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Madagascar

High teenage pregnancy rates—paired with grinding poverty—suggest that fistula will be a serious issue in Madagascar for years to come.

Why We Work in Madagascar

The island of Madagascar is home to some of the most diverse plant and animal life in the world. But its people face extreme poverty—three-quarters of the population live on less than $1.25 per day. In a country of over 24 million people, where there are not enough doctors to meet the demand for basic maternal health care, childbirth can be a life or death matter.  

Only 44.3% of births are attended by a skilled professional. This—combined with the country’s high fertility and teenage pregnancy rates—suggests that obstetric fistula is likely prevalent. 

Tragically, many Malagasy women who develop fistula are hesitant to seek treatment even if it is available, due to a common belief that surgeons only operate to steal a patient’s kidney or other body part. Additionally, Madagascar’s infrastructure is poor, making rural patients’ travel to the hospital both difficult and costly. As a result, women often suffer for years with obstetric fistula, in isolation and shame.

What You Help Us Do

We are investing in the following areas to build Madagascar’s in-country medical services and provide life-transforming surgery to as many women as possible:

Meet Our Partners

We are currently partnering with SALFA and Hopitaly Vaovao Mahafaly to deliver fistula treatment to women in Madagascar.

What projects are we currently funding?

Sampan’Asa Loterana momba ny Fahasalamana (SALFA)

Sampan’Asa Loterana momba ny Fahasalamana (SALFA) is the health department of the Malagasy Lutheran Church. Coordinating the activities of 10 hospitals, nearly 20 urban dispensaries, and 15 rural health clinics, they cover 21 out of 22 regions of the island. Six of SALFA’s 10 hospitals provide routine fistula treatment.

Hopitaly Vaovao Mahafaly, Mandritsara

Opened in 1996 in Mandritsara, a town of 30,000 people, Hopitaly Vaovao Mahafaly (HVM), also known as the Good News Hospital, is the chief healthcare provider for a radius of approximately 200km. Some patients live locally, while others travel the 200 km or more to get there, often taking several days. Among other specialized services, HVM offers two operating theatres and a maternity ward.

Who are our past partners?

In the past, we have provided grant support to Freedom from Fistula and several hospitals through Operation Fistula.

Our partner Freedom from Fistula has supported fistula treatment in Madagascar since 2014, through a partnership with Mercy Ships, a traveling charitable hospital providing free medical care to African coastal regions. In late 2016, Freedom from Fistula established a permanent Fistula Care Center in Madagascar at the Centre Hospitalier Universitaire Toamasina (CHUT), a hospital on the island’s east coast. Funding from Fistula Foundation covered the cost of surgery for 100 women at the new center, as well as pre- and postoperative care.

Through our partner Operation Fistula, a two-week fistula clinic was organized in August 2013, and a percentage of these surgeries were funded by Fistula Foundation. The clinic was held in southeastern Madagascar, as this is an area known to have a high prevalence of fistula based on a survey conducted by UNFPA. It included operations from both local and internationally renowned fistula surgeons, the former of which continued to provide obstetric fistula repair surgery throughout the year at their own hospitals under this grant.

How much funding have we granted?

SALFA

  • $450,000 in FY2019
  • $391,613 in FY2018
  • $25,000 in FY2018
  • $207,500 in FY2017
  • $75,000 in FY2016

Hopitaly Vaovao Mahafaly

  • Pending for 2019
  • $4,500 in FY2018
  • $6,500 in FY2016

Freedom from Fistula

  • $179,473 in FY2016

News from the Field

Meet Sodreine from Madagascar  •  December 14, 2017
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Sodreine is from Iabomora Village, about 56km from Vangaindrano. She gave birth to her first child at the age of 17, but her labor did not progress as planned. As...
Sodreine is from Iabomora Village, about 56km from Vangaindrano. She gave birth to her first child at the age of 17, but her labor did not progress as planned. As a result, she developed obstetric fistula. Not long after her fistula developed, her husband left. He told her he could not stand the smell from her incontinence. Heartbroken, she returned home to live with her family.
Field Notes: On the road in Madagascar  •  April 19, 2017
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I’m going to introduce you to Vavizely in a second. I warn you, her story is fairly difficult to imagine and a little hard to take. I met Vavizely at...
I’m going to introduce you to Vavizely in a second. I warn you, her story is fairly difficult to imagine and a little hard to take. I met Vavizely at Freedom from Fistula’s surgical center in Toamasina, Madagascar. Toamasina is a compact, neat, prosperous coastal town, the commercial capital and main port of Madagascar, and is blessed with a decent medical system.
Photo Gallery: Changing Lives in Madagascar  •  January 23, 2017
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Despite being known for its rich biodiversity, Madagascar’s people face extreme poverty three quarters of the population live on less than $1.25 per day. Fertility rates are high, and child...
Despite being known for its rich biodiversity, Madagascar’s people face extreme poverty three quarters of the population live on less than $1.25 per day. Fertility rates are high, and child marriage is prevalent in poor, rural areas. Many women lack access to skilled health care providers during delivery, significantly increasing the risk of childbirth complications like fistula.

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