Partnership Launched to Fight Fistula in Pakistan

As the New Year begins, Direct Relief is excited to announce a program that aims to increase the availability of obstetric fistula treatment and help prevent the occurrence of this devastating childbirth injury in Pakistan.

Obstetric fistula is a hole in the birth canal caused by prolonged and obstructed labor without prompt medical intervention. Fistula affects impoverished women in remote areas, far from medical care, and causes chronic incontinence that can lead to severe medical problems and social ostracization.

According to the Pakistan National Forum on Women’s Health, roughly 4,000-5,000 new cases of fistula occur annually in Pakistan. The current capacity to treat women with fistula in Pakistan remains at about 400-500 women per year.

The End Fistula Challenge Program is a partnership between Direct Relief, Janum Network, Abu Zafar Institute of Medical Sciences (AZIMS), and the Fistula Foundation. The program will focus on expanding treatment to five hospitals in high-risk districts in the remote areas of Pakistan with the goal of providing life-restoring fistula repair surgery for 400 women over the next 12 months.

Considering that approximately 400 women received fistula repair in Pakistan in 2011, this program will double the number of women in the country receiving treatment this year. This program will also address the financial constraints, lack of skilled human resources, and low awareness of treatment availability that impede access to fistula treatment.

The program will improve awareness of obstetric fistula in remote areas and enroll more women in treatment by training 200 health workers. The newly trained health workers will work with members of their community to increase knowledge of treatment availability and prevention activities.

The program will provide training in fistula management and ensure that the selected centers have personnel trained in fistula care. Capacity building efforts will also focus on fistula prevention through training of midwives, doctors, and gynecologists. Such efforts will help improve emergency obstetric and newborn care and early detection of obstructed labor, ultimately reducing the incidence of this condition.

To help women become productive members of their communities once again, rehabilitation of women following fistula repair surgery will be another important component of the program. Women will receive health education sessions and vocational skill development training after they have healed from their fistula surgery.

Direct Relief is thrilled to start 2013 with the initiation of such an important partnership that will do so much to transform the lives of women living with obstetric fistula and help prevent needless suffering through critical prevention efforts.

  1. Wish a huge success to the partnership. Fortunately when “Pakistan National Forum on Women’s Health (PNFOWH) was established in 1997, I was UNICEF’s lead consultant to facilitate the effort. Currently I work as independent public health consultant.

  2. Dear Fouzia,
    Thanks very much for your message and for your contributions in helping to establish the Pakistan National Forum on Women’s Health. We are very excited about this partnership which will significantly improve fistula care and prevention services in Pakistan.

  3. Dear Lindsey,

    The following link has a mention of PNFOWH in our report on HSS in Sindh Province Pakistan

  4. Hi ,Many many thanks for sharing the information and links it will be more helpful for me to work on obs: fistula in pakistan. Fouzia Rehman how i contact with you if i need your help ? is this possible ?

  5. Please send an email to with your inquiry.

  6. Dear Ms. Pollaczek
    We are performing Fistula Surgeries in our hospital in Pakistan on patients from Northern and peripheral areas of Punjab. How can your organization help?
    Dr. Riffat Najeeb
    FRCOG (London)
    Associate Professor

  7. Dear Dr. Riffat,

    I am consultant to a charity in UK. My client wants to work on Fistula surgeries and are in the middle to do some research. We are looking for partnership in Pakistan. Kindly send me response on by highlighting your work on it along with geographical coverage.