‘Fistula Should Not Happen’

Dr. Denis Mukwege visits Fistula Foundation to discuss challenges for women in the Democratic Republic of Congo.

When Dr. Denis Mukwege—founder of Panzi Hospital, our longest-standing partner, and winner of the 2018 Nobel Peace Prize—speaks of his countrywomen in the Democratic Republic of Congo (DRC), he speaks of abandoned people. For decades, women and girls in the DRC have endured countless acts of sexual violence. Rape has been (and still is) flagrantly used as a weapon of war in the civil conflict that continues to rage across the country. 

Even worse: Girls as young as 12 years old are giving birth, often as a result of being raped. In fact, 30% of the women who give birth in the DRC are under the age of 18.  The war in the DRC, Dr. Mukwege said, is an international crisis that should grab people’s attention everywhere. 

“Sometimes you ask yourself how this can go on and no one is talking about it.” — Dr. Denis Mukwege

Dr. Mukwege has been an advocate for women and girls for more than 20 years. In recognition of his remarkable commitment to fighting to end the use of rape as a weapon of war, Dr. Mukwege was recently awarded the Aurora Prize for Awakening Humanity. He hopes that this award will shine a light on women suffering in the DRC, and spark international outrage on a scale that will help end the civil war in his country.

Staff photo with Dr. Denis Mukwege.
Dr. Denis Mukwege with Fistula Foundation staff at the office headquarters in San Jose, California.

While in the United States to accept the Aurora Prize, Dr. Mukwege visited our office in San Jose, California, to discuss the crisis in his country and how it relates to our work in treating women with childbirth injuries. He described three reasons for continuing to focus on fistula, even amid all of the challenges that women face in the DRC:

Fistula should not exist. 

“With all the knowledge that we have when it comes to obstetric care, fistula should not happen,” Dr. Mukwege said. Fistula has been all but eradicated in wealthy nations because it is preventable with access to high-quality obstetric care. Today, Dr. Mukwege said, this problem should not exist anywhere

Fistula is a sign of poverty. 

“When I say poverty, it is a profound, profound poverty where people do not have any solution,” Dr. Mukwege explained. As an example, he noted that many women who arrive at his hospital are unable to meet basic needs, such as having underwear. “These women are naked when they come in. … They feel like they can’t even go outside to get water,” he said. In response, his team began providing women with “dignity kits,” which include items such as underwear, soap, and a toothbrush. “Before we can operate, we need to feed them and give them some dignity,” Dr. Mukwege said.


Fistula isolates a woman from her society. 

Dr. Mukwege likens fistula to what leprosy was 1,000 years ago. The profound shame associated with fistula is something that no woman should endure. “It excludes her from community services, from social opportunities, from economic opportunities,” Dr. Mukwege said. “She has no access to any solution.” 

Despite the challenges that women in the DRC face, Dr. Mukwege finds hope in their resilience. The women he helps are incredibly strong and committed to their communities. They return to their homes ready to start their lives again, and they spread the word about fistula treatment opportunities. “The impact [on] society is really very big,” Dr. Mukwege said. “Many women we treat … become leaders in their own society to support others, to help others, and to work with vulnerable women.” 

“What I am doing is really very small if I compare it with what women are doing. After they go through these terrible things, they’re still loving, they’re still supporting others, they are not complaining and they are able to forgive.”—Dr. Denis Mukwege 

While Dr. Mukwege lauded efforts to pursue an end to obstetric fistula by 2030, he commended Fistula Foundation’s commitment to treating women who are suffering from this condition today. “Thank you for the work that you are doing to raise money and support for this program [Panzi Hospital],” he said.

There are still many barriers to care and much work to be done, particularly in the DRC. By partnering with incredible advocates like Dr. Mukwege and organizations like Panzi Hospital, we are moving the needle to help the women who need us most. 

Published June 11, 2024

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