Foundation, Kate Grant.



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.

Click here to read the full interview at Girls Globe.

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