Each year, thousands of women die during pregnancy and childbirth in Mali. Among those who do not die, an unknown number suffer from obstetric fistula, a maternal injury with perhaps the most devastating aftermath. Obstetric fistula can lead to chronic incontinence and severe nerve damage, which can affect a woman’s ability to walk. In addition to the physical damage, women also endure a heavy psycological toll. In up to 90 percent of cases, the baby is stillborn or dies within weeks. And women suffering from this condition are often ostracized by their communities, religious houses of prayer and even their families.

As part of USAID’s assistance aimed at saving the lives of Malians, in 2008, the Fistula Care Project partnered with the regional hospital of Gao, and local NGO Groupe de Recherche, d’Étude, de Formation Femme Action (GREFFA) in northern Mali to make quality fistula treatment services available. In less than three years, the project supported 230 fistula repair surgeries and trained five doctors and 187 nurses in fistula surgery and management, over 200 doctors and nurses on safe motherhood-related topics, and 184 people in fistula counseling.

The future looked even brighter until the city of Gao fell into the hands of armed rebel groups in April 2012. The Gao hospital was ransacked and looted with 12 women in post-operative fistula care and another 12 awaiting surgery. The women were chased out of the hospital, some with their catheters and infusion bags still inserted.

Following a USAID-supported search, 22 of the women were found and transferred to Mopti regional hospital, in central Mali, for care. Their lives are no longer in danger.

R. Maïga, one of the rescued women, still recalls the episode vividly.

“I had been operated on, and they told me I needed care for a month. When the hospital was ransacked, my companion disappeared," she says. "We were all alone in the middle of the chaos at the hospital — even the bed I was sleeping on had been stolen. There was no health worker to remove my catheter. I truly give thanks to God and to GREFFA who looked for me and treated me. I was told I had an infection, and for several days I couldn’t tell the difference between day and night. ... I’m a real miracle. After my check-up in Mopti, the surgeon told me my fistula has completely closed.”

Today, like Maïga, most of the women are nearly healed. They have pledged to do everything they can to help find other women who continue to suffer from fistula and encourage them to undergo treatment. More importantly, since their recoveries, they feel better armed to overcome abandonment and neglect by their husbands and families, and to walk out of poverty and vulnerability associated with fistula.