Prevention Stories of Hope
Hope Multiplied
Against a backdrop of Nepal’s beautiful lakes and national parks, facilitators with the Fistula Outreach Project elevate community understanding about obstetric fistula. The Project, a partnership between two Surkhet hospitals and the International Nepal Fellowship (INF), aims to both prevent obstetric fistula and identify new cases within communities throughout Nepal. Working toward the global goal of eliminating obstetric fistula by the year 2030, outreach facilitators travel to remote and underserved regions, some of which have no road access and can only be reached by boat or plane.
Female Community Health Volunteers (FCHVs) are the primary focus of the fistula outreach initiative. FCHVs constitute the foundational pillar of Nepal’s healthcare system, playing a pivotal role at the grassroots level. Their contributions are extensive and include distributing family planning resources and offering guidance about safe birth practices and antenatal check-ups to expectant mothers. In one year, the Fistula Outreach Project reached over 1,000 FCVHs, who have already begun sharing their knowledge with the women they serve.
Outreach facilitators, working with FCHVs, also conducted orientation sessions for nearly 3,000 mothers, who learned about obstetric fistula, including its causes, symptoms, available treatment, and preventive measures. Following the orientations, these women pledged to disseminate the knowledge to their communities.
These newly empowered mothers, the FCHVs, and over 3,300 others reached through training for health workers and community groups are now equipped to spread a new message of hope. Throughout 61 municipalities in rural Nepal, women are empowered to share knowledge not only of available, free fistula treatment, but also the hope of a fistula-free future through prevention.
Celebrate with us the success story of Nyura, a beautiful sister who lives in a rural part of Angola. Nyura had a fistula repair in 2007 and was able to get pregnant again. Women who have been healed from fistula are counseled to deliver their future children via cesarean sections so they do not re-injure themselves and develop a repeat fistula. Nyura met with our partner doctors at Kalukembe Hospital after the start of labor and a healthy baby was delivered via c-section under their care. Nyura’s family was unable to pay the full cost for the surgery, so the remainder of the charges was covered by Hope for Our Sisters’ Maternal Health Fund.
First established in 2017, the Maternal Health Fund accounts help women requiring maternal health care but who lack the funds to pay. These funds are available to women with a prior fistula repair as well as those who have never suffered from fistula but require emergency maternal care. Preventing a repeat or new fistula protects our sisters from sliding back into a life of rejection, isolation and pain, and also prevents the death of their children. Every woman and child deserves emergency care, regardless of their ability to pay. Drs. Priscilla and Daniel Cummings have expressed a particular gratitude for the availability of the funds when necessary; they want Kalukembe Hospital to be a place where “women survive and thrive”. These Maternal Health Fund accounts enable women like Nyura to continue building their families and spreading hope of a renewed life after fistula repair.
On a trip to Angola, we traveled by way of a small plane to the other side of Angola, a flight of 5 hours. Moxico is the biggest province of Angola and, although there are several small health posts and a municipal hospital, it is quite isolated and most of their products still come in with the canoe from Zambia.
About 100 community leaders, pastors and community elders came for the fistula awareness and prevention training. The first day we broke up into small groups of 10 and discussed social issues that lead to fistula, in particular the pregnancies of girls under 18.
On the second day we had a large group of women. We explained in more detail about how to have a healthy pregnancy and baby and important steps, such as pre-natal care. We also taught them about risks for getting fistulas. The women came with lots of questions and we discussed the many causes of fistulas in Angola. We also told them about treatment for fistula at the Lubango mission hospital, Centro Evangélico de Medicina (CEML). Sadly many people knew women who have fistulas and we discussed ways they could travel for treatment to CEML.
On the last day, we once again spoke with a group of men and women. We discussed the urgency of investing in their children and youth. Two-thirds of our population in Angola is under 18 years yet there are few programs focused on working with them.
As often happens, the administrator of the local hospital invited us to come and give a teaching also in the hospital. Our time was too short but we hope to come back one day!
(Work described by Petra and Yolanda, Prevention and Empowerment Facilitators)
More stories: Treatment