Maternal Health

FIGO and Direct Relief Join to Expand, Improve Obstetric Fistula Repair Surgery

Global standard for surgery training complemented by standard module of essential surgical supplies

The International Federation of Gynecology and Obstetrics (FIGO) and Direct Relief have signed an agreement in Washington D.C. to expand and enhance the care provided to women receiving surgical repair for obstetric fistula, a devastating birth injury that occurs overwhelmingly in developing countries and typically leaves women socially ostracized and destitute in addition to physically injured.

FIGO, the standard-setting body for obstetric and gynecological care internationally, has developed a Global Competency-Based Fistula Surgery Training Manual to ensure quality of care for the repair of obstetric fistula.  Direct Relief, a nonprofit organization that is among the world’s largest providers of humanitarian medical material aid, has developed a complementary module of essential surgical supplies that are required to perform repair surgeries to the highest standards, consistent with the FIGO-identified competencies.

Obstetric fistula is a serious and debilitating childbirth injury primarily caused by prolonged and obstructed labor. In most cases of obstructed labor in which a fistula develops, the baby is stillborn. If untreated, a woman with obstetric fistula often will be left incontinent, stigmatized, and isolated as a result.  It is estimated that more than one million women across the globe are currently living with fistula, and this condition can be treated and often cured through what is often a simple surgical procedure.

However, in areas where obstetric fistula is most prevalent, women with the debilitating condition lack access to life-changing surgical care. Limited surgical capacity generally, even more limited specialized surgical training on fistula repair, and the costs of surgical supplies needed for the procedures are key factors that prevent access.

Fistula Repair Surgery 3Direct Relief’s Fistula Repair Module, which contains a standardized set of high-quality medicines and surgical supplies, is the product of a multi-year collaboration between Direct Relief and an extensive network of fistula surgeons, nurses, physiotherapists, infectious disease specialists, fistula advocacy and funding organizations, other experienced medical professionals, and healthcare companies.

Sized to equip 50 fistula repair surgeries, each module contains medications such as antibiotics, analgesics, drugs for anesthesia, and marker dye; surgical supplies such as gloves, sutures, instruments, and catheters; nursing supplies including gauze, IV catheters, and surgical tape; and basic diagnostic equipment such as thermometers and blood pressure kits.

The Modules, valued at $5,000 or roughly $100 per surgical procedure, are delivered free-of-charge to approved members of Direct Relief’s Fistula Repair Provider Network, which now encompasses 55 healthcare institutions in 23 countries.  Several products included in the Module are donated by healthcare companies, including Ansell (surgical gloves), BD (needles and syringes), Bard (catheters), Johnson & Johnson companies Ethicon (sutures) and Janssen (bladder control medications), and Merck (bladder medication), as well as donations of consumer health products requested by fistula surgeons, such as Vaseline from Unilever.

Direct Relief has been supporting healthcare facilities with donations of essential medical supplies to help enable fistula repair surgeries since 2003, and each year the program has continued to expand and extend its reach.  Also, in partnership with the Fistula Foundation and UNFPA, Direct Relief publishes and maintains the Global Fistula Map to aggregate and visualize information regarding obstetric fistula incidence, research, and surgical repair activities.

Global Fistula Map

In 2015, Direct Relief delivered 60 modules – enough to enable 3,000 life-restoring surgeries for women in need – to facilities in sub-Saharan Africa and South Asia.

In 2016, Direct Relief will be providing enough modules for over 5,000 surgeries.

About FIGO:

Established in 1954 in Geneva, Switzerland, FIGO was founded to bring professional obstetrical and gynecological associations from all over the world together to improve women’s health and rights and to reduce disparities in healthcare services available to women and newborns, as well as to advance the science and practice of obstetrics and gynecology. For more than 60 years, the organization has pursued its mission through advocacy, programmatic activities, capacity strengthening of member associations, education, and training. Now based in London, FIGO currently has members associations in 130 countries and territories across the globe.

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