Action on Fistula is led by the Fistula Foundation (“Foundation”) and supported by a grant from an affiliate of Astellas Pharma Inc., Astellas Pharma Europe Ltd. First launched in 2014, the initiative aimed to transform the lives of more than 1,200 women in Kenya living with obstetric fistula and build capacity in the country by training doctors who can perform surgeries. In May 2017, Astellas pledged its support to the Foundation as the second phase of Action on Fistula launched with an ambitious target to treat 4,500 women with obstetric fistula in Kenya by 2020.

An obstetric fistula is a hole between the vagina and rectum or bladder, causing incontinence. It is caused by prolonged obstructed hard labor which lasts for several days, when emergency care is unavailable. Untreated, fistulas can lead to chronic medical problems including ulcerations, kidney diseases and nerve damage in the legs. Because of incontinence, women with fistula can be socially marginalized. They are often abandoned by husbands and family. As a result, fistulas can cause poverty in some cases. The United Nations Population Fund estimates 3,000 new cases of obstetric fistulas occur annually in Kenya.

Through Astellas’ support, the Foundation has established a fistula treatment network, increased the number of fistula surgeons, significantly boosted the number of surgeries that take place in Kenya and built a major outreach program to identify and bring in women for treatment. The program far exceeded its initial goals and has transformed the lives of more than double the number of women it set out to treat. As of September 2017, the program had successfully treated 2,800 women with life-changing reconstructive surgery. One woman treated had waited 51 years for surgery.


Click here to watch the program in action.
Action on Fistula is a flagship program of Access Accelerated, a multi-stakeholder collaboration focused on improving non-communicable disease care supported by Astellas Pharma Inc.

Progress on Action on Fistula Program (May 2014-March 2018)

Patients successfully treated with
reconstructive surgery
Trained and certified doctors to the Standard Level of Competency set forth by FIGO* 6 Kenyan doctors
Centers in Fistula Treatment Network 6 centers
FIGO-accredited fistula training center Established Gynocare Women’s and Fistula Hospital in Eldoret, Kenya
Outreach Program Built a major outreach program to identify and bring women in for treatment
Reached counties** of Kenya 45 counties
Trained Community Outreach Workers 295 outreach workers
Conducted outreach activities 10,093 activities
Reached community members with fistula messages 845,578 community members

*FIGO (the International Federation of Gynecology and Obstetrics)
**Kenya is divided into 47 counties. There are several units of governance below the county level.
These units include sub-counties, wards and villages.