Obstetric fistula happens most frequently in rural areas, where emergency medical care is not easily accessible. A woman’s risk of developing fistula is also exacerbated by cultural misunderstanding about doctors and surgery. Madagascar faces both of these challenges: its infrastructure is poor, which can make travel to the hospital complicated and dangerous. Also, there is…

Meet Momakely
When it came time to deliver her baby, Momakely made her way to a health facility a great distance away from her home. But her labor was prolonged and difficult, and her baby did not survive. Momakely was left with an obstetric fistula for five years, until she learned about free fistula services offered by SALFA.
Momakely's Story
Momakely lives in a remote area of Madagascar. Her home is a great distance from the city of Morondava, but that was the closest large town to her home, so when it came time to deliver her child she dutifully made her way to a health facility there. But her labor was prolonged and difficult. Her baby did not survive, and Momakely was left with an obstetric fistula.
For five years, Momakely suffered with fistula. The smell of her incontinence kept her from interacting as frequently with others, and from enjoying the activities she used to enjoy. Her husband remained by her side, however, and his support was a great source of comfort.
Then one day she learned about free fistula services offered by SALFA in Morondava, and Momakely and her husband decided to set out for the hospital to seek care. Friends and family were concerned. They believed cultural myths that surgeons were “organ removers” and feared Momakely would die at their hands.
In August 2016 she was greeted warmly at the hospital where she would be healed. Her surgery was performed under spinal anesthesia, which allowed her to be conscious through the entire procedure. She watched as the surgeons healed her fistula. When they told her she was healed, she was overjoyed.
Momakely vowed to help other women with fistula access the free treatment she had just received. As she prepared to return home, she told hospital staff, “I will tell others because my eyes have seen. I will inform other women and tell them to come to SALFA Morondava.” Her husband vowed to do the same, to tell the truth to those who wrongly believed that surgeons would not help.
And then they left the hospital, happy to close this difficult chapter of their lives and start anew.
About Madagascar
- Population: 24,430,325
- Average Births per Woman: 4.12
- Female Literacy: 62.6%
- Population Living in Poverty: 75.3% (less than $1.25/day)