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The Fistula Challenge

Obstetric Fistula is one of the most devastating of all pregnancy-related disabilities that affect poor women. Usually as a result of obstructed labour coupled with a lack of skilled medical care, obstetric fistula most often leads to permanent incontinence – a continuous leakage of urine and loss of control over bowel movements.This injury usually means a woman will be isolated and she can no longer be a productive member of her family.

The Fistula Challenge is a fund-raising golf tournament brought to you by the British Chamber of Commerce Kenya, Rotary Clubs of Kenya aimed at raising Kes. 2.5m to operate on women suffering from Obstetric Fistula. The challenge aims at improving the quality of life for their lives through the surgical intervention.

In Kenya, maternal mortality remains high at above 488 maternal deaths per 100,000 live births. While this is below the Sub-Saharan average of 510 deaths per 100,000, Kenya experiences very slow progression in maternal health. (World Health Organization, UNICEF, UNFPA, The World Bank, & United Nations, 2014). Evidence from developed countries and developing countries that have made progress in reducing maternal mortality indicate access to skilled delivery is a high impact intervention.

Shortage of human resources for Emergency Obstetric Neonatal Care in sub-Saharan countries are particularly acute. Only about half of the mothers are assisted during delivery by a trained attendant. The rest are mostly assisted by Traditional Birth Attendants (TBAs), relatives and fellow women. In some instances, women give birth without assistance at all. This situation increases the risk of maternal death and birth related injuries.

It is estimated that everyday 20 women die due to birth related causes and for each woman who dies 2-3 women suffer life altering birth related injuries including Obstetric Fistula . It is estimated that two Obstetric Fistula cases occur per 1,000 births and this will bring the total number Fistula VVF cases to 2,400 every year(UNFPA , 2014). Current capacity for repair services in Kenya is less than 1000 patients every year or less than 50 per cent of the likely annual incidence.In Kenya, we are in dire need of trained medical personnel on Obstetric Fistula . Currently only a few Kenyan doctors and nurses have ventured into the treatment of Obstetric Fistula.

The Fistula Challenge will contribute to the goals of the Amref Health Africa Fistula Programme which aims at Improving the quality of life for women with debilitating childbirth injuries through specialized surgical interventions;


  1. To increase the uptake of the range of reproductive health services available at the local health facilities and reduce delays to reach medical care in case of complications through strengthening the capacity of health care providers to prevent, repair and support women with Obstetric Fistula.
  2. To increase community units capacity in surveillance and support for women living
    with Obstetric Fistula and prevention of Obstetric Fistula.
  3. To improve the quality of life of women living with debilitating childbirth related injuries such as Obstetric Fistula.

Amref Health Africa Fistula Programme was established in 1992 with the aim of building the capacities of local health care systems through training of local specialists such as gynecologists, surgeons, and registrars in fistula surgery. It also involves sensitization of the Nurses, Clinical Officers, and health manager on essential obstetric care services.

Amref Health Africa Fistula Programme currently has a pool of more than 20 of surgeons from East and West Africa. Since inception Amref Health Africa has cumulatively supported over 20,000 women with obstetric fistula repair services in the East Africa (Uganda, Kenya, Tanzania, Ethiopia, South Sudan, Somalia, DR Congo and Rwanda) and in West Africa (Senegal).