# Fistula Foundation

Fistula Foundation is a nonprofit 501(c)(3) organization focused on treatment of obstetric fistula, funding more repair surgeries than any other organization, public or private. As of December 2024, Fistula Foundation supports hospital and doctors in more than 30 countries across Africa and Asia. The foundation is dedicated to treating obstetric fistula by covering the full cost of fistula repair surgery for poor women who would otherwise not be able to access treatment. It also provides fistula surgeon training, equipment and facility upgrades that make fistula treatment as safe as possible, post-surgery counseling and support for healed patients. The foundation has been recognized by several organizations for its transparency, effectiveness and efficiency, earning a top "A" rating from CharityWatch and a four star rating from Charity Navigator since 2006, placing it in the top 1% of charities reviewed on the site. In 2024, the foundation was recognized by Pulitzer Prize-winning journalist Nicholas Kristof as a Holiday Impact Prize winner, and featured in The New York Times. In 2023, the foundation received a $15 million gift from philanthropist MacKenzie Scott, announced alongside a new five-year strategic plan that will advance the foundation's In It to End It vision. The foundation has also been selected as one of 22 charities recommended by Princeton Professor Peter Singer's organization, The Life You Can Save. The organization's cost-effectiveness was also noted by GiveWell in 2019.

## History

Fistula Foundation was founded in 2000 by Richard Haas and his daughter Shaleece Haas; they both left the organization in 2005. It is headquartered in San Jose, California, and has offices in Kenya and Zambia. Since its inception, the organization has raised more than $150 million from donors from more than 81 countries.
Until 2008, the foundation supported only the work of the Addis Ababa Fistula Hospital in Ethiopia, founded by Dr. Catherine Hamlin and her husband Reginald Hamlin. In 2009, the foundation expanded its mission to address fistula treatment globally. Since then, Fistula Foundation has supported projects in 35 countries across Africa and Asia, providing more than 100,000 surgeries to women in need.

## Focus

The need for fistula treatment far outstrips supply. For every woman who is treated, there are an estimated 50 more women who go without, according to the foundation and affirmed by a peer reviewed published meta-analysis. Because of this, Fistula Foundation focuses primarily on treatment, either directly through fistula repair surgeries, or by removing barriers to treatment through training of surgeons and the provision and equipping of medical facilities.
Since expanding to a global mission in 2009, the organization has grown to help address the large unmet need. It now provides more support than any other organization including USAID and the United Nations. Countries where the foundation has supported projects include Afghanistan, Angola, Bangladesh, Benin, Burkina Faso, Burundi, Cameroon, Chad, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Madagascar, Mali, Malawi, Mauritania, Mozambique, Nepal, Niger, Nigeria, Pakistan, Rwanda, Senegal, Sierra Leone, Somalia, Somaliland, Sudan, South Sudan, Tanzania, Uganda, Zambia and Zimbabwe.
The foundation also funds surgeon training, growing the pool of skilled fistula surgeons with the ability to perform what can be a very complex surgery. The organization supported the FIGO (International Federation of Gynaecology and Obstetrics) Fistula Training Initiative, which works to build the capacity of fistula surgeons in accredited training centers using the FIGO Global Competency-Based Fistula Surgery Training Manual.

## Leadership

Fistula Foundation is led by CEO Kate Grant, who joined the organization in 2005 as its first chief executive. Under her leadership, the foundation has grown from supporting one facility in one country, to becoming the global leader in fistula treatment. In 2014, Grant was the recipient of the American Marketing Association Foundation "Nonprofit Marketer of the Year Award".
The foundation has a six-member Board of Directors; the chair is Cleo Kiros. Philanthropist and former hedge fund manager Whitney Tilson has served on its Board of Directors.

## Ratings

Fistula Foundation has earned a four-star rating on Charity Navigator every year since 2006, an honor that only 1% of evaluated charities receive. The foundation meets all Better Business Bureau Standards of Charity Accountability, and is a Top-Rated Charity on GreatNonprofits. Peter Singer's organization The Life You Can Save has featured Fistula Foundation on its list of the "best charities for effective giving" since 2014.
In 2015, it was selected by the investment firm The Motley Fool as their holiday 'Foolanthropy' partner, raising over $75,000. ConsumerReports published a list of recommended charities for the 2018 holiday season, naming the Fistula Foundation as one of only five international organizations.
In 2019, the charity evaluator GiveWell said of the foundation: "From an initial cost-effectiveness analysis, our best estimate is that Fistula Foundation may be in the range of cost-effectiveness of our current top charities." GiveWell's evaluation of the organization is ongoing.

## Partnerships

The foundation is a partner of the United Nations Population Fund's Campaign to End Fistula. Other partners have included Direct Relief, the International Federation of Gynaecology and Obstetrics (FIGO) and the International Society of Obstetric Fistula Surgeons (ISOFS). The foundation was a primary funder of the Global Fistula Treatment Map.
When the organization expanded to fight fistula globally in 2009, its first surgeon partner was Dr. Denis Mukwege of Panzi Hospital in the Democratic Republic of Congo. This partnership has continued ever since, and in 2018, Mukwege was awarded the Nobel Peace Prize. Another notable partner is Edna Adan Ismail, founder of the Edna Adan Hospital and University, former First Lady and Foreign Minister of Somaliland, and the country's first qualified nurse midwife.
Fistula Foundation has received funding and support from Johnson & Johnson. The company has partnered with the foundation for the last decade, providing almost $4 million in support.
In 2014, the foundation launched its first countrywide treatment network in Kenya with seed funding from Astellas Pharma EMEA. The initiative is designed to treat women, train more fistula surgeons, and build a lasting network of treatment providers. The foundation launched a second countrywide treatment network in Zambia in 2017, with the support of Johnson & Johnson. Cumulatively, the networks in Kenya and Zambia have treated more than 7,300 women, added 12 facilities to a nationwide fistula treatment network, certified 14 new fistula surgeons at FIGO global competency level, and held over 28,101 community outreach events designed to educate communities about obstetric fistula, how to identify it and where to receive treatment.

## Media

Two-time Pulitzer Prize-winning journalist Nicholas D. Kristof has consistently covered the foundation's work in his New York Times column, most recently in December 2024. He first mentioned the organization in June 2005, and again in June 2006, February 2007, October 2009, December 2009, May 2010, May 2011, May 2012, June 2013, February 2014, March 2015, March 2016, February 2018, and October 2019.
The foundation also continues to generate attention through Grant's articles in international publications including The Guardian, The Lancet, The San Jose Mercury News, Medium, and The Huffington Post. The foundation was also featured in Kenyan television (CitizenTV, NTV) for celebrating the grand opening of the Gynocare Women's & Fistula Center, a hospital funded by Fistula Foundation's donors. Dr. Hillary Mabeya, co-founder of Gynocare, published an op-ed about his work as a fistula surgeon in U.S. News & World Report in May 2018. PBS NewsHour aired a segment on Fistula Foundation's countrywide treatment network in Kenya in December 2017. The organization has also garnered coverage in The Independent, Rolling Stone, USA Today, Reuters, NewsWeek, NewsDeeply, Money Magazine, and MSN News.
The foundation was featured prominently as a top effective charity in the 10th anniversary edition of ethicist professor Peter Singer's book, The Life You Can Save. Singer's partnership with the foundation is longstanding. In 2015, Singer put on a concert with Grammy Award-winning musician Paul Simon, which raised over $150,000 for fistula care.
The foundation was a primary sponsor of the documentary film A Walk to Beautiful which won the Best Feature-Length Documentary of 2007 from the International Documentary Association as well as an Emmy for best long form documentary in 2008. The film tells the story of five Ethiopian women treated by Dr. Hamlin and her staff at the Addis Ababa Fistula Hospital. PBS's NOVA is the other major sponsor of the documentary. In 2016, Comedian Louis C.K. won $50,000 for the Fistula Foundation on the Jeopardy! "Power Players" edition. Fistula Foundation was also featured in Nicholas Kristof and Sheryl WuDunn's book, Half the Sky: Turning Oppression into Opportunity for Women Worldwide. This campaign included a Facebook-based game, Half the Game. Thanks to $250,000 in support from Johnson & Johnson, players of this game can help fund fistula treatment in the real world, through online actions in the game.
In May 2023, Ms. Magazine published an article written by Fistula Foundation's CEO Kate Grant, titled "Skip the Flowers: This Mother's Day, Help Save Women Who Suffer During Childbirth". The article discusses the disparities in obstetric care for mothers around the world, and is a call to action for individuals to give to causes that support maternal health and to call on governments to support global maternal health.

## MacKenzie Scott Gift

In May 2023, Fistula Foundation received a $15 million gift from philanthropist MacKenzie Scott. According to the foundation, all of the funds will be fully deployed by Q1 of 2025, enabling more than 10,000 curative surgeries for women in need. The donation was announced on May 23, International Day to End Obstetric Fistula, an annual event sponsored by the United Nations. The announcement of this donation coincided with an announcement of a new $110 million, five-year strategic plan. Under the plan, Fistula Foundation aims to provide 80,000 surgeries to women with childbirth injuries in sub-Saharan Africa and Asia. The plan also includes a plan to extend treatment networks into five new countries and bring at least 40 new surgery and outreach organizations into the foundation's network of partners. While most of recipients of Scott's philanthropy have been organizations serving U.S. populations, Fistula Foundation is one of the few recipients to work with populations entirely in developing countries.

## Allan Rosenfield Award

The foundation's Allan Rosenfield Award recognizes outstanding contributions of those who have left a deep and accomplished legacy for Fistula Foundation and its mission. The award was inaugurated in 2013, and is named for Dr. Allan Rosenfield, who served on the organization's board of directors for five years. As dean of Columbia University's Mailman School of Public Health, Rosenfield was known globally for his pioneering leadership and myriad of contributions to the field of women's health.
In 2016, Conrad Person of Johnson & Johnson was awarded for his key role in forging an enduring partnership between the foundation and its biggest corporate sponsor. In 2017, the late Jerry Goldstein was honored as Fistula Foundation's longest-standing volunteer, dedicating a portion of his time every week since 2005. Recipients of the award include past board members Kelly Brennan, Mal Warwick, Larry William, Rob Tessler, Jerry Shefren, Kassahun Kebede, Linda Tripp, Teri Whitcraft, Bill Mann, Denis Robson, Ling Lew, and Thomas Huntington, as well as notable advocates and supporters of the foundation’s work, such as Conrad Person, Jerry Goldstein, Al Malvino, Dr. Iftikher Mahmood, Peter Singer, and Charlie Bresler. Former staff members Anne Ferguson, Habiba Mohamed, and Mike Slind have also received the award.