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Wednesday, December 2, 2009

Experts Meeting to Address Obstetric Fistula in Rwanda

KIGALI, RWANDA—Leading experts and physicians working in the reproductive and maternal health field will convene in Kigali December 7–8, 2009, to identify challenges and solutions to a pressing and preventable health concern in Rwanda—obstetric fistula. Hosted by the Ministry of Health, in collaboration with the Rwanda Medical Association and the U.S. Agency for International Development-supported Fistula Care Project (managed by EngenderHealth), the meeting will engage policymakers, health officials, medical staff, and community leaders to set achievable goals for preventing fistula and improving Rwandan women’s health.

Fistula affects an estimated 2–4 million women globally, including in Rwanda. It is a devastating gynecological injury usually caused by prolonged labor without medical intervention or cesarean section. As a result, women with fistula have chronic leakage of urine and/or feces. In most cases, fistula can be repaired through surgery, and it is almost always preventable—with timely, high-quality obstetric care as well as family planning.

At the meeting, national and international experts will strategize on how to best to integrate family planning with maternal health services to prevent fistula and improve the health and lives of Rwandan women. Leading physicians will be available to offer their expertise and comment on the issues, including:

  • Dr. Isaiah Ndong, Vice President for Programs, EngenderHealth
  • Dr. Joseph Ruminjo, Clinical Director of Fistula Care, EngenderHealth
  • Dr. Theobald Hategekimana, Director, University Central Hospital of Kigali
  • Dr Serigne Magueye Gueye, Fistula Master Trainer, Cheikh Anta Diop University/Grand Yoff General Hospital, Senegal

The meeting will be held at the Serena Hotel in Kigali. Members of the media are invited to attend the opening ceremony on December 7 and the morning session on December 8. Please contact Kellen Kebikomi by telephone at 250-25257-0912 or by email at to confirm your attendance.

About Fistula Care
The Fistula Care project is a five-year cooperative agreement funded by USAID and managed by EngenderHealth. The project works to address the enormous backlog of women awaiting life-altering fistula repair, ensuring they receive timely and quality care from trained providers. At the same time, we work to remove barriers to emergency obstetric care that lead to fistula in the first place, so that women in labor get to the right place with the right services at the right time. The project is supporting a network of facilities offering a continuum of services, from emergency obstetric care, referrals, and family planning, to complex fistula repairs and advanced surgical training. Visit for more information or contact us at:

About EngenderHealth
EngenderHealth is a leading international reproductive health organization working to improve the quality of health care in the world’s poorest communities. EngenderHealth empowers people to make informed choices about contraception, trains health providers to make motherhood safer, promotes gender equity, enhances the quality of HIV and AIDS services, and advocates for positive policy change. The nonprofit organization works in partnership with governments, institutions, communities, and health care professionals in more than 20 countries around the world. For more than 65 years, EngenderHealth has reached more than 100 million people to help them realize a better life. For more information, visit

(From the EngenderHealth press release)

1 comment:

Kate de Rivero said...

Thank you for raising awareness about obstetric fistula through your blog.

At Women and Health Alliance (WAHA) International, we support many fistula care projects across Africa.

However, despite the efforts of fistula surgeons across Africa, the backlog of up to 2 million cases continues to grow. Every year, for every fistula surgery that is performed, 5 new cases will occur!

It is in this context that at WAHA International, we believe that midwives should play a much greater role in fistula prevention and early fistula treatment. In terms of early treatment of obstetric fistula, midwives could potentially play a key role in substantially reducing the number of sustained cases if they were trained to systematically use Foley catheters for all women who leaked urine following delivery.

Dr Kees Waaldijk (President of the International Society of Fistula Surgeons and Director of the Nigeria National Fistula Programme) has collected data from a case series of over 4000 patients at the Nigeria National Fistula Programme. These data show that up to 37% of new fistula cases could be cured through using a Foley catheter, if the procedure is started within 75 days post-partum, and without any need for subsequent surgery!

So how does it work? To put it simply, the indwelling Foley catheter drains urine from the bladder. This decompresses the bladder wall so that the wounded edges come together and stay together, promoting spontaneous healing - at least of the smaller fistulas.

These promising data represent a potential change in the role that midwives can play in the fight to eradicate obstetric fistula. If guidelines were developed such that midwives were trained and equipped to carry out this procedure (which costs a ~ 1 USD compared to the 300 USD for a surgical intervention), then this could be a cost-efficient and highly effective way to reduce the incidence of fistula cases. This would also permit early identification of the other 75% of women who did not heal and who need to be referred for surgical treatment in short delay in order to reduce the risk of being marginalized within their community.

These data from Nigeria were shared during the First International Conference for Midwife Associations from French-speaking Africa which was organised by WAHA International and held on the 18th and 19th of May in Benin. During the conference, a new campaign was launched by WAHA International and Dr Kees Waaldijk to promote systematic use of Foley catheters by midwives for all women who are leaking urine following delivery.

The midwives present at the conference all called on their greater involvement through the use of Foley catheters - an approach which was also endorsed by the many gynaecologists, fistula surgeons, and representatives from the Ministry of health, WHO and UNFPA who attended.

You can find out more about the Foley catheter campaign, our fistula projects and the conference in Benin on our website: or by contacting Kate at