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FAQ Topic: Effective Altruism

What is a quality-adjusted life year (QALY)?

One way of measuring the high impact of fistula surgery is through the lens of “quality-adjusted life-years.” Known as QALYs, this metric considers both the quality and the quantity of life saved through a health intervention. Fistula’s QALY measurement proves that fistula repair surgery is a highly effective investment in women’s health.

For example, by healing a woman who is leaking urine uncontrollably due to fistula, you can give her an estimated 14 QALYs—14 years of improved life. Healing a woman who is leaking feces due to fistula gives her an estimated 21 QALYs—21 years of improved life. This means fistula surgery costs only $28-$42 per year of improved life.


What is effective altruism?

Effective altruism is an approach to philanthropic giving that focuses on maximizing the good from one’s charitable donations. This evidence-based approach first identifies issues where the next dollar spent could have the greatest impact on human welfare, and then supports the most effective charities tackling these issues. 

In his book, The Life You Can Save, ethicist Peter Singer asserts charities operating effectively in low-resource countries—where poverty and its effects are most pronounced—are best positioned to make the largest impact.

Obstetric fistula is one of humanity’s most disabling injuries, but it can be cured by a surgery that costs $586. From a health metrics standpoint, healing a woman with fistula is a highly effective intervention—comparing favorably with vaccines and bed nets.

The Institute for Health Metrics and Evaluation (IHME) compares the burden of different health conditions through a relative-weight metric. A weight of 0 means perfect health, and a weight of 1 means death. The IHME rates Vesico-vaginal fistula (incontinence of urine) at 0.342, putting it on par with complete hearing loss and drug-resistant tuberculosis. It rates recto-vaginal fistula (incontinence of feces) at 0.501—on par with terminal cancer. Learn more about what effective altruism means to Fistula Foundation supporters

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