What is Obstetric Fistula?

"The Moral Challenge of this Century"

“[Fistula] Victims are the lepers of the 21st century, and although the condition is almost entirely preventable, it is suffered by hundreds of thousands of women worldwide….. They’re the same group that is routinely denied education, denied the right to own property, denied jobs and denied any recourse after being battered, raped or married against their will.”

The World’s Modern-Day Lepers: Women With Fistulas By: Nicholas Kristof, New York Times, March 19,2016

Imagine a world in which a woman endures a long and painful labor only to wake up to the horror of incontinence, or worse – the double sorrow of also losing her baby. Each year, this is a reality for 3,500 women living in rural Ethiopia. This reality has a name: Obstetric Fistula. Obstetric fistula is a physical, social, and economic injury. A woman with obstetric fistula is often abandoned by her husband, ostracized by her family and village, and left to live the rest of her life alone and ashamed.

Fistula Facts

  • Only 10% of women in Ethiopia give birth with skilled assistance (WHO)
  • 80% of women who develop fistula lose their babies during the traumatic childbirth
  • 70% of women who develop fistula are divorced by their husbands



  • Fistula develops (not always immediately)
  • Baby is stillborn (95% of cases)
  • Leaks urine and/or feces
  • Smells chronically
  • Severe nerve damage can affect ability to walk
  • Skin infection from urine burn


  • Ostracized in her community
  • Abandonment (husband and own family)
  • Deepening poverty and deprivation
  • Education/Employment prospects grim
  • Often begging or very low paid work
  • High risk of depression and suicide

Why Obstetric Fistula?

While women with obstetric fistula can be healed physically through a network of designated fistula hospitals, her complex emotional, spiritual, psychological, and economic needs requires a different treatment.

There is increasing recognition for the need to integrate prevention and treatment strategies for obstetric fistula alongside rehabilitation and social reintegration programs. In fact, according to the United Nations Population Fund (UNFPA), the core components of these programs include education, counseling, life skills training, and support services that help women reconnect with their families and become economically self-sufficient (UNFPA and EngenderHealth 2003).

Healing Hands of Joy exists to fill this critical gap by giving former fistula patients a second chance through its two-week Safe Motherhood Ambassador training and rehabilitation program. As a Safe Motherhood Ambassador, a woman has the opportunity to improve the maternal health prospects of her village, save lives, and protect futures incidents. The Safe Motherhood Ambassadors are also empowered economically with income-generating skills training and a micro-loan to start her own business.


To see new cases of obstetric fistula radically reduced in Ethiopia by 2020 with the goal of elimination and to see fistula survivors empowered and successfully reintegrate as self-contributors to their communities and educators in safe delivery.