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Action on Fistula is a program led by the Fistula Foundation and supported by an affiliate of Astellas Pharma Inc., Astellas Pharma Europe Ltd. At its launch in 2014, the program aimed at changing the lives of more than 1,200 Kenyan women living with obstetric fistula and arming the country against the disease by training doctors to perform the required surgery. In May 2017, Astellas supported the foundation as it launched the second phase of Action on Fistula program, with the goal of treating 4,500 Kenyan women by 2020.

Obstetric fistula is an orifice formed between the vagina and the rectum or bladder, which induces incontinence. It occurs after a difficult delivery that lasted several days and was not followed by the necessary emergency care. Untreated fistulas can lead to chronic conditions, including ulceration, kidney disease and nerve damage in the legs. Incontinence that affects women with fistula can lead to their marginalization. It is common for their husbands and families to abandon them. These women sometimes find themselves in destitution. According to the United Nations Population Fund, it is estimated that 3,000 new cases of obstetric fistula are recorded in Kenya every year.

With the support of Astellas, the foundation has been able to establish a fistula management network, increase the number of qualified surgeons to treat fistula, dramatically increase the number of interventions performed in Kenya and set up a major program of identification and support for the care of women with the disease. The program has far exceeded its original goals by doubling the number of women treated. By September 2017, 2,800 women had benefited from life-saving reconstructive surgery. One of these women had to wait to be 51 years old before the operation.

Action on Fistula is the main intervention of Access Accelerated, a program supported by Astellas Pharma Inc. which involves collaboration between the various players of the sector in order to improve the management of non communicable diseases.

Current results of the program Action on Fistula (June 2014 – September 2017)

Patients who have benefited from
reconstructive surgery


Training and certification of doctors according to the competence level defined by FIGO*

6 surgeons authorized to treat fistulas, net increase in surgical capacity in Kenya

Fistula management network centers

6 centers participating in the program and performing regular fistula reconstructive surgery

Training center for the management of fistula accredited by FIGO

Opening of Gynocare Women's and Fistula Hospital, a hospital dedicated to gynecologic and fistula care in Kenya

Awareness program

Development of a large scale awareness program aimed at the identification and care of affected women

Counties** of Kenya covered

42 counties

Workers trained for the purpose of awareness operations within the community

264 workers

Awareness activities conducted

8,500 activities

Community members who have become aware of issues related to fistula

518,300 persons

*FIGO (Fédération Internationale des Gynécologues et Obstétriciens-International Federation of Gynecology and Obstetrics)
**Kenya is divided in 47 counties. Each county has several sub-units of governance: sub-counties, districts and villages.