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The Action on Fistula programme aims to transform the lives of over 1,200 women in Kenya suffering due to obstetric fistula.

What is obstetric fistula?

Watch the programme in action

Key facts

An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour when emergency care is unavailable, causing incontinence.

  • 1,000,000

    women living with fistula

    Around 1,000,000 women live with obstetric fistula in developing countries


    women’s lives transformed

    The Action on Fistula programme aims to transform the lives of over 1,200 women in Kenya suffering due to obstetric fistula

  • 3,000

    new cases every year in Kenya

    UNFPA estimates 3,000 new cases of obstetric fistula occur annually in Kenya, with approximately one to two fistulas for every 1,000 deliveries

    Fistula ambassadors throughout Kenya

    Recognising that many of the women with obstetric fistula live in isolation in rural communities, Action on Fistula will support the creation of a Fistula Treatment Network across Kenya and fund a major outreach programme with many Fistula ambassadors working in the field

  • Causes stigma and isolation

    Sufferers of obstetric fistula are often stigmatised and isolated from their families and communities. The damage often prevents further pregnancies

    Genuine change

    The Action on Fistula programme will free more women from this devastating condition and build capacity through surgical training so that more women can be treated in the future

  • Difficult
    to get treatment

    While obstetric fistula cases can be repaired with reconstructive plastic surgery and straightforward cases have around 90% success rate, surgery and other costs such as nursing care and transport make treatment beyond the reach of the majority of the women affected

    €1.5 million

    Astellas will provide funding of over €1.5 million over a three year period between 2014-2017

  • Complicated to treat

    Fistula surgery is complicated and requires experienced healthcare professionals. Kenya currently only has four who are members of the ISOFS, the International Society of Fistula Surgeons

    More qualified surgeons

    The Action on Fistula programme will increase the number of fistula surgeons in Kenya by 100% through the FIGO (International Federation of Gynecology and Obstetrics) Competency Based Training Programme

Changing lives

Programme news and views

  • July 2014: Campaign update

    July 2014: Campaign update

    Successful launch of Action on Fistula secures widespread media coverage
July 2014: Campaign update

July 2014: Campaign update

Successful launch of Action on Fistula secures widespread media coverage

On 23 May 2014, Astellas and the Fistula Foundation proudly announced the launch of Action on Fistula – to coincide with the International Day to End Obstetric Fistula.

The launch, which took place at Astellas’ EMEA HQ in Chertsey, Surrey, was attended by 300 employees and featured presentations from Ken Jones, Astellas Pharma EMEA President & CEO and Dr Soheir Elneil, Chair of the Fistula Foundation and clinical lead for the programme. They discussed the issue of fistula in Kenya and explained the aims of the Action on Fistula campaign.

The Action on Fistula launch secured a number of high profile pieces of coverage in UK and international media, including Thomson Reuters Foundation, The Guardian, PharmaTimes, Pharmaceutical Marketing Europe and Ethical Performance.

Ken Jones, President & CEO of Astellas Pharma EMEA, said:

“Action on Fistula tackles a significant unmet need for treatment in urology, where we have a strong heritage. Obstetric fistula has been virtually eliminated in higher income countries yet is estimated to still affect around one million women worldwide, mainly in sub‐saharan Africa.

“Through our flagship corporate giving programme and in partnership with the Fistula Foundation we want to help treat more women living with this devastating condition. Critically, the programme will build capacity through surgical training so that even more women can be treated in the future.”

Astellas employees raise £1600 to help more women receive life changing fistula treatment

At the end of June, Astellas employees came together for a Wild West themed company party and raised funding for the Action on Fistula programme. The event, which included tombola and a raffle, was a huge success with an impressive £800 being raised on the day. The Astellas European Foundation match funded this amount for a grand total of £1600 to be donated to the Fistula Foundation. This donation will enable the treatment of at least six women suffering from the condition.

Astellas is actively encouraging employees to fundraise to support Action on Fistula and welcomes involvement from other interested parties. For every €350 raised, an additional woman can receive life changing surgery.


See the impact the Action on Fistula programme team is making.

Dr. Sohier Elneil

Dr. Sohier Elneil

Chair, Board of Directors, Fistula Foundation
Consultant in Urogynaecology and Uro-neurology, University College London Hospital and National Hospital for Neurology and Neurosurgery.

Dr. Sohier Elneil is trained in Uro-Gynecology surgery and practices in London as a consultant at University College Hospital. She is a member of the FIGO Committee on Fistula, and the lead author and editor of FIGO’s Global Competency-Based Fistula Surgery Training Manual to develop standardised training programmes and improve outcomes for women with fistula.

Dr. Elneil will be overseeing the direction of the Action on Fistula programme, providing her clinical expertise to inform the fistula surgery training programme.

“One of the greatest obstacles in providing access to care for women suffering with fistula is the lack of appropriately trained surgeons. Action on Fistula, in tandem with the International Federation of Gynecology and Obstetrics’ Competency-Based Training Programme, will significantly increase the number of skilled local surgeons who can help reduce the backlog of women waiting for fistula treatment in Kenya.”



Kate Grant

Kate Grant

CEO, Fistula Foundation

Kate Grant joined the Foundation as its first Chief Executive in 2005 and leads the Board and staff team, expanding the Foundation from supporting one institution in one country, Ethiopia, to its current global reach in 38 sites throughout 19 countries.

Kate will lead the Action on Fistula programme, overseeing delivery on the ground in Kenya, including training of fistula surgeons and a major outreach programme.

“The need for fistula treatment in Kenya is great and we can’t face this challenge alone. We’re honoured to be working with Astellas to end the suffering caused by fistula for women across the country.”

“Our programme with Astellas will help provide the vital treatment these women need and deserve to live happy, fulfilled lives. This generous support will also help us train more surgeons to deliver high quality treatment, enabling many more women to be treated in the future.”

“We value the expertise of Astellas as a global urology leader and look forward to working together to help transform many more lives of women affected by fistula.”



Dr. Hillary Mabeya

Dr. Hillary Mabeya

MBCHB, MMED obs/gyn, Fistula Surgeon, Gynocare

Dr. Hillary Mabeya is the founder and lead surgeon at Gynocare Fistula Center, a nongovernmental organisation in Western Kenya that provides reproductive health services to women. Since becoming the first specialised fistula surgeon in the region in 2003, Dr. Mabeya has performed thousands of surgeries that have transformed the lives of women suffering from obstetric fistula.

He previously served as the Chairman for the Division of Reproductive Health at Moi Teaching and Referral Hospital, as the District Medical Officer of Health, West Pokot District, Kenya, and the District Obstetrician/Gynecologist, Kajiado District, Kenya. He also served at the Hamlin Fistula Hospital in Addis Ababa, Ethiopia, and as a fistula surgeon for Africa Medical Research Foundation (AMREF). His professional memberships include the Kenya Medical Association (KMA), the Kenya Medical Practitioners and Dentists Board (KMPDB), Kenya Obstetrics and Gynecological Society (KOGS), and the East, Central Southern Africa Obstetric and Gynecological Society (ECSAOGS). Dr. Mabeya has provided numerous presentations on obstetric fistula in rural hospitals, HIV infected pregnant women, the social, economic, and cultural determinants of obstetric fistula, and surgical outcomes for obstetric fistula. He is also a lecturer and an obstetrician gynaecologist at Moi University School of Medicine in Eldoret, Kenya.

Dr. Mabeya holds a MBChB in Medicine and Surgery and a MMED in Obstetrics and Gynecology from the University of Nairobi. He is also certified in reproductive research by the World Health Organization and served as a Fellow of HIV in Women at Brown University.

“The backlog of patients waiting for treatment is tremendous. Some women have waited for over 70 years to get surgery! Action on Fistula will ease this backlog on a scale never before seen in Kenya.”



Lindsey Pollaczek

Lindsey Pollaczek

Kenya Action on Fistula Programme Director Fistula Foundation

Lindsey Pollaczek directs Fistula Foundation’s work in Kenya. As part of the Action on Fistula programme, Lindsay will coordinate delivery of the fistula surgery training programme and manage the development of a Fistula Treatment Network and outreach programme in Kenya. She was seconded from Direct Relief where she worked since 2006, overseeing the organisation’s Maternal and Child Health initiatives and partnerships in Sub-Saharan Africa.

“Action on Fistula is the first program of its kind to approach fistula on such a comprehensive scale. Pairing the knowledge and efforts of partners on the ground throughout Kenya with the expertise of globally focused organisations like Fistula Foundation and the International Federation of Gynecology and Obstetrics in this way is not only smart, but respectful of the work that is already underway in Kenya to heal women who are suffering from obstetric fistula.”



  • Dr. Sohier Elneil

    Dr. Sohier Elneil

    Overseeing the programme
  • Kate Grant

    Kate Grant

    Architect and leader of the programme in Kenya
  • Dr. Hillary Mabeya

    Dr. Hillary Mabeya

    Obstetric Fistula Surgeon in Kenya
  • Lindsey Pollaczek

    Lindsey Pollaczek

    Delivering and managing the programme in Kenya

Get involved

If you want to find out about ways of getting involved, or have any questions about the Action on Fistula programme, please contact the Fistula Foundation

All photography © Georgina Goodwin

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APEL/14/0014/EU January 2015