Two nonprofits working on obstetric fistula across Africa have merged to expand their reach and resources, forming Maternal Dignity Project this month through the combination of Worldwide Fistula Fund and Terrewode Women's Fund.
The new organization will back African-led partners in Burkina Faso, Ethiopia, Kenya, Niger and Uganda as they treat and prevent obstetric fistula, a childbirth injury affecting an estimated 500,000 women worldwide.
Obstetric fistula occurs when women in labor cannot access emergency Cesarean sections in time, creating an internal rupture that causes chronic incontinence and social isolation. The injury is both preventable and treatable, yet many women never learn repair is possible and live with it for years.
"Every woman with fistula today is living with something we already know how to prevent and repair," said Bonnie Ruder, executive director of Maternal Dignity Project. "That is the part I cannot accept."
The merger addresses a key bottleneck: funding and coordination. The predecessor organizations had spent years supporting clinicians, survivors and community health workers, often with insufficient resources and operating largely independently.
The unified partners include ARENA Medical Center in Burkina Faso, the country's first dedicated fistula repair center founded by Dr. Itengre Ouedraogo; Let's End Fistula Initiative in Kenya, founded by survivor and advocate Sarah Omega; and TERREWODE in Uganda, which operates the nation's only dedicated fistula hospital while providing post-operative support and community reintegration services.
These organizations were built by people embedded in their communities with deep understanding of local health systems and cultural contexts.
Maternal Dignity Project plans to expand prevention efforts as maternal health infrastructure improves across the region. An increasing proportion of new fistula cases are now linked to Cesarean sections performed by providers lacking adequate training or resources. Several partners are researching this emerging pattern.
The merger reflects a broader truth about global health: organizations doing effective work often operate on limited budgets while competing for donor attention. Philanthropic incentives typically reward separate identities and distinct funding streams, making the decision to consolidate significant.
For women with fistula in these five countries, the merger means more consistent funding, larger-scale programming and the ability for partners to share learning across borders. Obstetric fistula is entirely preventable with access to timely emergency care and safe surgical services and treatable through relatively straightforward surgical repair.
