Fistula Foundation

Fistula Foundation is a United States-based nonprofit organization focused on treating obstetric fistula, a severe childbirth injury that can cause chronic urinary or fecal incontinence, social isolation, and serious health complications. The condition disproportionately affects women who lack access to timely obstetric care, particularly in low-resource settings. The foundation’s central intervention is to pay the full cost of fistula-repair surgery for patients who cannot afford treatment, while also supporting the surrounding care system needed to identify patients, bring them to hospitals, train clinicians, and help them recover and return to their communities. The organization began in 2000 when Richard and Shaleece Haas created a volunteer initiative supporting the Addis Ababa Fistula Hospital in Ethiopia. Its initial work was country-specific, but the foundation broadened its scope internationally in 2009. Its first partner outside Ethiopia was physician Denis Mukwege in the Democratic Republic of the Congo. Since then, the organization has developed partnerships with hospitals, health ministries, community groups, and medical-training institutions across Africa and Asia. Fistula Foundation’s model extends beyond paying for individual operations. It funds patient education and outreach, screening and referral, surgical treatment, clinical training, facility expansion, follow-up care, support groups, and vocational or social reintegration programs. The organization has also created country-level treatment networks intended to make free care available across an entire national health system rather than at only one hospital. Its Kenya network, launched in 2014 under the Action on Fistula name, connected community organizations with providers and incorporated training supported by the International Federation of Gynecology and Obstetrics. From 2014 through 2020, that program reported free surgery for 5,720 patients. A second network began in Zambia in 2017; from 2017 through 2023, at least 1,439 women received treatment, with an 88 percent successful closure outcome reported at hospital discharge. As of 2024, the foundation reported supporting more than 100,000 surgeries in over 35 countries, while describing active work in 26 countries in Africa and Asia. Kenya, Nigeria, and the Democratic Republic of the Congo were identified as the leading countries by supported surgery volume. In 2025, the organization and Nigeria’s Federal Ministry of Health and Social Welfare opened the Fistula Foundation Treatment Network in Nigeria, intended to expand free surgery and rehabilitation for women affected by obstetric fistula. The foundation has attracted attention from charity evaluators, journalists, philanthropists, and advocates of effective giving. It has received a four-star Charity Navigator rating each year since 2006 according to the cited reference material, and CharityWatch has given it an A rating. Peter Singer’s The Life You Can Save has recommended the organization as a potentially high-impact charity, while GiveWell has described its estimated cost-effectiveness as potentially comparable to that of its leading charities but subject to substantial uncertainty. Journalist Nicholas Kristof has repeatedly highlighted the foundation’s work, including naming it as an awardee of his 2024 Holiday Impact Prize. In 2023, MacKenzie Scott gave the organization a $15 million grant, which the foundation said would support a five-year plan involving 80,000 surgeries, treatment networks in five additional countries, and 40 more partner organizations.

Fistula Foundation was established in 2000 by Richard and Shaleece Haas as a volunteer organization supporting the Addis Ababa Fistula Hospital in Ethiopia. Its original purpose was to help women obtain treatment for obstetric fistula, a childbirth-related injury associated with prolonged or obstructed labor and inadequate access to emergency obstetric care. The injury can leave patients incontinent and socially marginalized, even after the original obstetric event has ended. The organization expanded internationally in 2009. Its first partner outside Ethiopia was Denis Mukwege in the Democratic Republic of the Congo, marking a shift from support for a single institution toward a broader network of country and clinical partners. The foundation’s approach has generally emphasized paying for care that patients cannot otherwise obtain, while strengthening the systems that make treatment possible. In 2014, Fistula Foundation launched its first Fistula Treatment Network in Kenya, formally associated with the Action on Fistula initiative. The program worked with community-serving organizations to locate potential patients, provide education and screening, and connect eligible women with hospitals offering free repair surgery. It also collaborated with the International Federation of Gynecology and Obstetrics to train healthcare workers in fistula treatment. Follow-up visits, support groups, and vocational assistance were included to help patients resume family and economic life after surgery. Between 2014 and 2020, the Kenya initiative treated 5,720 patients with free operations. Astellas Pharma EMEA supplied seed funding. A second national network was launched in Zambia in 2017. Between 2017 and 2023, at least 1,439 women were treated through the program. The organization reported that 88 percent had a successful result at discharge, defined in the cited material as closure of the fistula without urinary incontinence. The network model sought to address the full chain of care, from finding women who needed treatment to providing surgery, rehabilitation, and continuing support. The foundation has subsequently operated across Africa and Asia. By 2024, it described active work in 26 countries and more than 100,000 surgeries supported across over 35 countries since its founding. Kenya, Nigeria, and the Democratic Republic of the Congo were reported as the three countries with the highest numbers of supported surgeries. In 2025, the foundation and Nigeria’s Federal Ministry of Health and Social Welfare opened the Fistula Foundation Treatment Network in Nigeria, with the stated purpose of expanding access to free surgical and rehabilitative services. The organization’s public profile has also been shaped by charity evaluation and media coverage. Charity Navigator has awarded it four stars annually since 2006 according to the cited reference, largely on accountability and financial criteria, and CharityWatch has assigned it an A rating. Peter Singer’s The Life You Can Save has included the foundation among recommended high-impact charities. GiveWell assessed it in 2021 as potentially within the cost-effectiveness range of its top charities, while emphasizing uncertainty concerning counterfactual funding, long-term surgical outcomes, and the value of fistula repair. Nicholas Kristof first highlighted the organization in a New York Times column in 2009 and continued to encourage donations. The foundation also sponsored the 2007 documentary A Walk to Beautiful, which followed Ethiopian women receiving fistula treatment. Public fundraising support included The Motley Fool’s 2015 Foolanthropy drive and a $50,000 fundraising appearance by Louis C.K. on Celebrity Jeopardy in 2016. In 2023, MacKenzie Scott contributed $15 million, which the foundation said would finance a five-year expansion plan. In 2024, Kristof named the foundation an awardee of his Holiday Impact Prize, providing a further $50,000 award. Fistula Foundation is headquartered in San Jose, California, with offices in Kenya and Zambia. Pam Lowney leads the organization as chief executive officer and joined it in 2018; she served as chief operating officer from 2022 to 2025. Cleo Kiros is chair of the board of directors.

• 2025

  Nigeria treatment network opened

  [1]Fistula Foundationen.wikipedia.org

  The organization and Nigeria’s Federal Ministry of Health and Social Welfare opened a treatment network for free surgery and rehabilitation.

• 2024

  More than 100,000 surgeries supported

  [1]Fistula Foundationen.wikipedia.org

  The foundation reported having supported over 100,000 surgeries in more than 35 countries.

• 2023

  MacKenzie Scott grant

  [1]Fistula Foundationen.wikipedia.org

  A $15 million gift was announced to support the foundation’s five-year growth plan.

• 2017

  Zambia Fistula Treatment Network launched

  [1]Fistula Foundationen.wikipedia.org

  The foundation established a second national treatment network in Zambia.

• 2014

  Kenya Fistula Treatment Network launched

  [1]Fistula Foundationen.wikipedia.org

  The Action on Fistula initiative began connecting community outreach, free surgery, provider training, and rehabilitation in Kenya.

• 2009

  International expansion

  [1]Fistula Foundationen.wikipedia.org

  The organization expanded beyond Ethiopia and formed an early partnership with Denis Mukwege in the Democratic Republic of the Congo.

• 2007

  A Walk to Beautiful sponsorship

  [1]Fistula Foundationen.wikipedia.org

  The foundation sponsored a documentary about Ethiopian women receiving treatment for obstetric fistula.

• 2000

  Foundation established

  [1]Fistula Foundationen.wikipedia.org

  Richard and Shaleece Haas founded the organization as a volunteer effort supporting Addis Ababa Fistula Hospital in Ethiopia.

A specialist, high-impact global health nonprofit that combines direct funding for fistula surgery with patient identification, medical training, health-system development, and post-operative reintegration.

• Medical treatment · 2000

  Obstetric fistula repair surgery

  The foundation’s core service is funding complete fistula-repair operations for women who cannot pay for care. Funding is directed through partner hospitals and treatment networks, with associated patient identification, referral, transport, clinical care, and discharge support. The model addresses a condition that is frequently treatable through surgery but remains inaccessible to many women in low-resource settings.

• Health-system program · 2014

  Fistula Treatment Networks

  These country-level networks coordinate community education, outreach, screening, referral, free surgery, provider training, hospital capacity, and post-operative services. The intended effect is to create a connected national pathway for patients rather than relying on isolated charitable operations. Networks have operated in Kenya and Zambia, with a Nigeria network opened in 2025 and plans described for further countries.

• Medical capacity building

  Clinical training and facility support

  Fistula Foundation supports training for healthcare professionals, including work with the International Federation of Gynecology and Obstetrics, and helps expand treatment capacity at partner facilities. These activities are intended to increase the number of qualified providers and hospitals able to deliver safe fistula care over time.

• Patient support · 2014

  Post-surgery rehabilitation and reintegration

  The organization funds follow-up visits, support groups, rehabilitation, and vocational or social reintegration assistance. These services recognize that successful surgical closure is only one part of recovery and that patients may need help rebuilding relationships, livelihoods, and confidence after years of illness and stigma.

• 2024Holiday Impact Prize

  United States

  Nicholas Kristof selected Fistula Foundation as one of three recipients of his Holiday Impact Prize and promoted the organization’s work to readers.

  Outcome. The foundation received $50,000 directly through the prize.

  Source
• 2016Celebrity Jeopardy fundraising

  United States

  Louis C.K. raised money for the organization through a Celebrity Jeopardy appearance.

  Outcome. The fundraising generated $50,000 for the foundation.

  Source
• 2015Foolanthropy

  United States

  The Motley Fool selected Fistula Foundation for its holiday fundraising drive and promoted donations to support fistula treatment.

  Outcome. The campaign reportedly raised more than $75,000.

  Source
• 2007A Walk to Beautiful

  United States · Ethiopia

  The foundation sponsored a documentary film about Ethiopian women who received treatment for obstetric fistula, helping bring public attention to the condition and the organization’s work.

  Outcome. The film served as an awareness and advocacy vehicle; a quantified fundraising outcome is not specified in the reference material.

  Source

• 2025

  Open the Nigeria treatment networkStrategy

  Background

  Nigeria has a substantial need for obstetric fistula treatment, while access to free surgery and rehabilitation remains uneven.

  Action taken

  The foundation partnered with Nigeria’s Federal Ministry of Health and Social Welfare to open the Fistula Foundation Treatment Network.

  Aftermath

  The network was intended to expand access to free surgery and rehabilitation; a quantified long-term outcome is not provided.

  Source

• 2023

  Accelerate expansion through a major philanthropic grantStrategy

  Background

  The foundation sought to increase surgery volume and broaden its network of national and local partners.

  Action taken

  It accepted a $15 million gift from MacKenzie Scott and announced a five-year plan to provide 80,000 surgeries, establish networks in five new countries, and add 40 organizations to its network.

  Aftermath

  The grant provided a major source of expansion capital; the cited material does not provide a later completion assessment of the plan.

  Philanthropic gift. $15 million (2023)

  Source

• 2017

  Extend the network model to ZambiaStrategy

  Background

  The Kenya program provided a model for coordinating patient discovery, surgical capacity, and recovery services at national scale.

  Action taken

  Fistula Foundation launched a second Fistula Treatment Network in Zambia.

  Aftermath

  At least 1,439 women received treatment between 2017 and 2023, with an 88 percent successful outcome reported at hospital discharge.

  Source

• 2014

  Create a national treatment network in KenyaStrategy

  Background

  Funding individual operations alone did not ensure that women knew where to seek care or that sufficient trained providers and follow-up services existed.

  Action taken

  The organization launched the Action on Fistula program, linking outreach groups, patient screening, free surgery, provider training, and reintegration support.

  Aftermath

  The program reported 5,720 free surgical treatments between 2014 and 2020 and became the foundation’s first national network model.

  Source

• 2009

  Shift to international operationsStrategy

  Background

  The foundation began as a volunteer effort supporting one Ethiopian hospital and later identified a need to address fistula treatment access across multiple countries.

  Action taken

  It expanded its partnership and funding model internationally, beginning with work outside Ethiopia in the Democratic Republic of the Congo.

  Aftermath

  The change established the global operating model that later supported programs across Africa and Asia.

  Source

1. 1Fistula Foundationen.wikipedia.org
2. 2Fistula Foundation official websitefistulafoundation.org