Why Do We Work in Madagascar?

The fourth largest island on Earth, Madagascar is home to some of the most diverse plant and animal life in the world. But despite its lush environment and resources, the population of Madagascar faces extreme poverty — 2/3 of the population lives below the national poverty line. And in a country of almost 23 million people, the limited numbers of health care facilities and doctors are insufficient to meet the need for maternal health care.

Over 2% of women will die in childbirth during their lifetime in Madagascar as a result of inadequate maternal health care. There is also a high rate of teenage pregnancy — almost one-third of girls are teenage mothers. When these factors are combined with the prevalence of grinding poverty, it is likely that obstetric fistula is a serious issue in Madagascar.

What You Help Us Do in Madagascar

We’re helping fund:

  • Fistula surgeries
  • Surgeon training
  • Community outreach


Hopitaly Vaovao Mahafaly, Mandritsara
CHRR, Sambava
Fondation Médicale, Ampasimanjeva
CHD2, Morondava
CHD2, Mahajanga
Sampan’Asa Loterana momba ny Fahasalamana (SALFA)

How much funding have we granted?

$99,500 in FY2012 (divided between projects in Madagascar, Malawi and Mauritania)

Hopitaly Vaovao Mahafaly

$6,500 in FY2016


$50,000 in FY2016

Freedom from Fistula

$179,473 in FY2016

Who is our partner?

In the past, we provided grant support to several hospitals through Operation Fistula. We currently provide grant support directly to SALFA.

How will this help women in Madagascar?

Through our partner Operation Fistula, a two-week fistula clinic was organized in August 2013 with funding from Fistula Foundation. The clinic was held in Southeastern Madagascar, as this is an area known to have a high prevalence of fistula based on a survey conducted by UNFPA. It included operations from both local and internationally renowned fistula surgeons, the former of which continued to provide obstetric fistula repair surgery throughout the year at their own hospitals under this grant.

Sampan’Asa Loterana momba ny Fahasalamana (SALFA) is the Health Department of the Malagasy Lutheran Church. Coordinating the activities of 10 hospitals, nearly 20 urban dispensaries, and 15 rural health clinics, they cover 21 out of 22 regions of the island, one of the most geographically challenging countries on Earth. With several qualified fistula surgeons, SALFA has been successfully providing some fistula surgeries over the last two years. And with funding from Fistula Foundation, they aim to treat 100 women over the next year. Fistula Foundation sponsors community outreach, fistula surgeries, follow-up, and rehabilitation.

Where is Madagascar?


Facts About Madagascar

  • Population:24,430,325
  • Average births per woman:4.12
  • Physicians per 10,000 people:1.6
  • Births attended by skilled personnel:44.3%
  • Lifetime risk of maternal death:1 in 60(chances a woman will die during childbirth)
  • Female life expectancy:66.67 years
  • Female literacy:62.6%
  • Population living in rural areas:64.8%
  • Population living in poverty:75.3%(less than $1.25/day)
  • Surgeries completed through Fistula Foundation funding to date:168

Sources: CIA World Factbook; WHO; World Bank

We’re Making a Difference in Madagascar


Meet Felana from Madagascar

At the tender age of 15, Felana became pregnant. She suffered a prolonged obstructed labor, and by the time her stillborn baby was delivered, she had developed obstetric fistula.

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