Beyond Repair: Involving Communities in Fistula Prevention and Reintegration - Experience From Kissidougou, Guinea

The city of Kissidougou, located in the eastern forest region of central Guinea close to Sierra Leone and Liberia, has a population of approximately 137,000 people. Kissidougou District Hospital, the referral institution in the area, provides a variety of health services, including surgery, maternity care, and pediatrics. Since October 2005, EngenderHealth, with U.S. Agency for International Development (USAID) funding, has supported Kissidougou District Hospital to provide fistula care services. In addition to the USAID support, EngenderHealth has provided private funds to support several of the community activities described in this brief. (Fistula Care also supports
fistula repair at three other sites in Guinea, and the United Nations Population Fund [UNFPA] supports repairs at one site.)
The program was funded initially by USAID through the ACQUIRE Project and most recently through Fistula Care. From the beginning, the Kissidougou project established three program services: surgical repair, fistula prevention, and reintegration of fistula patients into their communities. USAID is working in Guinea to strengthen democratic processes and institutionsand to help national and local governments become more efficient and accountable. That initiative has been an important building block for fistula repair efforts in
Kissidougou, contributing substantially to the program, especially to prevention and reintegration.