Obstetric Fistula

What is Obstetric Fistula?

Obstetric fistula is a childbirth injury resulting from obstructed labor as a result of no access to emergency obstetric care. During the obstruction the mother develops a hole in her genitalia which in turn causes her to leak feces, urine or both if it goes untreated. Her baby often dies in the womb as she is giving birth at home for days on end. Many times the husband leaves her due to the foul smell and her community ostracizes her.


  • In Bangladesh there are 70,000 women in need of fistula repair surgery.
  • Each year 2,000 new cases of fistula develop.
  • In Cox’s Bazar there is an estimated 5,000 women living with fistula.
  • Malnutrition coupled with young age at delivery creates complicated cases of fistula in Bangladesh.
  • A lack of midwives and other healthcare professionals in rural areas leads women to give birth at home attended to by a traditional birth attendant who often engages in life-threatening practices causing obstructed labor.

HOPE’s Obstetric Fistula Program

Obstetric Fistula Surgical Repair:
Since 2011 HOPE Foundation, through its partner Fistula Foundation, has provided obstetric fistula repair surgery free of charge to the women of Cox’s Bazar. HOPE currently has the only FIGO trained fistula surgeon in the entire country, and is the only fistula provider in the southeastern region of the country. Fistula Foundation further assists us in annual visits by international fistula surgeons for advanced, complicated cases. Through their support we are able to reach so many women in desperate need.

Obstetric Fistula Dedicated Team:
HOPE Foundation was awarded funding by Dining for Women to train and establish an Obstetric Fistula Team in 2014 that will provide repair surgeries and support our fistula surgeon on a year-round basis. The team will consist of a support physician, fistula nurse, social worker and outreach coordinator. The project will enhance our current fistula project, provide unmatched care to our fistula patients, and allow us to conduct more surgeries per year as well as conduct a mass prevention and awareness campaign. This project will allow us to reduce suffering and continue the fight to rid obstetric fistula from Cox’s Bazar or good.

Financial Empowerment Program:
Support from the Henry E. Niles Foundation has afforded HOPE to implement a financial empowerment program for our fistula sufferers. These women are victims of poverty, hence why the fistula occurs in the first place. Throughout the years they are suffering, they cannot work as they are to be kept inside due to the embarrassment in the community. As a result they owe family and friends a tremendous amount of money. This pilot project offers training in sewing to a handful of patients to not only provide them the skills and supplies to start their own businesses but to also create a support group of women overcoming fistula. Women with fistula lack confidence and the social skills, and creating a safe environment for them to regain their social skills around other fistula survivors and learn to empower each other will greatly assist in their rehabilitation.

Additional Fistula Services:
Physical therapy, social rehabilitation and reintegration, nutrition counseling, postoperative follow-up care.

Our Partners:
Fistula Foundation
Dining for Women
Henry E. Niles Foundation

surgical-repairSurgical Repair building-awarenessBuilding Awareness social-reintegrationSocial Reintegration

Jolchina Begum – Free of Fistula


Fourteen years ago Jolchina became pregnant with her first child and enlisted the help of a traditional birth attendant, as all of her neighbors and family members do. During labor Jolchina felt something was wrong and asked the attendant if she should seek care at a hospital. The attendant replied “no, everything is fine”. Jolchina was enduring obstructed labor for three days before the attendant finally agreed she should go to the hospital. At the hospital they performed an emergency cesarean section to remove the already deceased child. The urinary incontinence began a few days after her surgery. Jolchina became pregnant again and gave birth to a little girl, even while suffering with the fistula. That delivery was also an emergency cesarean section and the doctor performed an ovarian ligation. The doctor at that time informed Jolchina’s husband that they should not come into physical contact because of her fistula; her husband divorced her immediately, taking her only daughter.

Jolchina came to learn about HOPE’s fistula program from another patient who was successfully cured of her fistula at HOPE. She felt optimistic that if her friend is repaired, then maybe she too can be. She was operated on by HOPE’s Fistula surgeon Dr. Biswas, and her first surgery was a success! As Jolchina is remarried, she wants very badly to have a child. Dr. Biswas will perform the complicated surgery of reversing the ligation, at an appropriate time after recovery, to hopefully enable her to bear a child. She is looking forward to a life without incontinence and becoming a mother again.