I began my involvement with One By One as a volunteer five years ago after finding out about the devastating condition of obstetric fistula. One By One was founded by two passionate individuals who wanted to shine a light on this horrible, but preventable and treatable injury. We now work with partners here and in the developing world to support both treatment of women who have this condition as well as prevention efforts in order to eradicate obstetric fistula--as it was eradicated in the United States over a century ago. One By One began by supporting repair surgeries for women with fistula; now we have grown to support a more comprehensive approach toward treatment and prevention. The ability of One By One's staff and board to work collaboratively with other organizations and their attention to the real needs of our grantees gives us the opportunity to make a difference in the lives of women and girls who suffer needlessly from this condition.

Obstetric fistula is a preventable devastating childbirth injury that only happens to ladies who live so far from health care that if they have a difficult labor and can't deliver without a Ceaserean section, they stay in obstructed labor for up to a week, their baby dies and the have an injury that leaves them leaking usine and sometimes feces too. They live an aweful isolated life. It takes $300-$400 to fix a fistula. With proper access to medical care and the education to know when labor isn't going to succeed, fistula is ENTIRELY preventable. The last US fistula was 100 years ago. In Mwanza Tanzania, I met a woman survivor on a fistula ward that One by One supports who had been leaking for 11 years. I met fistula surgeons who said because of our and others' support, that these women are becoming rarer as women are learning about free fistula surgery and are coming in sooner for repair. Less than a year is now common. One by One also works in prevention of fistula. Another grantee I met was an organization of dynamic bright women who are setting up leadership groups in villages to educate and enable women,to get treatment when they need it, set up microfinancing and medical care so women can become healthier and more important in their community. I was in one of their community meetings to educate men and women about fistula. There were at least 100 people there, men, women and kids of differnt faiths and ethnic groups. A young man lead it and very easily got people to talk about fistula. It was an amazing and powerful experience. He concluded that "We must take care of our women. They get up first in the morning, and go to bed last at night. Be sure to get them to a clinic when they are to deliver." We are supporting a hard working group in Niger that has set up a networking and transportation system of Health Promoters. Their message is, among others, "The sun shouldn't set a second time on a woman in labor." In this two year project, they have managed no not have an obstructed birth ending in fistula in the last 10 months, and have increased the rate of mothers delivering in a health care facility by 70%. It is a simple and successful model we hope to replicate in other countries. We fund small local groups who are doing what it takes and in doing so, we are improving the health education of men and women and improving the health of women and their children.

Few global health problems are as directly addressed as ending the scourge of obstetic fistula by funding access to pre-natal care ( prevention) and surgical repair to restore lives. One by One addresses direct service delivery, awareness and prevention, research, and stigma. And they do well-close partnerships, accountable funding, monitoring and support, follow-up.

Obstetric fistula is a devastating and debilitating injury to women during child birth.Women are left smelling and leaking urine and/or feces uncontrollably and therefore end up as outcasts of society. One By One have been terrific donors for our program which offers free surgical care. Women are often unable to access the financial help that allows them to seek services on their own. Through the generous help of One by One, we have been able to continue to offer free care. One by One listens to the needs of those of us in the field and responds. This is a gift as so often we as recipients of donor funds are told how we must spend the money given. One by One asks us what we need and how they can help. We needed an operating table to be able to continue to do surgery as the old one was completely in pieces. We got it! When we ask for basic surgical and patient supplies we are listened to. Donors often "tire" of continuing to give for services and yet that is truly the need here as we still have a back log of cases in the country as well as "fresh" cases happening due to poor maternal services. We need to be working on both fronts-preventative as well as curative. It is not either/or, it is both. I think that with One by One we can work even harder to address both of these paths. One by One has been generous with their networking and supportive of our women in need.