On June 10, 2010, Dr. Joseph Ruminjo, the clinical director of EngenderHealth’s Fistula Care project, and Josephine Elechi, the First Lady of Ebonyi State in southeastern Nigeria and the founder of the Mother and Child Care Initiative, were among a group who briefed members of Congress on obstetric fistula.

The briefing was part of an effort to gain support among members of the House of Representatives for the bipartisan Obstetric Fistula Prevention, Treatment, Hope and Dignity Restoration Act of 2010, H.R. 5441. This bill would authorize funding to prevent obstetric fistula and treat women suffering from this debilitating injury, which can occur during prolonged or obstructed labor and often leaves the mother with chronic incontinence. Fistula, which is almost always preventable, is estimated to affect more than 2 million girls and women worldwide.

Elechi, who comes from Nigeria, a country that accounts for 10% of global maternal deaths, spoke about witnessing women die during childbirth in her small village. “I also learned about obstetric fistula, a hole that can develop between the bladder and the birth canal following obstructed labor,” she told members of Congress. “I was moved by the stories of women with fistula who were performing their God-given role to give life.”

These experiences stuck with Elechi, and when her husband became governor of Ebonyi State, she used her position to advocate for better maternal and child health and to create the Mother and Child Care Initiative, which helped establish a 100-bed hospital in her state staffed with a full-time fistula surgeon and four nurses. The hospital operates in collaboration with EngenderHealth’s Fistula Care project, supported by the U.S. Agency for International Development (USAID), and other organizations.

In up to 90% of cases, fistula scan be surgically repaired. Ruminjo spoke to this when he told members of Congress about the more than 15,000 fistula repair surgeries the U.S. government has enabled in 11 countries. He stressed the need for continued international support and partnering at different levels to help transform women’s lives.

“This requires collaboration with individual champions. It requires working with communities. It requires ownership at the facility and national levels.  And it requires the support of international coordination,” he said. “At all of these levels, we are working in partnership to build local capacity to support not only the treatment but, crucially, also the prevention of this devastating condition.”

EngenderHealth’s five-year Fistula Care project is the largest U.S. government–funded effort to date dedicated to treating and preventing fistula. With support from USAID, the project aims to train doctors in fistula repair surgery and strengthen the capacity of hospitals to provide fistula care; improve the quality of existing fistula services; raise awareness in communities and hospitals about both fistula prevention and the availability of care and repair for affected women; and support women as they reenter family and community life.

The Obstetric Fistula Prevention, Treatment, Hope and Dignity Restoration Act of 2010, H.R. 5441, was introduced by Reps. Carolyn Maloney (D-NY) and Mike Castle (R-DE) in late May 2010. It is currently in the first step of the legislative process and has been referred to committee.