Why are women still suffering?

Fistula repair surgery originated in the late 19th century. Yet at least one million women today suffer for want of a surgery that can transform their lives.

Barriers to Treatment

Women suffering with untreated fistula or severe perineal tears are some of the world’s most vulnerable individuals.

Living primarily in rural areas of Africa and Asia, they endure the burden of debilitating injuries on top of crushing poverty and gender inequality. There are three main barriers that prevent them from accessing the care they need:

Stigma and lack of awareness

Women with untreated fistula and tears often live in rural communities in Africa and Asia. Some may not even be aware that they are suffering from a known, treatable condition—they simply believe that they are cursed. Too often, they are ridiculed by their neighbors and cast out of their families because of their smell. Many hide themselves in shame.

Community education and outreach are vital to finding and treating the vast backlog of women suffering with fistula and untreated tears.


Poverty is another important barrier to treatment. The cost of fistula surgery and rehabilitation is out of reach for nearly all fistula patients with fistula and severe tears.

What’s more, too few hospitals in Africa and Asia offer repair surgery, which means most women must travel long distances for help, adding to the total cost of care. Public transportation can be challenging for a woman with fistula or a severe tear, because of her incontinence and odor.

Inadequate healthcare systems

A lack of adequately trained surgeons has long been a barrier to scaling up treatment for injuries like fistula and severe perineal tears. Repair surgeries are difficult to perform, and require special training. There are simply not enough surgeons to meet the need. Moreover, many women live in countries where it is not culturally acceptable to be treated by male physicians, and female surgeons are scarce.

Compounding this shortage of surgeons, many hospitals lack adequate capacity to keep up with the volume of patients needing care.

Those suffering fistulas are completely voiceless – young, female, poor, rural, and ostracized. They are the 21st century’s lepers.
Nicholas D. Kristof Journalist, The New York Times

Fistula Foundation works to end the suffering caused by obstetric fistula because we believe no woman should endure a life of misery, simply for trying to bring a child into the world.

What We Do

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