Global Map of Devastating Childbirth Injury Launched

Direct Relief International, Fistula Foundation, and UNFPA Expand Awareness of Worldwide Fistula Treatment Capacity

The release of the Global Fistula Map, a major step forward in understanding the landscape of worldwide treatment capacity for obstetric fistula, will help streamline the allocation of resources and raise awareness of the condition.

Obstetric fistula, one of the most devastating childbirth injuries, is caused by the lack of a skilled birth attendant and access to emergency care during delivery. It is a highly stigmatizing, though in most cases treatable condition that results from prolonged, obstructed labor and causes chronic incontinence. According to currently accepted estimates, there are some 50,000–100,000 new cases every year.

“Tragically, there are unacceptably high numbers of fistula cases, yet we see from the map data gathered so far that treatment currently only reaches a fraction of patients annually—an estimated 14,000 women in 2010—not counting the significant backlog of cases,” said Gillian Slinger, the UNFPA Coordinator of the Campaign to End Fistula. “Documenting where treatment is available is critical to providing care, raising resources and restoring the health and dignity of women and girls living with fistula. If we know where service gaps are, we can then better steer activities forward, to get help to all those who need it.”

The Global Fistula Map is an evolving collaborative effort that was developed by Direct Relief and can be found at It highlights over 150 health facilities providing fistula repair in 40 countries across Africa, South East Asia, and the Middle East. While availability of surgical treatment for obstetric fistula is growing, the current capacity of most facilities is low. Over half of reporting facilities treated less than 50 patients in 2010, while only 5 facilities worldwide reported treating more than 500 women. It is anticipated that the map will improve coordination, and enhance fistula prevention and treatment efforts worldwide.

“Helping women with fistula receive life-restoring surgical care requires knowing where the women are and where care is available,” said Lindsey Pollaczek, the Senior Program Manager who led the effort on behalf of Direct Relief International. “Direct Relief uses mapping technology and tools to target medical resources more effectively, and we are so pleased to do this work to support the larger effort to help women with fistula get the care they need.”

The map will be expanded and continuously updated with information provided by experts and practitioners around the globe about facilities providing fistula repair and rehabilitation services.

“The Global Fistula Map is a crucial step forward in the field of fistula treatment. It is a dynamic and powerful tool that can help target scarce resources where they are most needed to treat women with obstetric fistula,” said Kate Grant, CEO of the Fistula Foundation.

The Global Fistula Map is a joint project by Direct Relief International, the Fistula Foundation and UNFPA, with data also contributed by EngenderHealth, WAHA International, and the International Society of Obstetric Fistula Surgeons.

Explore and share the map:

About Direct Relief International

Direct Relief International is a medical relief organization active in all 50 states and 70 countries. It works with more than 1,000 health clinics across the U.S. to assist in emergencies and an ongoing basis, providing them with free medications for people in need. The organization has been among the world’s largest medical suppliers in Haiti after the 2010 earthquake, has top charity ratings, including four-star and “top-notch” rating from Charity Navigator, and a 100% fundraising efficiency rating from Forbes magazine. Direct Relief was awarded the 2011 Peter F. Drucker Award for Nonprofit Innovation for its ability to adapt the insight, approaches, and tools of commercial technology for humanitarian purposes. For more information, please visit

About The Fistula Foundation

The Fistula Foundation is dedicated to the treatment and prevention of obstetric fistula, the most devastating injury resulting from unrelieved obstructed labor. The Foundation is the largest organization in the world focused solely on fistula, supporting programs in 15 countries and does not take money from any government. Based in San Jose, California, in the heart of Silicon Valley, the Foundation is honored to have received six consecutive 4-Star ratings from Charity Navigator; only 3 percent of charities have received this designation. For more information, please visit

About UNFPA and the Campaign to End Fistula

UNFPA, the United Nations Population Fund works to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect. The Campaign to End Fistula, launched in 2003 is led by UNFPA. The Campaign has expanded over the years and currently involves 64 global partner agencies, including Direct Relief International and the Fistula Foundation. The Campaign addresses all aspects of obstetric fistula: prevention, treatment and social reintegration of women recovering from treatment. Its long-term goal is to make fistula as rare in developing countries as it is in the industrialized world. For more information, please visit:


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