Fistula Foundation

Results: Fistula Foundation is the global leader in obstetric fistula treatment. Since 2009, we have provided more than 100,000 surgeries to women in more than 35 countries across sub-Saharan Africa and Asia by funding more than 150 hospital partners and community organizations. In addition to partnering with local community organizations, hospitals, and surgical teams to identify and treat women with fistula, we also build countrywide treatment networks—called Fistula Foundation Treatment Networks (FFTNs)—that work through our partners to integrate outreach, training, treatment, and reintegration services. We design these networks with the goal of connecting all women in all parts of a country with timely, high-quality care. We launched the first FFTN in Kenya (2014) and additional treatment networks in Zambia (2017) the Democratic Republic of Congo (2022), and Tanzania (2023).

Peer-reviewed research, published in 2022, revealed several key results from the first six years of our treatment network in Kenya.

1) Extensive reach. Women from all 47 counties of Kenya were referred by outreach partners for treatment at FFTN partner hospitals.

2) High-quality care. For women who received treatment, the majority of procedures (91%) resulted in an outcome of “fistula closed and woman continent at discharge.”

3) Quality-of-life improvement. More than 85% of women treated by FFTN partners reported being able to fully socialize, work, and function normally one year after surgery—compared with 18% who reported normal functioning before surgery.

One of the most striking achievements of our network in Kenya involves wait times for treatment. Among women treated by our partners in Kenya, the average time that they had lived with fistula before being healed dropped from 9.3 years in 2014 to 5.6 years in 2021—a 40% decrease. In less than a decade, FFTN in Kenya provided more than 10,000 surgeries to women in need.

When a woman with fistula receives treatment, the effects of her restored health on both her family and her community are profound. Since fistula typically affects women who are in their twenties, a successful repair surgery will provide them with an average of 37 years of healthy, productive life. By our projection, surgeries provided by our partners since 2009 will yield an estimated 2.1 million years of restored continence.

We run a lean operation maximizing funds sent to the field because that’s where lives are changed. Today, more than 85% of our revenue goes to support the work of our partners in Africa and Asia. Each year since 2006, Fistula Foundation has earned an “exceptional” four-star rating from Charity Navigator. We are also recommended by The Life You Can Save—an organization that follows the principles of renowned ethicist Peter Singer.

Target demographics: Obstetric fistula is a childbirth injury that occurs when a woman has a prolonged, obstructed labor but is unable to access emergency obstetric care. As a result, the woman can develop a fistula—a hole between her vagina and her bladder or rectum. If left untreated, the fistula will cause her to leak urine, stool, or both for the rest of her life. All too often, she will be shunned by her friends, her family, and her community. Worldwide, at least one million women suffer from obstetric fistula. The condition affects some of the most vulnerable people in the world—poor women, usually living in rural regions of Africa and Asia. The prevalence of fistula reflects two deep-seated global problems: extreme poverty and gender inequality.

Direct beneficiaries per year: In 2024, we provided 16,587 life-transforming surgeries to women in need. In 2025, we aim to provide more than 17,500 surgeries to women in 32 countries. Since 2009, we’ve increased our annual surgery count by a factor of more than 20—a rate that is three times faster than our growth in annual revenue. To maximize the number of women we can help, we also fund activities that remove obstacles to treatment—including providing certified training for fistula surgeons, enabling grassroots outreach and education in rural communities, and equipping hospitals so that they can provide the type of specialized care that fistula patients need.

Geographic areas served: Since 2009, we have provided more than 100,000 surgeries to women in more than 35 countries across sub-Saharan Africa and Asia by funding more than 150 hospital partners and community organizations. We have also built countrywide treatment networks in four countries (Kenya, Zambia, the Democratic Republic of Congo, and Tanzania).

Programs: We focus on one measurable outcome: the number of life-transforming surgeries that we provide to women who need healing. We partner directly with established, in-country hospitals and with teams of providers who understand how best to serve women in their communities. In addition to paying the direct costs of fistula repair surgery, we strengthen the efforts of local experts, equip hospitals to provide high-quality fistula care, and use grassroots community outreach initiatives to find women in need of treatment and refer them to our partner hospitals. Our goal is to work in true partnership with hospitals to help build the human and physical infrastructure for expanding fistula care at each facility that we support.