VESICO-VAGINAL FISTULA REPAIR: AMREF Experiences and Results
Projects: National Fistula Program of Tanzania
Regional Obstetric Fistula Project in Kenya and Uganda
Vesico-Vaginal Fistula (VVF) is a public health problem of developing countries and a sign of a failure of the health care delivery system. AMREF runs two VVF-projects: one located in Tanzania; and one in Kenya, Uganda and Southern Sudan. Additionally, AMREF visits Mogadisho, Somalia and Ruhengeri, Rwanda. The main project objectives are service delivery through surgical treatment for women living with fistula, training local specialists in VVF-repair, providing surgical equipment and raising awareness. To prevent obstetric fistula and to help affected women, National VVF-programs, integrated in the Reproductive Health Services, should be developed in each country in partnership with Ministries of Health (MOH), AMREF, UNFPA, other NGOs and donors.
The AMREF surgeons started repairing VVF in 1992 through the Surgical and Specialist Outreach Programs. The first of the two VVF-projects is in Tanzania and was started in October 2000 through funding from the Royal Netherlands Embassy in Dar es Salaam. The second VVF-project, active in Kenya, Uganda and Southern Sudan, was started in May 2002 and funded by the Bill and Melinda Gates Foundation through the Averting Maternal Death and Disability (AMDD) program of Columbia University, and presently by AMREF Germany, AMREF USA, the Australian High Commission of Kenya, the Flying Doctor Society of Africa and Danida.
1. Service Delivery: operating on women with VVF/RVF in over 40 hospitals in Eastern Africa (See Figure 1)
2. Capacity Building: training local specialists and nurses in the management of women with VVF/RVF, provision of surgical equipment for VVF-repair to all trained specialists and the hospitals where they work, and giving financial support to the hospitals,