ACTION ON FISTULA™ was conceived, built and is run by the Fistula Foundation. It was started in 2014 by a grant given to the Fistula Foundation from an affiliate of Astellas, Astellas Pharma Europe Ltd. By 2020, ACTION ON FISTULA™ aimed to help more than 4,500 patients in total to access fistula treatment. Since 2014, 4,738*1 surgeries have been carried out, transforming the lives of women in Kenya who are suffering with obstetric fistula*2. The Fistula Foundation and Astellas jointly funded the first phase of the program, which ran from 2014 to 2017.Astellas provided funding of €1.5 million (approximately 50% of the total) and the remaining was provided by the Fistula Foundation. In this phase, the program improved the lives of patients with obstetric fistula while simultaneously training doctors who would be able to provide surgical treatment in Kenya. The program also set up the Fistula Treatment Network to extend access to services, with 6 hospitals enrolled and providing fistula surgeries on a routine basis.

The second phase of ACTION ON FISTULA™ is scheduled to run from 2017 to 2020. Astellas has committed to continue supporting the Fistula Foundation for this phase. Astellas is funding €0.75 million (approximately 25% of the total) and the remaining was funded by the Fistula Foundation. In the second phase of the program, ACTION ON FISTULA™ aims to build capacity to deliver ongoing treatment and provide surgeries to even more patients with obstetric fistula.

Specifically, the program aims to increase the number of hospitals enrolled in the Fistula Treatment Network to 8 hospitals, train an additional 6 surgeons specializing in fistula, and train an additional 10 fistula nurses. In addition, ACTION ON FISTULA™ wants to help fistula patients who have undergone treatment with emotional assistance, economic empowerment and employment support so that they can return to their communities. To this end, the program plans to establish 20 support groups that will be enrolled in the Fistula Treatment Network.

*1 As of 31st March 2019
*2 An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labor when emergency care is unavailable, causing fecal 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 odor, which is constant and humiliating,
often driving the patients’ family, friends and neighbors away. Stigmatized, these women are also often denied access to education and employment and live in isolation and poverty.

A fistula survivor and advocate addresses patients

A fistula survivor and advocate addresses patients at the Gynocare Women’s and Fistula Hospital in Kenya.

Fistula survivors participating in Beyond Fistula

Fistula survivors participating in Beyond Fistula, a skills building and empowerment program offered to patients waiting for or recovering from surgery at the Gynocare Women’s & Fistula Hospital in Eldoret, Kenya.

Progress in ACTION ON FISTULA™(May 2014 – 31st March 2019)

Patients successfully treated with reconstructive surgery 4,738 patients
Trained and certified doctors to the standard level of competency 9 Kenyan doctors
Centers in the Fistula Treatment Network 6 centers
FIGO-accredited fistula training center Established Gynocare Women’s and Fistula Hospital in Eldoret, Kenya
Kenyan counties reached 47 counties
Trained community outreach workers 350 outreach workers
Conducted outreach activities 14,677 activities
Community members reached with fistula messages 1,303,257 community members