New Fistula Treatment and Prevention Project Will Expand Access to Care in Mali

A new $8 million project will expand access to high-quality treatment and prevention services for obstetric fistula in Mali. IntraHealth International’s Capacity Building for Fistula Treatment and Prevention in Mali Project, which launches June 19 in Sikasso, focuses on making fistula repair services routinely available within health facilities and building the capacity of health workers to prevent, diagnose, and treat the condition effectively. 

Obstetric fistula is a childbirth injury that can occur during obstructed or prolonged labor when the tissues between the baby’s head and the mother’s pelvis become compressed. This cuts off blood flow to her bladder and rectum. Within three to 10 days, the tissue sometimes dies and creates an opening—called a fistula—between the vagina and bladder and/or rectum. The result can be chronic incontinence, and sometimes even severe nerve damage.

In Mali, a combination of high fertility, low use of modern contraceptive methods, early marriage, and low rates of facility births puts up to 2,400 women at high risk of fistula each year.

Many of these women do not know the condition can be treated. And even if they did, the health services they need are not readily available. Fistula repair surgeries in Mali are only available routinely in the capital city of Bamako.

Women living with the condition are often shamed and isolated, and many live in poverty.

IntraHealth is partnering with three local groups through the project: Women Action Research, Study, and Training Group (GREFFA), the International Association for Maternal and Neonatal Health in Mali (IAMANEH Mali), and the Medical Alliance against Malaria (AMCP). Together, we will work within Malian communities to reduce stigma, increase community knowledge, recruit and transport clients for fistula repair campaigns, and provide clients with psychosocial support.

The project will also increase the number of surgeons in Mali who can perform fistula repair surgeries, conduct fistula campaigns in each region, and prepare selected health facilities to offer services on a routine basis.

During 2008-2013, under the USAID-funded Fistula Care Project, IntraHealth trained 13 surgeons to perform simple repairs and provided 460 women with fistula repair surgeries. This new project will build on those successes.

Former project coordinator for the Fistula Care Project, Demba Traoré, will lead the project from IntraHealth’s office in Bamako. Traore is a medical doctor and public health specialist with over 13 years of clinical experience in reducing maternal, newborn, and child morbidity and mortality in Mali.

The Capacity Building for Fistula Treatment and Prevention in Mali Project is funded by the US Agency for International Development and will focus on the regions of Gao, Kayes, Sikasso, Koulikoro, and Bamako.