Fistula Foundation

Fistula Foundation is the global leader in treating obstetric fistula, a devastating childbirth injury that leaves women incontinent and often humiliated and shunned by their communities. In addition to covering direct surgery costs, Fistula Foundation also supports surgeon training, facilities equipment, grassroots community outreach, and holistic post-surgery reintegration. 

Their annual demonstrated impact includes:

  • Providing over 10,000 surgeries to repair childbirth injuries, including fistula.
  • Supporting 8 new treatment partners throughout Africa, expanding fistula repair services into Liberia and Sierra Leone. 
  • Launching a new treatment network in Tanzania.

Key Strengths: Scale, Depth of impact

Multidimensional Poverty Index Indicators: Social connectedness, Empowerment, Psychological well-being, Assets

Other Key Outcomes: Disease burden

Recent Expense Budget: US$16,000,000

Year Founded: 2000

Globally active since
Active in
surgeries funded annually
partner hospitals and field organizations supported

Other ways to donate

We recommend that gifts up to $1,000 be made online by credit card. If you are giving more than $1,000, please consider one of these alternatives.

Check Bank Transfer Donor Advised Fund Cryptocurrencies Stocks or Shares Bequests Corporate Matching Program

The problem: obstetric fistula

Obstetric fistula is one of the most devastating and serious childbirth injuries. It most commonly occurs in poor, rural areas in Africa and Asia where women have limited access to emergency obstetric care, such as C-section. When a woman experiences a prolonged, obstructed labor under these conditions, she will likely be in excruciating pain for days. The constant pressure of the baby’s head on the pelvis restricts blood flow to the soft tissue between the mother’s vagina and her bladder or rectum, leaving holes known as “fistulae.” These holes cause incontinence.

Unable to control her urine and/or feces, a woman will often also suffer from chronic infections and pain. What’s more, with too little community understanding of fistula and its causes, a woman can be blamed for her condition and shunned by her neighbors and family.

Each year between 50,000 to 100,000 women worldwide are affected by this wrenching condition. [1]

Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula — but fewer than 20,000 corrective surgeries occur annually.
Fistula Foundation patients in Kenya.

The solution: cost-effective, restorative surgery

An obstetric fistula can only be treated with corrective surgery. If the operation is performed by a skilled surgeon, a woman with fistula can very often return to a normal life, with her continence and hope restored. However, due to stigma,lack of awareness, poverty, and inadequate healthcare systems, field experts estimate fewer than 20,000 procedures take place annually. [2]

Aggregated data from Fistula Foundation’s current partners shows that it typically only costs $616 to provide a woman in Africa or Asia with life-changing fistula repair surgery and rehabilitation services — less than a single night’s stay in most hospitals in the United States. [3] Actual surgical costs vary depending on the local economies and healthcare infrastructure where partners work. The costs for more complicated surgeries, such as treating dual vaginal and rectal fistula, can be greater. The global success rate for fistula repair surgeries is approximately 86%. [4]

Fistula most commonly occurs to women in their twenties, in countries where the average lifespan is approximately 65 years—meaning a one-time surgical intervention can restore 40+ years of health. Without access to care, fistula survivors are forced to live with this devastating injury for the rest of their lives. 

Fistula Foundation provides fistula surgery, rehabilitation, counseling, and reintegration services at an estimated cost of $1169 per woman treated - less than one night's stay in most hospital's in the US.
A fistula surgery in progress at a Madagascar hospital funded by Fistula Foundation

How Fistula Foundation works

Fistula Foundation is the global leader in fistula treatment, funding more surgeries than any other organization, including the US government. Their work supports one goal: to provide as many life-changing fistula surgeries as possible. More than 80% of funds raised by Fistula Foundation go directly to supporting programs.

Fistula Foundation’s strategy builds sustainable in-country capacity by covering the cost of surgery, surgeon and nurse training, medical equipment and post-surgery rehabilitationFistula Foundation partners closely with local doctors and nurses, who are best positioned to understand the cultural nuances of how to implement effective programs.

Grants are invitation only.  Potential partners go through a rigorous review process, including external reference checks of local doctors’ reputations, fistula surgery skills, and certification. Grant recipients receive funds in stages and are required to provide regular, detailed reports. Site visits are also conducted regularly, both to build a closer relationship between Fistula Foundation staff and their partners on the ground, as well as to help ensure funds are used appropriately.

Dr. Denis Mukwege smiling
Fistula Foundation’s longest-term partner is 2018 Nobel Peace Prize recipient, Dr. Denis Mukwege of Panzi Hospital.

In 2014, Fistula Foundation launched an innovative countrywide treatment network program in Kenya, with the potential to end fistula across the country in a generation. Its integrated network allows surgeons, outreach workers, and hospitals to share resources and information to effectively treat more Kenyan women than ever before. The program was so successful, Fistula Foundation deployed the same countrywide treatment model to Zambia in 2017 and to the Democratic Republic of Congo in 2022. All of these programs are thriving, and the organization looks forward to expanding its Fistula Foundation Treatment Network into more countries.

What makes Fistula Foundation so effective


Obstetric fistula can be cured by a surgery that costs an estimated $1,169 including patient follow-up and reintegration services. The suffering and health burden averted is comparable to the most cost-effective health interventions, such as vaccines and bed nets. [5]

Dramatic impact

The Institute for Health Metrics and Evaluations estimated in 2017 that the burden of living with obstetric fistula is comparable to living with terminal cancer, and double the burden of blindness. [6]

Fistula Foundation’s accountability

Fistula Foundation vets potential partners through a careful review process that involves the Foundation’s Program Development staff, Board of Directors, and Grants Review Committee. They also rely on expert input from two senior fistula surgeons who advise its staff and board. Surgeons and hospitals receiving funding are required to provide quarterly progress reports detailing their project activities and costs, surgical outcomes, and any challenges encountered. Fistula Foundation releases funds once a partner’s report has been reviewed and approved.

Since 2005, Fistula Foundation has met the Better Business Bureau’s standards in all 20 categories of accountability, earning their seal of accreditation. [7] A breakdown of expenditures, tax returns, audits, and annual reports is available on Fistula Foundation’s website. [8]


Recognition for Fistula Foundation

Fistula Foundation is a GuideStar Platinum Participant — the highest rating that is awarded to nonprofits — and since 2006, Charity Navigator has awarded Fistula Foundation four stars, a rating given to only 1% of charities. Additionally, Fistula Foundation has been named a top-rated charity by both Charity Watch and GreatBest Charities. [9] [10] [11] [12]

GiveWell, the sector’s most rigorous voice on effective giving (and one of our charity evaluators), states that: “Fistula Foundation may be in the range of cost-effectiveness of our current top charities.” [13]