Hope for Our Sisters, Inc.

HFOS is a 501(c)(3) non-profit that advocates for women and girls suffering from and at risk for obstetric and traumatic fistula. We share their stories and raise support for the effective treatment and prevention of this hope-destroying condition and the empowerment of the women and girls we serve. We partner with doctors, foundations, and others committed to bringing an end to fistula and to caring for these women and girls. Our vision is a world where women are valued, live to their fullest potential, and are positive change-agents within their communities. Fistula is an abnormal communication, or hole, between the tracts of the bladder and its structures with the vagina, the rectum with the vagina, or both. These holes allow for the constant leakage of urine and/or feces from the vaginal opening. Fistulas most often occur from obstructed labor, in which women strain to deliver their infant for several days and the pressure from the infant's head causes damage to the soft tissues of the pelvic region. A second cause of fistula is from violence, as these holes can occur when women are gang raped or forcefully penetrated with a foreign object. Fistulas are nearly obsolete in developed countries where cesarean deliveries (sections) are readily available to relieve obstructed labor and where extreme sexual violence against women is frequently used as a tool of oppression. Currently, our work is mostly based in Angola, the Democratic Republic of the Congo (DRC), and Nepal. We have specific individual or organizational partners in each of these locations that enable us to carry out programs that we have either designed on our own or chosen to act as involved partners. (Since we fund this work for our partners to carry out, we are not required to have licenses to operate within each country.) In Angola, we partner with doctors, nurses and administrative staff at two hospitals: Kalukembe and Central Evangelical Medical Center in Lubango (CEML). In the DRC, we partner with World Relief, a well-known non-profit organization that works across the world on issues of social justice, health and development, economics and peace-building. In Nepal, we partner with Dr. Shirley Heywood, who has been serving women with fistula there for 14 years. We seek to eradicate fistula by way of a three-pronged, cyclical approach - prevention, treatment and empowerment. Because 2-3 million women worldwide are currently living with fistula, and surgical capacity in most low- and middle-income countries (LMICs) cannot address both the number of new cases each year and the backlog of women who already have fistula, prevention is critical. We are unique among fistula advocacy organizations in that prevention, not treatment, is our main focus. The majority of the funds we raise go to preventative efforts. We fund Fistula Education& Awareness Sessions that provide women, men and healthcare workers with important information about what fistula is, its causes and how to prevent it, and how to seek treatment. These have been instrumental in helping to reduce the shame and stigma surrounding the condition of fistula. We also carry out an Ultrasound Empowerment Program in which one of our partner doctors takes a portable ultrasound into remote areas to provide families with information about their pregnancy. Women who are at risk for complicated delivery, such as women carrying multiples or whose babies are in sub-optimal positioning, are counseled to seek cesarean deliveries or assisted delivery from trained personnel at the time of labor. We have seen women heeding this advice and showing up to protect themselves and their infants. Related to this, we administer two Maternal Health Funds in which money is set aside to help pay for cesarean deliveries for women who cannot afford the procedure in part or in full. This makes them more likely to show up when needed, and also is an important resource for post-fistula repair patients, who are at risk for fistula recurrence if they undergo another vaginal delivery. One program straddling the space between prevention and treatment is that of our surgical education funds. We are currently supporting two physicians who have determined that they will go on to become gynecological surgeons under the tutelage of the Pan-African Academy of Christian Surgeons (PAACS). Dr. Sam Fabiano is from Angola and Dr. Tresor Mbazana is from the DRC. They will both return to their countries once their surgical education is complete and will be able to provide cesarean deliveries to women in need and/or fistula repairs for women who have already suffered from an obstructed labor or violent act. In this way, some fistulas may be prevented from occurring and others will be reversed, restoring life to these women. We are continually searching for a female doctor from one of our partner countries to support as well. In terms of treatment, we always have and still fund some fistula surgeries. However, many other groups are focused on this and we find that our money is often able best applied to other areas of need that are unaddressed. Empowerment is the final important piece of our cycle. In Angola, we have an empowerment program for women recovering from or awaiting fistula surgery, in which they are taught basic literacy and some vocational skills, such as sewing and basket weaving. This enables these women to provide for themselves in the event that they cannot return to their communities, as many have been abandoned by their husbands and families due to their condition and inability to keep clean and odor-free when leaking. The program teaches women that they are able and still have value and a way to contribute to their communities. Additionally, in DRC, we are funding Sexual Gender-Based Violence groups, in which women who have been victims of assault are empowered to share their stories with others, men and women, in order to bring about gender equality and mutual respect between men and women. These programs are administered by World Relief and have been very successful and important as the DRC continues to heal from many years of armed conflict. We are doubling our investment in Nepal this year to help our partners there establish a new empowerment program for selected women who need new skills to provide for themselves and their families. Our partners at home and abroad all have a heart for the eventual eradication of fistula. It is a devastating, tragic condition that is easily preventable and fixable were there are better systems in place for health promotion and gender equality in some of our partner countries and other low and middle income countries around the world.