Action on Fistula

ACTION ON FISTULA™ was conceived, built and is run by the Fistula Foundation. The six-year programme started in 2014 by a grant given to the Fistula Foundation from an affiliate of Astellas, Astellas Pharma Europe Ltd. By 2020, the programme aimed to help 4,500 patients to access fistula treatment. In total, since 2014, 6,223*1 surgeries have been carried out at 7 hospitals, transforming the lives of women in Kenya who are suffering with obstetric fistula*2

Through continued efforts contributing towards ending obstetric fistula, Fistula Foundation’s ACTION ON FISTULA carried out interventions in Kenya via the organisation’s outreach and treatment partners. From inception to at the end of the programme, 11 surgeons have been trained at Gynocare Women’s and Fistula Hospital, expanding to include surgeons beyond Kenya to build capacity across sub-Saharan Africa and Southeast Asia. A total of 19 nurses have also been trained at this facility. 

In April 2019, the number of programme outreach partners increased to five. These community outreach teams are critical to the success of the programme and, to date, almost 2 million community members were reached with fistula messages through outreach activities. This Community Mobilisation Programme trains Community Health Volunteers, sensitises local and traditional leaders, and utilises radio and media programmes to raise awareness of fistula and help identify and refer women with fistula for treatment. 

In addition, ACTION ON FISTULA helped fistula patients who have undergone treatment with psychological support, and economic empowerment opportunities so that they can return to their communities. To this end, the programme established 22 support groups to reach and assist survivors.

ACTION ON FISTULA has been externally recognised for its contribution to Access to Health. In 2015 it was highly commended at the PMLiVE Awards, in 2017 it won 'Excellence in CSR' and in 2021 it won 'The Langland Award for Excellence in Healthcare Partnerships' at the Communiqué Awards.

*1 At the end of the programme
*2 An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour when emergency care is unavailable, causing faecal and/or urinary incontinence. Although it has been virtually eradicated in developed countries, the UNFPA estimates 3,000 new cases of obstetric fistula occur annually in Kenya. Women with obstetric fistula are often subject to severe social stigma due to odour, which is constant and humiliating, often driving the patients’ family, friends and neighbours away. Stigmatised, these women are also often denied access to education and employment and live in isolation and poverty.

A fistula survivor participating in Beyond Fistula

A fistula survivor participating in Beyond Fistula, a skills-building and empowerment programme offered to patients waiting for or recovering from surgery at the Gynocare Women’s & Fistula Hospital in Eldoret, Kenya.
Photography: ©Georgina Goodwin

A patient listening to an advocate who is addressing patients

A patient listening to an advocate who is addressing patients at the Gynocare Women’s and Fistula Hospital in Kenya.

Progress in ACTION ON FISTULA™(May 2014 – at the end of the programme)

Patients successfully treated with reconstructive surgery 6,223 surgeries
Surgeons trained at Gynocare Women’s and Fistula Hospital (expanding to include surgeons beyond Kenya to build capacity across sub-Saharan Africa and Southeast Asia) 11 surgeons
Hospitals in the Fistula Treatment Network (new)  7 hospitals
FIGO*1-accredited fistula training center Established Gynocare Women’s and Fistula Hospital in Eldoret, Kenya
Kenyan counties*2 reached 47 counties
Trained community outreach workers 424 outreach workers
Conducted outreach activities 20,050 activities
Community members reached with fistula messages 1,964,452 community members


*1 FIGO: International Federation of Gynecology and Obstetrics
*2 47 counties have been established in Kenya, which are in charge of local governments. Under counties, the following divisions have been established: sub-counties, wards and villages.