The Soigner Fistula Project


Soigner (pronounced “swan-yay”) is a French word meaning “to heal.” The goal of the Soigner Fistula Project, a pilot-program under the direction of Children of the Nations, is to bring healing and transformation to young women suffering from a debilitating condition known as obstetric fistula in Sierra Leone, Africa. As a doula (a certified childbirth assistant) for the past twelve years, I help women and their partners prepare for birth with their heart, mind, and spirit. I believe that birth is one of the most powerful miracles that God has graced us with. I also believe that all women have the right to give birth and recover in a safe and empowering environment. In 2005, I had the opportunity to travel to Sierra Leone with Children of the Nations. While there, I witnessed firsthand the challenges faced by fistula sufferers and felt called to do something to help them.

Sierra Leone is the one of the poorest country in the world and also has the world’s highest documented incidence of maternal mortality (mothers that die during childbirth). According to a recent UNICEF report, there are approximately 5,000 new cases of obstetric fistula reported in Sierra Leone each year and untold thousands remain undocumented, as many young women suffer in silence.

An obstetric fistula is caused by prolonged and obstructed labor coupled with a lack of appropriate medical intervention, typically a caesarean section. The constant pressure of the baby’s head pressing against the bony sidewall of the mother’s pelvis causes necrosis of tissue. As the tissue dies, a hole (or fistula) forms between the woman’s vagina and bladder and/or rectum. The resulting fistula, if left untreated, is life shattering; leaving these women in a state of chronic incontinence. The uncontrollable leaking of urine or feces is humiliating. Most women are ostracized as a result of the smell. In spite of one’s best efforts to stay clean, the smell of leaking urine or feces is hard to eliminate and difficult to ignore. The bacterial-ridden dampness causes rashes and infections which oftentimes leads to other medical conditions. In nearly all cases, the baby dies. The grief of losing a child and becoming disabled exacerbates the suffering.

Compounding the sense of shame and humiliation is the pain and loneliness often associated with fistula. In some communities, the condition is seen as a punishment or a curse for an assumed wrongdoing, rather than as a medical condition. Most women are abandoned by their husbands and families and left to a solitary life of utter rejection and poverty. For many women, the profound social isolation is worse than the physical torment. “Everyone deserted me—my husband deserted me, my friends deserted me. I know I will never have a husband, I will never have a boyfriend, I will never have a baby. So I just live by myself,” says Fatmata Kargbo of Sierra Leone (as quoted by Robert Pignott in “Sierra Leone’s Silent Sufferers.”)

Fistula patients are most commonly under 20 years old with many being as young as 10. For some, their bodies are not mature enough to accommodate a vaginal birth. While malnutrition can also contribute to having a small pelvis, occasionally a fistula results from sexual abuse and female genital mutilation. One of the heart-wrenching things about this condition is that some fistula sufferers are unaware that surgical treatment is available through free clinics such as the Mercy Ship Aberdeen Fistula Clinic in Freetown. And, those that are aware often have no means to travel from their remote villages.

In November 2005, I was part of a short-term mission group from Children of the Nations that visited the remote village of Banta Mokelleh in Sierra Leone, West Africa. While there, I conducted a needs assessment and observed firsthand the condition and plight of young African women afflicted with obstetric fistula. I found that women there have a 1-in-6 chance of dying every time they are pregnant, young girls being at even higher risk. Of those that survive pregnancy, many will develop an obstetric fistula due to the immaturity of their bodies and/or the lack of access to proper healthcare.

On the last night of my visit, Nurse Midwife Jennifer Jigba introduced me to Yamma Conteh, a 26-year-old woman who developed a fistula resulting from a teen pregnancy and had been living with it ever since. My heart ached for her. After returning to the US, moved by what I had learned, I joined forces with COTN and launched a pilot-program called the Soigner Fistula Project. (I thought the name appropriate as the word “swan” conjures up the image of the story of The Ugly Duckling. Just as the displaced baby swan was outcast and ostracized by his duckling siblings, these girls are rejected and alone. However, just as the Ugly Duckling’s life had a happy ending, so do the girls that receive this surgery—they are restored to the beautiful creations they have always been.)

I enlisted the help of friends and family, and together we raised funds for several victims suffering with this wretched affliction. Yamma, along with Hawa Syvellie and Amie Nabieu were transported from their remote villages to Mercy Ship Aberdeen Fistula Clinic for their life-changing surgeries. Each of the girls stayed at the Children of the Nations Medical Clinic during their recovery. They were cared for by the COTN nursing staff and offered vocational rehabilitation and spiritual counseling before returning to their villages—renewed with hope for a future.

The vision of the Soigner Fistula Project is to bring aid to women and girls who suffer with obstetric fistula. We facilitate transportation between their home village and the surgical repair clinic. We offer rehabilitation services such as food, clothing, shelter, and vocational training at a skills center. Our long-term goal is to improve access to quality reproductive healthcare in Banta Mokelleh, Sierra Leone with special focus on pregnancy resources within the district. Reducing maternal mortality will lower the number of children orphaned and reduce the numbers of families living in poverty. As a nonprofit ministry, the Soigner Fistula Project relies entirely on donations and fundraising from individuals and groups for funding of this important project. It is our goal to enlist sponsors who will partner with us to support these young girls in need of care. The needs are many.

  • $5.00 provides a new dress
  • $10.00 provides food to a recovering fistula patient for a week.
  • $20.00 covers transportation to and from the Abeerdeen Fistula Clinic.
  • $30.00 provides teaching supplies to educate villagers about fistula symptoms and fistula prevention.
  • $40.00 equips the skill center with materials for vocational training.
  • $90.00 covers a caesarean section, which will prevent obstetric fistula
  • $300.00 provides education of traditional birth attendants.
  • $27,000 provides for a four-wheel drive emergency vehicle.

Click here if you’d like more information on the Soigner Fistula Project or if you’d like to make a donation to support this program.