Expanding Fistula Treatment in Bangladesh - Fistula Foundation

Transformations © Paula Allen / V-Day

IN THIS ISSUE Page 2 | One Woman’s Story: Sudan New Tribute Card Page 3 | Expanding Care in the West African Country of Chad “Keepsakes Keep Lives" Page 4 | Foundation funds first program in Nepal Partnering with CCBRT in Tanzania Page 5 | Half the Sky comes to PBS Page 6 | Book Review: Plumbing and Renovations Donor Spotlight Page 7 | What you’re saying Donor Carolyn Braden’s Labor of Love

News from the Fistula Foundation, Summer 2012

Expanding Fistula Treatment in Bangladesh Southern Bangladesh has the highest incidence of fistula cases in the country. Cox’s Bazaar, a major city in this region, is bustling, but up until recently had no services available to treat the many women in the area with fistula. That was before Dr. Iftikher Mahmood, a Bangladeshi-American and founder of the Hope Foundation, decided to change that situation. Dr. Mahmood contacted the Fistula Foundation last year with the hopes of expanding the services at Cox’s Bazaar Hospital for Women and Children to treat fistula patients. The Foundation is committed to helping to expand treatment services in underserved rural areas where most fistula patients live, and so there was a good fit between Dr. Mahmood’s goals and the Foundation’s mission. Last year the Foundation partnered with Dr. Mahmood and Ethiopian surgeon Dr. Mulu Muleta at WAHA International to provide advanced fistula care and training. Dr. Biswas, a dedicated Bangladeshi surgeon, received expert training from Dr. Muleta. Then this April, the Foundation worked with Dr. Mahmood to bring Dr. Steve Arrowsmith to Cox’s Bazaar, and thanks in part to Foundation funding, Dr. Biswas went to Ethiopia to train with Dr. Muleta as a fellow in the new FIGO (International Federation of Gynecology and Obstetrics) training program.

In September, Fistula Foundation CEO, Kate Grant, and Dr. Lauri Romanzi will be hosting a special conference call to hear about the Foundation’s work in Afghanistan. To learn more and RSVP, please contact the Foundation.

Dr. Steve Arrowsmith and Dr. Iftikher Mahmood performed fistula surgeries on 21 women, restoring their health and changing their lives. Besides receiving surgery, the women were provided with accommodations and follow-up medical care. Doctors, staff and patients cooked and shared their meals together. continued on page 8

Patient story: Fatima, 28 years old, from western Sudan I was married at the age of 16 years. In my society, girls barely receive any formal education. When I became pregnant, I was unable to attend the antenatal clinic follow-up program because my people are nomads. We move around all year round after grazing grounds for our cattle and sheep, so most of the time we are far away from any health facility that provides basic medical care. After being in labor for three days, I was taken to the nearest hospital on a camel. When we arrived, the doctor examined me and performed a Cesarean section. Unfortunately, the baby was stillborn. After the operation, I noticed the continuous leakage of urine, and the doctor informed me that as a result of the difficult labor, I had developed an obstetric fistula, and that I needed an operation to rectify this. My husband could not stand the smell of the urine, and divorced me a few months later. My father and mother took me to the capital, Khartoum, where I was examined at the Dr. Abbo Khartoum Teaching Hospital’s Fistula Center. When I complained about the pain and weakness of my left leg, the doctor told me that it was also the result of the difficult labor. I received physiotherapy exercises for my leg before and after the repair operation. The repair was successful, and I then underwent physical and psychological rehabilitation sessions. As a result, I regained my self-confidence and self-esteem. I was also offered vocational training, where I learned some incoming-generating activities like knitting and baking cakes. So now I am an empowered healthy woman, and can start my own small business when I get back to my community. When I go back to my village, I’ll speak to women in social gatherings about fistula and how routine follow-up in pregnancy can prevent it.

Fistula Foundation Board Of Directors CHAIR Kassahun Kebede DIRECTORS Dr. France Donnay Dr. Sohier Elneil Sarah Omega Kidangasi Linda Samuels Dr. Gerald Shefren Stephen Saunders, Esq. Robert Tessler, Esq. Whitney Tilson Linda Tripp Dr. Larry William Susan Wilson Kate Grant, (ex-officio)

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“IN MEMORY” Tribute Card

We’ve found that some of our donors would like to make a donation in memory of a special person. In thanks for your donation of $10 or more, we will send a 5 x 7-inch “In Memory” tribute card to the person of your choice. We add a handwritten note that a donation has been made by you in memory of their loved one, and we include the name of the person to be remembered. It’s a meaningful way to honor someone special—by supporting women with fistula and helping them to regain their health and reclaim their lives.

Expanding Care in the West African Country of Chad Center for Reproductive Health and Fistula Repair - WAHA

Michelline is a former fistula patient in Chad. After treatment she became an auxiliary nurse and now works at the Fistula Centre. She gives priceless counseling support to women coming for surgery, sharing her story and providing basic information.

The opening of the Center for Reproductive Health and Fistula Repair in N’Djamena, Chad, was initially delayed. In order to fulfill their commitment to patients who were waiting to be treated, the Center, in partnership with a team from Paris based Women and Health International temporarily operated at the “Hospital de la Liberte,” a neighboring hospital with fistula care infrastructure available. They used this opportunity to their advantage, training the resident staff at this hospital in basic and advanced fistula surgery.

Meanwhile, in collaboration with local community-based organizations and NGOs, the Center disseminated information about obstetric fistula in general and the possibility for treatment, reaching out to women in need of fistula surgery as well as supporting their reintegration upon their return from the hospital. The aim was to establish referral links and reintegration support with local civil society organizations. Once the Center was able to open, the results of the community outreach lead to so many women presenting for care that a tent had to be put up in the Center’s garden to host the many women awaiting fistula surgery.

Since the Center began operation, they have operated on 97 women with fistula. Their goal is to provide surgery to 160 women suffering from obstetric fistula.

“Keepsakes Keep Lives” Donor Jo Bernard turns Tiffany Silver into Gold Donor Jo Bernard has taken the concept of recycling to a new level with her recent donation to the Fistula Foundation. Jo was new to the Southern California area when she met Jocelyn Tetel of the Skirball Center in Los Angeles. Jocelyn invited Jo to visit the Skirball’s “Half the Sky” exhibit, and also gave her the book to read. Jo was so moved by the stories portraying women at risk that she became passionate about doing something to help. Fistula is especially meaningful to her because of her personal experience in her own company, which manufactures and markets an underwear-free replacement product for women who have feminine health and medical issues. She learned about the Fistula Foundation in "Half the Sky" and felt a profound need to focus on supporting women with fistula. Soon after, Jo’s mother came for a visit and remarked what a shame it was that Jo never used her Tiffany silver. Jo rarely used the place settings as she felt they were “too pretty” and not in keeping with her lifestyle. Inspiration struck! “It was doing me no good sitting there,” said Jo, “so I thought, why not do some good with it?” She promptly put the silver up for auction, and donated the proceeds to the Fistula Foundation. We are always delighted to discover the clever and ingenious ways our donors devise to raise funds for and awareness about fistula. Jo came up with the concept that “keepsakes keep lives” once she realized, “How many of us have stuff sitting on shelves, not being used? Why not turn it into something practical?” And the women her donation helped whose lives have now been restored through fistula surgery are glad she did.

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FOUNDATION FUNDS FIRST PROGRAM IN NEPAL Nepal is a beautiful country nestled in the Himalayan mountains. The terrain is rugged and it is one of the poorest countries in the world. Not surprisingly given the terrain and the poverty, a majority of women give birth at home. Those women in obstructed labor often have few options for delivering a healthy child. While data on the incidence of fistula in Nepal is scarce, anecdotal reports indicate a significant population of women confront this horrible injury. The Foundation is thrilled to be able to support International Nepal Fellowship (INF), the country’s longest serving international Christian non-governmental organization. INF is located in the Surkhet area in Western Nepal. INF is working to develop an obstetric fistula surveillance network for Nepal to help identify women suffering from fistula and facilitate their prompt referral for treatment. The effort is an extension of their existing outreach program for raising awareness of obstetric fistula. The Foundation will help support the provision of free obstetric fistula surgery by enabling the purchase of equipment required so that the center can provide more surgeries to more women with fistula in Western Nepal.

Foundation partners with Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) Kate Grant, Fistula Foundation CEO Established in 1994, CBRT is the largest indigenous provider of disability and rehabilitation services in the country, providing quality rehabilitative services to 120,000 people with disabilities and their caregivers each year, and has been providing fistula treatment since 2009. The Foundation is honored to partner with this outstanding Hospital. Funds from the Foundation will help pay to expand the main treatment ward and pay the salary of a Deputy Matron. CCBRT has ambitious plans for itself, to double the number of surgeries between 2012 and 2016. For this expansion to take place it is necessary to expand physical space and nursing care. The existing ward is growing from 36 beds to 60 beds.

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with CCBRT CEO, Edwin Telemans at Hospital in Dar es Salaam, Tanzania

Save the Date:

October 1 and 2 on PBS for the two night four hour documentary In 2009 Pulitzer Prize winning journalists, Nicholas Kristof and Sheryl WuDunn, launched their best-selling book Half the Sky: Turning Oppression into Opportunity for Women Worldwide. The book asserts that the central moral challenge of the 21st century is the full emancipation of the world’s women. Drawing on the breadth of their combined reporting experience, Kristof and WuDunn depict our world with anger, sadness, clarity, and ultimately hope, telling engaging stories of women triumphing over considerable obstacles. Their central argument is that women hold the keys to eradicating global poverty. This masterful and deeply inspiring book has been turned into an equally moving four-hour television documentary series to air on PBS this fall, October 1 and 2, with an international broadcast to follow. The documentary was shot in 10 countries: Cambodia, Kenya, India, Sierra Leone, Somaliland, Vietnam, Afghanistan, Pakistan, Liberia and the U.S. The film follows intrepid reporter Nicholas Kristof and A-list celebrity advocates Diane Lane, America Ferrera, Eva Mendes, Meg Ryan, Gabrielle Union and Olivia Wilde. It introduces women and girls who are living under some of the most difficult circumstances imaginable — and fighting bravely to change them. Their intimate, dramatic and immediate stories of struggle reflect viable and sustainable options for empowerment and offer an actionable blueprint for transformation. We are delighted that one of our longest term partners, the Edna Adan Hospital in Somaliland, named for its visionary and dedicated founder, is one of the main features in the documentary. Actress Diane Lane and Nicholas Kristof take viewers on an unforgettable journey inside Edna’s Hospital to learn more about the nearly unimaginable challenges mothers and would-be mothers face in countries like Somaliland. The Half the Sky movement is cutting across platforms to ignite the change needed to put an end to the oppression of women and girls worldwide, the defining issue of our time. Half the Sky brings together video, websites, games, blogs and other educational tools to not only raise awareness of women's issues, but to also provide concrete steps to fight these problems and empower women. Change is possible, and you can be part of the solution. The Foundation is honored to be one of the key organizations featured as partners in the Half the Sky Movement focused on maternal health. Check that out, as well as short videos of leaders from George Clooney to Hilary Clinton talking about the importance of women’s empowerment at:

www.halftheskymovement.org

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RECOMMENDED READING:

Plumbing and Renovations by Lauri Romanzi, M.D. “If you have a uterus or know someone who does, this book is for you.” ~ Lauri Romanzi Urogynecologist, Dr. Lauri Romanzi, provides the inside scoop on female anatomy and reconstructive pelvic procedures. She uses humor and a conversational tone to educate women about their bodies generally and vaginal rejuvenation specifically. What is vaginal rejuvenation? Here’s Dr. Romanzi’s answer: For some women, it's cosmetic. For others, it's about pelvic fitness. And for many, it's also about prolapse, that dubious badge of honor suffered by scores of women living robust lives. If you have prolapse, you can use a pessary. Or your doctor can fix it for you, in which case you're very likely to end up with a hysterectomy. Of the 600,000 hysterectomies done in the United States every year, 13% are done for prolapse. For women with prolapse who don't like that statistic, there is hope. That hope is called "uterine resuspension". That's right, if your parts are out of place, they can be put back into position without sacrificing your womb on the altar of gynecologic dogma! Or you can use a potato. Interested in getting your own copy? The book is available now on Amazon.com. For those of you who may recognize the name, Dr. Romanzi is a US-based surgeon who travels globally in countries as far flung as Afghanistan and Senegal to treat women with fistula and other pelvic floor problems. She’ll be a featured guest of the Foundation on a supporter conference call in September. To learn more, call or email our office: [email protected] or (408) 249-9596. Earlier this year she was in Somaliland at Edna Adan Hospital, a Foundation partner, and was in Kabul, Afghanistan with partner organization CURE Hospital. Dr. Romanzi is a clinical associate professor at Weill/Cornell New York Presbyterian Hospital in New York City.

Donor Spotlight: Rhythm and Brews On April 16, Rhythm and Brews hosted a benefit for the Fistula Foundation organized by the West Virginia University Community Medicine Student Association (CMEDSA). The group worked together to find a venue, musicians, and dance teachers for the event, develop posters advertising the benefit and post them around Morgantown, contact local radio stations and the Dominion Post, and run a raffle to generate extra funds. The High Street Jazz band was the featured performer, and swing dance lessons were also immensely popular with those who attended. The event was a decided success, raising nearly $950 from the benefit as well as the sale of raffle tickets, which will cover the costs of fistula surgery for two women. Kestrel Innes-Wimsatt, chair of social justice for CMEDSA and one of the fundraiser organizers, stated: “It was so inspiring to see everyone, both within CMEDSA and outside of it, who donated their money, time, or services to make this happen. People just came out of the woodwork to help, and really seemed to genuinely care about these women, and made really substantial contributions.”

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What You’re Saying: Kathy Beresford: “Thanks for the most recent newsletter and the smile-provoking photos of Wortay and her nurse, you and Dr. Muleta. It does my heart good to know that good things happen every time you get my modest check.”

Eva Elsner: “I enclose a donation which represents the cost of birthday cards that might have been given to me on my birthday. Our small group of friends decided to donate the cost of a card to the charitable organization of the honoree’s choice, and I have elected to make my ‘birthday’ donation to your work.”

Elyria High School Women’s Studies classes: “We are grateful for the strength and beauty of your patients. Their stories uplift us all. Thank you for all the work you do to bring renewal to so many women.”

Dr. Ilene Fischer: “At a recent family holiday gathering, we voted on a handful of nonprofits toward which we’d all pool our contributions. As a gynecologist, I gave an impassioned speech about the important work being done by the Fistula Foundation, and it was one of the charities chosen.”

Episcopal Church Women of Christ Church, Charlotte, NC: “The profits from [our book and gift store] Good News as well as our Christmas Bazaar are the funds we use to support exemplary agencies like yours. The Missions Funding Committee is thrilled to have this opportunity to share our blessings with local as well as international agencies.”

C.C.A. Baldi Middle School, Philadelphia, PA, Benjamin Hover, 8th Grade Literacy Teacher: “This year my class read Nicholas Kristof ’s article about the circumstances of women in Ethiopia and Kenya who suffer from obstetric fistula. Through their educational and fundraising efforts, my students and the Baldi Student Diplomats raised over $1000 to donate to organizations that support the goals of eradicating obstetric fistula worldwide. Through their research, my students decided that your organization contributed the most to ending obstetric fistula. Please continue the good work that you do (and please recognize my students for their efforts; they don’t realize how atypical their excellent behavior is for eighth graders).”

Donor Spotlight: Carolyn Braden’s Labor of Love Carolyn Braden found a way in these tough economic times to follow her heart and do something that meant a lot to her. This Mother’s Day she decided to try her hand at website construction for the first time, creating the “Another Mother’s Day” page for six under-the-radar charitable groups based on six basic principles: warmth, wisdom, trust, acceptance, hope and perspective. She selected the Fistula Foundation as the example for acceptance, describing the suffering women with fistula endure as well as providing information about how readers can help. Carolyn’s mother, Lucy Bugea, was delighted at the feedback generated by the website: “We are getting responses from everywhere and it is all positive. Young people in particular seem to feel really touched by it. All that Carolyn ever wanted was to shed light and hopefully make some money for organizations that were not the ‘big gorilla in the room’.

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Multiply the power of your donation with a Matching Gift! If you are an employee or retiree of a company with a Matching Gift program, you can increase the power of your gift to the Fistula Foundation. Thousands of organizations, large and small, have Matching Gift programs which can double or even triple individual tax-deductible contributions. Your employer may be one of them! Contact your human resources department to see whether your company has a Matching Gift program. In 2011, corporations donated $15 billion to nonprofit organizations; matching gifts represented 20% of corporate cash donations. (http://www.givingusareports.org)

Expanding Fistula Treatment in Bangladesh… continued from page 1 Through the work of Drs. Mahmood, Biswas, Arrowsmith and Muleta, the community is now aware that free fistula services are available. Hospital staff will have access to very remote areas through satellite centers—patients can locate and identify where medical services are available through the hospital’s efforts to maintain a grassroots presence. The Hospital has plans to develop a physical therapy program, and hopes to work on a social integration program which provides income-generating activities for fistula patients. Cox’s Bazaar Hospital has the potential to become the busiest center in Bangladesh and be a part of the global fistula effort.