Fistula Surgery Training Initiative
Since 2012, the FIGO Fistula Surgery Training Initiative has been building the capacities of local trainee fistula surgeons – ‘FIGO Fellows’ – and multidisciplinary teams to provide treatment to women suffering from obstetric fistula in some of the world’s most underserved communities.
Gillian Slinger - Senior Project Manager
What is obstetric fistula?
An obstetric fistula is a devastating childbirth injury that results from prolonged, obstructed labour, causing an abnormal opening between the vagina and the bladder and/or rectum. If not surgically repaired, the affected woman is incontinent for the rest of her life, often leading to immense suffering and isolation.
The condition affects two million women in 59 low-resource countries of Sub-Saharan Africa and certain parts of Asia, with up to 100,000 additional women developing a fistula every year in some of the world’s poorest and most disadvantaged communities. Obstetric fistula is a neglected public health and human rights issue.
Training fistula surgeons and multidisciplinary teams
A skilled fistula surgeon can repair most cases of obstetric fistula. But because of a global shortage of these specialists, it is estimated that only one woman in 50 has access to fistula treatment. When taking into account the sheer magnitude of human suffering brought about by the condition, this is unacceptable.
To make a meaningful contribution to addressing the global treatment gap, the FIGO Fistula Surgery Training Initiative is an ambitious multi-year programme training fistula surgeons and multidisciplinary teams to provide life-transforming care to significantly greater numbers of women suffering from this debilitating condition.
FIGO’s game changing programme builds the capacities of local fistula surgeons – FIGO Fellows – and multidisciplinary teams over time. This capacity building takes place through training placements in accredited Training Centres, followed by intermittent coaching visits with FIGO Trainers, in Fellows’ home facilities where possible. The training programme utilises FIGO and Partners Global Competency-Based Fistula Surgery Training Manual, the first standardised, evidence-based tool to train fistula surgeons.
As of April 2021, 66 surgeons from 22 affected countries are enrolled on the programme, and have collectively provided more than 13,000 fistula repair operations. FIGO is committed to expanding this initiative, to train more surgeons so that significantly more women are treated in the future.
Apply to be a FIGO Fellow
We welcome applications from dedicated medical doctors who are committed to helping women with fistula. Please read the selection criteria carefully before applying, and send a completed application form to the fistula project team.
Recommended training resources
- FIGO and Partners, Global Competency-Based Fistula Surgery Training Manual (2011)
- Dr Brian Hancock, An Introduction to Obstetric Fistula Surgery (2013)
- Dr Brian Hancock, First Steps in Vesico-Vaginal Fistula Surgery (2005)
- Dr Brian Hancock with Dr Andrew Browning, Practical Obstetric Fistula Surgery (2009)
- Dr Michael Breen, Manual of Obstetric Fistula Surgery (2019)
- WHO, Obstetric Fistula: Guiding principles for clinical management and programme development (2006)
- Ishbel Marion Campbell & Ian Shane Asiimwe, Nursing Care for Women with Childbirth Injuries (2021)
- Global Library of Women’s Medicine (GLOWM)
Supplying fistula surgery equipment
To address the fistula surgery equipment gap and ensure women receive the best possible care, FIGO, in collaboration with Medical Aid International (MAI), supplies much needed surgical equipment to Fellows. Equipment supplied through this collaboration includes the FIGO Specification Fistula Instrument set, which was developed based on the recommendations of leading fistula surgeons.
A pioneering FIGO-MedAid Fistula Equipment Alliance has also been set up to generate bulk orders with interested parties, in order to reduce prices and therefore make quality fistula equipment more accessible.
For more information, or to enquire about placing an order, please contact the fistula project team.
Raising awareness on the International Day to End Obstetric Fistula
On 23 May each year, FIGO joins the global community to raise awareness about obstetric fistula and generate much-needed additional support for women affected.
Visit our International Day to End Obstetric Fistula page for an excellent range of resources, including authentic stories, graphics and social media assets to help you call attention to the International Day to #EndFistula.