Fistula Surgery

Fistula Surgery

The Passing of Dr. Leonard A. Wall, MD, 92

The Worldwide Fistula Fund is sad to note the passing of Dr. Leonard Wall. Dr. Wall was the father of the WFF’s founder Dr. Lewis Wall and WFF’s current treasurer Dr. Terry Wall. In his memory, WFF has established the Dr. Leonard Wall Memorial Fund. Dr. Leonard Wall was a long time advocate for women around the world and a tireless supporter of the Worldwide Fistula Fund.

Dr. Leonard A. Wall, MD, 92, of Leawood, KS, passed away on December 24, 2013. Dr. Wall was born on March 20, 1921 in Domby, Oklahoma. His early education came in a one-room country schoolhouse. After graduating from high school, he enrolled at the University of Oklahoma to study biology with the hope of eventually fulfilling his life-long dream of becoming a doctor.

His education was interrupted by military service in the US Army Air Corps during World War II. He married his childhood sweetheart, Evelyn Balzer, just before he was shipped overseas to fight the Nazis. Stationed in England, he was a co-pilot flying B-17 bombers when his plane was shot down over Germany in early 1945. He was the last man to make it out of the dying aircraft before it exploded. Listed as “missing in action,” he was presumed dead. In reality, he had become a German prisoner-of-war. After his POW camp was liberated by Gen. George Patton’s Third Army, he was reunited with his young wife and resumed his education.

Dr. Wall graduated from the University of Oklahoma School of Medicine in 1951 and subsequently undertook residency training in obstetrics and gynecology at the University of Kansas. He was a pioneer in laparoscopic surgery, fetal monitoring and urogynecology. After completing his residency training, he became the only obstetrician-gynecologist in central Kansas, practicing in the university town of Manhattan. Two years later, he moved to Kansas City where he was in active practice for 35 years. He became known as “the obstetrician’s obstetrician.” He pioneered the use of fetal monitoring, obstetrical ultrasonography and the development of regional referral centers for high risk pregnancies. He served on the Missouri Maternal Mortality Committee and was the President of the St. Luke’s Hospital staff. Quiet, humble and unassuming, he was noted for his dedication to medicine, his compassionate care of patients and his service to his community. Years after his retirement, St. Luke’s Hospital recognized his contributions by naming the hospital urogynecology laboratory in his honor.

Dr. Wall was also the founding member of the board of directors of the Worldwide Fistula Fund (WFF). He made trips to Nigeria, Ghana and Ethiopia to further work among women with obstetric fistulas. He took great pride in the opening of WFF’s Danja Fistula Center in southern Niger in 2012. In recognition of his contributions, the outpatient clinic at that institution was also named in his honor.

A lifelong learner, Dr. Leonard Wall took special pride in medical education and was beloved by his residents who did their clinical training under his guidance, regarding him as the model physician. His two sons, Leonard Lewis Wall and Terry John Wall, both entered medicine.

Dr. Leonard Wall was preceded in death by his loving wife of 65 years, Evelyn. Survivors include his two sons, Dr. Terry Wall and Dr. Leonard Lewis Wall, his daughter-in-law, Helen, and his two grandsons, Jimmy Wall and Thom Wall.

Memorial contributions may be sent to the Dr. Leonard Wall Memorial Fund at Worldwide Fistula Fund, 1100 E. Woodfield Road, Suite 350, Schaumburg, IL 60173 or online at Fond memories and condolences for the family may be left in the comment section below.

Two October Days That Resonate for Worldwide Fistula Fund

The international community is increasingly using a designated ‘day’ to highlight issues that need greater global attention. Two of these days had particular resonance for us here at the Worldwide Fistula Fund─International Day of the Girl – October 11th, and The World Food Day – October 16th.

International Day of the Girl reminds us that in many parts of the world, girls do not have the opportunity to go to school, determine when or who they will marry, when to have children, or even whether they can seek medical help during labor.  Giving girls the opportunity to grow up before they are married, to be children before having children, and to learn in schools surrounded by their peers benefits everyone.

One of the tragedies of Obstetric Fistula is that it is an injury suffered by girls. Girls who are married young, sometimes as young as eight, can be pregnant by age 12 or 13, before their bodies have grown enough to give birth. A girl of 13, suffering through a painful, prolonged labor without skilled medical attention can develop fistula, a condition that will impact the rest of her life.

We hope that someday soon, International Day of the Girl will no longer be necessary, and girls will be able to grow up and take ownership of their bodies and lives, without needing a day dedicated to giving them this basic human right.

World Food Day is a day devoted to the knowledge that many people around the world suffer from a lack of access to food. It is estimated that about 840 million people suffer from chronic hunger—not having enough food to be able to live an active and healthy life. To put this into perspective, there are approximately 317 million people living in the US, the third most populated country in the world, and yet, that total population would have to more than double in size in order to reach the number of people that are suffering from chronic hunger worldwide.

In areas with food insecurity or scarcity, it is often women and girls who have less access to healthy foods. When hunger is sustained, it can lead to malnutrition, which leads to women and young girls having more difficulties with pregnancy and childbirth.

At the Danja Fistula Center in Niger, patients are given free, nutritious food. Patients who are too weak or malnourished to undergo surgery upon arrival, remain at the Center until their bodies are strong enough to endure the repair surgery, as well as the recovery process. It is important in the recovery of these women, not to have to worry about where their next meal will come from and instead, spend their time focusing on healing.

Obstetric Fistula is a very specific type of injury, yet, providing holistic, multi-tiered care for women with fistula is one of our core values. We understand that there are many problems faced by women and young girls that are universal, and fistula is just a part of these. We are happy to recognize and celebrate every day that promotes the wellness and well-being of women everywhere!

We need your help. Please help Worldwide Fistula Fund remain on the Top-Rated list of by writing us a positive review of what WFF means to you. Please click on the below link and write your review today. We only need 10 more to achieve this award!


The Close of Summer Brings a New Fall

538_3858857 As schools start and vacations end, Labor Day draws a close to summer and welcomes in fall, while Rosh Hashanah ushers in a new year. The beginning of fall is the traditional time to say goodbye to the laid-back pace of summer, and kick off a new beginning. As an organization, WFF works throughout the year to bring new beginnings to women across Africa who, for some, have spent years of their lives battling the stigmatisms associated with having Obstetric Fistula.

This summer was a busy time for us here at WFF. As many of you know, WFF was featured in the New York Times in a beautiful and moving article by Nicholas Kristof. We were also honored by our upcoming inclusion in the Giving Library’s collection of organizations, and their wonderful video production of our Board of Director’s Chair, Nancy Muller, BA, MBA, PhD. And finally, Dr. Lewis Wall, the founder of WFF, was featured in an article in the St. Louis Post-Dispatch.

While much attention has focused on the Danja Fistula Center in Niger, WFF has also several other important programs that we support across Africa. Our work is to prevent and repair Obstetric Fistulas, and to develop programs to assist women with their new lives after fistula. What we want is a world without fistula, and a world where women who have suffered the injury in the past can live successful, dignified lives.

This need stretches beyond Niger. Therefore, our attention and assistance stretch as well. In the coming months, we will include information and new voices from our programs and projects in our newsletters, letting you meet and know the wonderful partners with whom WFF works, and the ways in which we offer assistance to women across Africa, such as Terrewode, an organization which assists women with Obstetric Fistula in Eastern Uganda to receive counseling, support and treatment. In Ethiopia, WFF has established relationships with Hamlin Hospital in Addis Ababa and Makalle University College of Health Science. There is also an ongoing need for better understanding effective pre- and post-operative therapy for the pelvic floor muscles and other effects of obstructed labor.

WFF is fortunate to have a wide variety of generous, dedicated supporters, and we look forward to introducing these programs and people to our many supporters throughout the world. One of the joys we have at WFF is being able to read all the notes and emails that arrive in our mailbox daily. It is a pure joy to know that we are supported by such a wide variety of generous and dedicated people, and that we are then able to extend that generosity and dedication to help women across Africa. If you would like to share your story of supporting WFF, we encourage you to send us an email. Selected stories may be included as excerpts in future newsletters.

Some Valuable Links Include:
Aid for Africa
FIGO Article
The Giving Library
Great Nonprofits: Top-Rated Program
Great Nonprofits: Write a Review
New York Times Article
St. Louis Post-Dispatch Article

The Legend of Dr. John Kelly

Dr. John Kelly

Photo Courtesy of Fistula Care/EngenderHealth

It is with great sadness that Worldwide Fistula Fund has learned of the death of Dr. John Kelly, who had been, for so many years, a storied champion in the battle against obstetric fistula in the developing world. His commitment began in 1967 when he traveled to a hospital in rural Nigeria, where he preformed his first fistula surgery. Since that first surgery, Dr. Kelly provided care to over 9,000 women. After retiring from his practice in England, Dr. Kelly devoted nine months of the year to fistula surgery and traveled to some of the poorest countries to provide fistula care, including Sudan, Pakistan, Angola, Ethiopia, Ghana, Kenya and many more. For the women he helped, he offered the opportunity to rebuild their lives free of the difficulties and stigma that having a fistula can bring. His surgical work ethic and stamina were utterly remarkable.

Dr. Kelly believed that it was as important to teach communities how to prevent fistula as it was to teach surgeons how to repair them. He trained many surgeons and medical professionals throughout the world, and was dogged in his determination that it was as necessary to work to create policies to prevent fistula in the first place. He once said, “Some people may say you’ll never prevent [fistula]. But we must prevent it! It’s the only complete cure we have.”

His life was spent helping others in need. He will be remembered for his warm smile and his amazing commitment to those who needed him the most.

Nicholas Kristof Visits Danja Fistula Center

Thanks to all the work and incredible generosity from all our supporters, Worldwide Fistula Fund was able to realize a dream last year in the opening of the Danja Fistula Center in Niger. Several years ago Nicholas D. Kristof first wrote about Worldwide Fistula Fund and recently returned to the center to write a new op-ed for his column in the New York Times.

The fistula center was the dream of Drs. Steve Arrowsmith and Lewis Wall, and in keeping with the original vision of having the center be run by Africans, Dr. Itengre Ouedraogo, a surgeon from Burkina Faso, has been trained to be its medical director. Danja Fistula Center handles some of the toughest cases of obstetric fistulas in the region and offers so much more to its patients than just surgery, with the reintegration program teaching women skills that will ultimately help them become better prepared and educated to what they can achieve in life.

Operating Room

Nicholas Kristof highlights the story of Hadiza Soulaye who doesn’t know her age and was married off to her uncle before she started menstruating. A year after marriage, she was pregnant and developed an obstetric fistula during three days of labor. Not only did she lose her baby but when she returned home she was ostracized from her community and kicked out of her home by her husband. Recently, Hadiza learned of the Danja Fistula Center and received the surgical treatment that would allow her back into her life and community without the humiliation she had previously endured. However, on her return home, her husband summoned her to bed, and even though Dr. Arrowsmith had warned her not to have sex for six months after surgery, Hadiza was left with no choice and had the fistula torn open. As a result she was again thrown from her home by her husband and returned to the fistula center with hope that this injury can be mended again. Hadiza vows not to return to her husband this time. This kind of story exemplifies the need for education, which Worldwide Fistula Fund sets high among its goals to not only offer surgery but to help prevent surgery from ever being needed.

Without the generosity of our donors none of the work Worldwide Fistula Fund do would be possible, and we would like to thank everyone for their continued support.

Click here to read Nicholas Kristof’s full op-ed!

The Central Pillars of the Work We Do, Part One

operating room, fistula, danja The Worldwide Fistula Fund is dedicated to providing holistic care to women afflicted with obstetric fistula. Our comprehensive programs address the effects of fistula on people who have been wounded physically, socially, emotionally, and spiritually. We believe a program that does not address all these issues is not good enough—fixing the fistula alone does not necessarily heal the whole person.

We are devoted to providing excellent clinical care at our fistula center. Though we’ve based this project in Danja, Niger, we also recognize the importance of implementing rational, effective strategies of fistula prevention around the world. Obstetric fistula is a devastating, yet very preventable, condition, and we believe that with comprehensive preventative programs, it can and will be eradicated.

To these ends, we uphold our core values by organizing our activities around five central pillars: clinical activity, training, research, rehabilitation, and prevention. We’d like to tell you more about each of these pillars, starting with the first one today.


Unlike many other hospitals in the developing world that treat a variety of conditions, the Danja Fistula Center is special in that it exclusively treats obstetric fistula. This focus allows our medical team to provide excellent care to women with fistula even in the context of limited resources.

danja, fistula center, hospitalThe ward has 42 beds and the operating theater is capable of accommodating three simultaneous operations. The facility is also equipped with a large outpatient clinic and laboratory facilities. Our team has performed more than 130 surgeries so far this year, making it one of the busiest fistula hospitals in the world, though we haven’t been open that long. Within a few years, we will be able to perform more than 500 surgeries a year.

High quality treatment is offered to all, regardless of their ability to pay, religious or cultural background, or any other social or political factor. The doctors with whom we work have extensive experience in the management of obstetric fistula, and help us ensure that the Danja Fistula Center operates according to the highest possible clinical and ethical standards.

Please stay tuned in the coming weeks, as we’ll share details about the work we do related to training, research, rehabilitation, and prevention. Until then, here’s a synopsis of our work, which you can support here.

This post was written by WFF staffers Kim and Anne.


Busy Days at the Danja Fistula Center

The Danja Fistula Center in Niger officially opens on February 11 . . . and we are so excited! Our staff is already on site in west Africa making sure that everything is ready to hit the ground running for the first surgeries. The doctors and nurses are trained, the medicines have been stocked, the equipment have been set up, and the wards and treatment areas are sparkling clean to accomodate our eager guests.

Because the need for obstetric fistula treatment and care is so great, the first clinic and admittance day is actually on February 6 — five full days before the opening celebration. The Minister of Health will tour the facility and cut a ceremonial ribbon to mark the event. Surgery will begin on Tuesday and the grand opening will follow on Saturday.

Our executive director, Mark Shaker, wrote that there are already 42 women at the facility awaiting treatment. One woman in particular has been living with a fistula for 15 years and told the staff that she just cannot take it anymore. Although she knew the Danja Fistula Center wasn’t opening until February, she left her home at the end of December. It took her 30 days to travel the roughly 600 mile-distance to the hospital grounds. She ran out of money on day five and begged for food and rides until she got there. Mark wrote, “She could not stop hugging and thanking us.”

It is women like this — and supporters like you — who inspire us every day. Please continue to watch this space for further updates and donate today to help fund the Danja Fistula Center and bring an end to this horrific condition.

Field Report From Danja: Fistula Surgery Update

Day two of surgeries ended with four more repairs. Two of the women that received surgeries were near 50 years in age and had been living with obstetric fistulas for decades. The team has also admitted four more women that are scheduled for surgeries tomorrow. It is remarkable to see the spirit and courage in all of the women. They are jubilant with hope and also fearful of undergoing a surgical repair. They comfort each other on the ward, and while they may be alone in their village or even their home, they have found wonderful company and support from the other survivors.

Field Report From Danja: Fistula Surgeries Have Begun

The last time the medical team was in Danja (November), they were able to
complete enough screenings for women that were not repaired to fill up all of the surgical spots for this trip. Twenty-four women have been waiting since then for the team to return and for the fistula surgeries to begin. Word spread through the area that the team was coming out, so more than 40 women arrived prior to the team in a hope that they could be seen for surgery. In fact, some women have been on the grounds for as long as eight days to make sure that they did not miss out on this surgical opportunity. They have gathered just outside the medical ward under a shaded tree and patiently waited for a chance to speak with the nurses and to be evaluated.

Surgeries have started and the team is currently working on their fourth and last one of the day. The first three have gone exceptionally well, and the women are resting in the recovery ward. One of the ladies just completed her third repair, and has been coaching the other women, who are very nervous, about how they can expect to feel after obstetric fistula surgery.

WFF Team Completes 12 Successful Surgeries!

Worldwide Fistula Fund physicians, nurses and staff just returned home from a successful trip to Danja, Niger. Each of the 12 women they operated on during the visit are recuperating in good health. Approximately two-thirds of the women the team treated had undergone repair previously at other facilities, and one woman came for her fifth attempt at repair.

Another highlight of the recently completed trip was the introduction of a new orientation process for the surgical patients. Along with a patient volunteer (who had surgery here in August), we performed a small drama about fistula surgery. The patient donned a patient gown, had her blood pressure taken, acted out all of the steps of having fistula surgery and finished her performance by singing a ballad about the experience. The audience then had time to ask questions. Overall, the team felt that this was a very appropriate means of describing the hospitalization process to the patients, and hope to expand upon it for future work at Danja.