United in Prevention


This is a personal From the Field story by Direct Relief Staff, Lindsey Pollaczek.

Today is the final day of the International Society of Obstetric Fistula Surgeons (ISOFS) meeting in Dakar, Senegal. It has been an incredibly busy few days as fistula surgeons and health professionals have come together to share diverse experiences, research findings, and recommendations for improving quality of treatment, management, and prevention of obstetric fistula. Representatives from more than 40 countries are participating in the conference, all sharing the common goal of working to improve fistula care and a vision for eradication of this preventable condition due to failures in maternal health care.

Representing Direct Relief, I have had the unique opportunity to engage with many of the preeminent fistula surgeons in the world. Many of the pioneers in the field are here, surgeons who have dedicated their careers to treating women with fistula, training other surgeons, and spearheading research to improve the outcomes for fistula care. Many more youthful faces from the next generation are here—motivated, committed, primarily African surgeons from all parts of the continent have come to learn from each other and improve their expertise in a region where the burden of obstetric fistula is highest.

The surgeons provide an essential service for helping restore the dignity of women living with obstetric fistula. Also present are advocates, community organizers, and public health professionals who are addressing the important areas of prevention of fistula through improved obstetric care and also social reintegration of women back into their communities after their physical wound has been healed. This community recognizes that it is simply not enough to surgically repair the fistula and send a woman on her way after she has lived often for many years with a highly stigmatizing and socially humiliating condition. The conference theme acknowledges the increased effort which must be made not only to treat the physical condition but to ensure that women can return to normal, healthy lives in their community.

A great deal of good work is being done by many organizations across Africa and Asia to address obstetric fistula. A shared understanding of exactly where these services are located and the current capacity for treatment remains elusive. Direct Relief is working together with ISOFS and the Fistula Foundation to help illuminate this information in a way that is accessible to all stakeholders.  Using our experience in GIS (geographic information systems) technology, Direct Relief hopes to help create powerful tool for everyone in the fistula care community—to understand the current landscape for treatment, help identify unmet need, and provide a tool to guide decisions on future resource and service allocation.

Direct Relief is currently providing surgical supplies to support fistula-repair programs in seven hospitals across Africa, many of which are represented here.  It is clear through the level of engagement at this conference – and by the preliminary results of the fistula treatment mapping – that there are many more facilities where surgical supplies are needed. Working together with healthcare companies like Johnson & Johnson, Ethicon, Covidien, and CR Bard, Direct Relief hopes to support more surgeons so they have the supplies they need to do this valuable work.

This gathering has reassured my confidence in Direct Relief’s decision in making fistula care and prevention a central part of its maternal health strategy over the next five years. There is a lot of good momentum and energy here at this conference. We all agree that a lot remains to be done.

Now off to the closing ceremony and to the work ahead!

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