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New Clinton Global Initiative Commitment to Action to Address Obstetric Fistula in Mali

Today at the 2014 Clinton Global Initiative (CGI) Annual Meeting, Louise Winstanly, chair of IntraHealth International’s board of directors, joined president and CEO Pape Gaye to announce a new CGI Commitment to Action to promote dignity and wellbeing among Mali’s most vulnerable women by expanding access to high-quality obstetric fistula treatment and support services.

Through this commitment, IntraHealth and its partners will work with the government and communities of Mali to offer a holistic package of services to 800 women suffering from this devastating condition across seven regions.

“Right now, fistula in Mali is often treated as a purely surgical matter,” Winstanly says. “But the surgical repair is not enough. We must take into consideration the social, psychological and economic aspects that encapsulate a holistic approach, so that women affected by fistula have an opportunity to start new and meaningful lives. That is what our commitment is about and why I am so passionate about this cause.”

Obstetric fistula is a preventable condition caused by prolonged, obstructed labor. The tissues between the baby’s head and the mother’s pelvis can become compressed, cutting off blood flow and creating an opening—called a fistula. The results are debilitating and include chronic incontinence, pain and sometimes even severe nerve damage. The infant is often stillborn.

Two million women around the world live with fistula. Up to 100,000 more develop the condition every year, according to the World Health Organization. In low-income countries such as Mali, many women do not have access to the skilled health care that can prevent fistula, and may suffer with the condition for years. They are often shunned by their communities and families.

But most fistulas—up to 90% of cases—can be repaired with a surgical procedure.

Since 2008, IntraHealth has worked with the government of Mali, local partners and the US Agency for International Development to improve access to and quality of fistula prevention and treatment services, including training 13 surgeons to perform simple repairs for 460 women between 2008 and 2013. But women with fistula need a range of services and support to reintegrate into their communities successfully, stay healthy, restore and safeguard their dignity and improve their quality of life.

IntraHealth’s CGI commitment partners include UNFPA/Mali, SamaHope, Direct Relief, Orange Mali Foundation, Inner Wheel Mali and the Peter C. Alderman Foundation. Together, we will work with Malian health authorities and communities to expand the scope and quality of health and social services for women with fistula and to address the critical need for social and economic reintegration.

The partners will expand fistula treatment and care; improve data collection about the mental, psychosocial and financial effects of fistula on women in Mali; develop a telephone support network and call-in center for peer support; and build the capacity of Mali’s health workforce to provide critical mental health and psychosocial assistance.

“Health workers are the unsung heroes of health care, and they have an enormous role to play in the lives of women with fistula,” Winstanly says. “Health workers can educate entire communities about the dangers and health consequences of young girls giving birth. They have the ability to repair fistulas, to help women through the process and to be advocates in their communities to prevent it from happening at all. And afterward, health workers can help women reintegrate into their communities and lead healthy, prosperous lives.”

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