The Fistula Foundation was founded as American Friends Foundation for Childbirth Injuries (AFFCI) in 2000 by Richard Haas and his daughter Shaleece. Mr. Haas served as a teacher in the Peace Corps in Ethiopia from 1967 to 1969, prompting him to return with his daughter to visit the East African country in 1999. The Haases visited the Fistula Hospital and were moved by the oasis of healing created by Dr. Catherine Hamlin and her late husband, Dr. Reginald Hamlin. They returned to California and established a US-based non-profit dedicated to supporting the treatment and prevention activities of the Fistula Hospital.

In 2003, a highly praised New York Times Op-Ed by Pulitzer Prize winning author, Nicholas Kristof, lauded the work of Dr. Hamlin and raised awareness of and funding for the hospital. In January 2004, the Oprah Winfrey Show invited Dr. Hamlin to speak about the plight of fistula patients in Ethiopia. In the first six weeks after her appearance on the show, over 6,000 donors contributed $1.3 million through the Fistula Foundation to Dr. Hamlin's cause. That spring, the Foundation changed its name to the Fistula Foundation to more succinctly describe the organization’s mission.

New York Times Writer, Nicholas Kristof, in June 2005 wrote another inspiring article about the Hospital, and in December 2005, the Oprah Winfrey Show aired another show about the Hospital, this time featuring Ms. Winfrey’s visit to the Hospital, titled "Oprah goes to Ethiopia". In summer 2005, the Foundation Board elected Ethiopian-American, Mr. Kassahun Kebede, as Chair of the Board and hired its first full-time Executive Director, Kate Grant.

Since 2006 the Foundation has consistently earned the Better Business Bureau (BBB) Seal for meeting all twenty of the BBB's Standards for Charity Accountability.  In 2006, 2007, and 2008 the Foundation also earned consecutive 4-Star ratings from the charity rating service "Charity Navigator".  This places the Foundation in the top 11% of nonprofits evaluated by Charity Navigator.  The Foundation published annual reports for 2005, 2006, 2007 and 2008.  The Foundation completed annual audits and published its financial statements and tax returns on this website.  In 2007 the Foundation was awarded a "Google Grant" from the internet powerhouse Google, providing the Foundation with free advertising on the Google network.

In 2006-8, the Fistula Foundation furthered its mission by funding, among other things:

Capital Projects:

• The construction, building and furnishing costs for the new Fistula Hospital in Harrar, Ethiopia, serving fistula victims in an underserved region and providing emergency obstetric care to women at high risk of obstructed labor.
• The building of Nurses Quarters near the Bahir Dar Fistula Hospital and maternal health unit upgrade
• The construction, building and furnishing costs for Nurses Quarters near the Harrar Fistula Hospital
• The Construction of primary buildings for the Hamlin Midwifery School
• Incinerator for the Bahir Dar Fistula Hospital
• Expansion of new mini-hospital at Bahir Dar
• Physiotherapy Center at AAFH
• Incinerator for the Bahir Dar Fistula Hospital

Running Costs:

• Over $2 million USD in Operating Support of the Hamlin Fistula Hospital to help fund life-restoring surgery for thousands of patients
• Yearly running costs for the new Harar Hospital ($170,000)

Equipment/Supplies/Training:

• Medications and medical supplies required for fistula care at the Hamlin Fistula Hospital in Addis Ababa
• Advanced Medical training for Fistula Hospital Senior Surgeon
• Medical conference for Addis Ababa Hospital Senior Staff
• Advanced Medical training for Fistula Hospital Senior Surgeon
• Computers and Software to help Hospital streamline its financial system
• 4 Wheel Drive Vehicles for use at the Hospital and the Midwifery College
• Incinerator for the Bahir Dar Fistula Hospital
• Six vehicles for AAFH

In February 2009 the Fistula Foundation Board of Directors officially broadened the Foundation's mission. While the Foundation remains the largest funder of the Hamlin Fistula Hospitals, the Foundation's new mission is to prevent and treat fistula worldwide. In March 2009, the Fistula Foundation made its first grant to fight fistula outside of Ethiopia with a $50,000 grant to the Panzi Hospital in the Democratic Republic of Congo. In June 2009, the Foundation's board approved a second grant to the Panzi Hospital of $150,000 and new grants to the CURE International Hospital in Kabul, Afghanistan and to the Central Evangelical Medical Center in Lubango, Angola. The additional support for the Panzi Hospital makes the Fistula Foundation one of the largest supporters for the Panzi Hospital's inspiring work to treat victims of fistula in D.R. Congo. The new grants in Angola and Afghanistan will help expand the fistula treatment capacity at these two countries.