Fistula Care



Obstetric Fistula Repair and Care Project

Globally it is estimated that there are 3 million women suffering from Obstetric Fistula, of which a majority are in Sub Sahara Africa. In Kenya, where approximately 1.2 million births take place annually, the incidence is about 3000 per year. The rate is particularly high in the parts of Kenya where access to skilled delivery remains low such as the Nyanza region in Western Kenya with some areas having less than 30% of women delivering under a skilled attendant.  Women who develop fistulae ends up with an abnormal opening between a woman’s vagina and bladder (Vesico-Vaginal Fistula) and/or rectum (Recto-Vaginal Fistula) associated with reduction of quality of life as well as stigma and discrimination from the community and even close family members such as the husband.

OGRA Foundation started the Obstetric Fistula repair project is in response to the launch of the safe Motherhood Initiate in Nairobi, Kenya which aims at reversing poor levels of Obstetric Fistula. Through support from Direct Relief International and the Fistula Foundation, OGRA Foundation now funds Obstetric Fistula repairs at Jaramogi Oginga Odinga Teaching and Referral Hospital, JOOTRH (formerly Nyanza Provincial General Hospital). The ultimate aim is to have routine repairs at the hospital as opposed to ‘camps’. However, to clear the huge backlog of cases, OGRA Foundation has organized fistula repair camps at the hospital alongside routine repairs which are now stable with 3-5 repairs done every week.

In addition to JOOTRH, OGRA Foundation has trained a network of Health Care Workers across western Kenya such that several diagnostic centers across the region are on high alert to identify and refer cases of Obstetric Fistula to the regional Referral Hospital, JOOTRH. The diagnostic centers are spread across all counties in Nyanza Province.

The activities done under this project include:

  1. 1. Conducting Community Mobilization to identify cases of Obstetric Fistula and conduct screening tests.
  2. 2. Diagnostic tests for suspected cases.
  3. 3. Treatment of cases including repair and inpatient care for at least 2 weeks post-operative. OGRA Foundation pays all the hospital bills and associated costs for these mothers.
  4. 4. Follow up of treated cases to ensure proper healing and assimilation in the community.


The project aims to conduct repairs for 120 women each year with most of them done as routine fistula repair at the JOOTRH (formerly PGH). So far, the project is on course and meeting its targets. This is made possible by a competent team led by a Fistula Surgeon and brings together the program managers, medical officers, anesthetists, clinical officers and nurses.  The project equally aims at building capacities for ongoing Obstetric Fistula repair, collecting data on Obstetric Fistula/ maternal health indicators and mapping the extent of the problem in Nyanza. Until now about 80 women have been repaired with only 5 difficult cases referred to Kenyatta national hospital.