Day 2 of Training

On the second day of training, the Regional Representatives met in small groups to discuss their personal plans of who they were going to contact in their respective communities to start their outreach work. They jotted down ideas of specific people to speak with, such as religious leaders, chiefs, politicians, women’s group leaders, coaches, and teachers, in order to organize educational outreach activities. Volunteers were given resources to help them with public speaking and to organize their presentations to include personal stories as well as the information they have been taught on the prevention, causes, and treatment of obstetric fistula. Presenting to their communities is one of the many ways that One by One is addressing prevention steps. It also presents the opportunity for women who may not have known there were others with this condition to understand that there is a treatment or for someone in the community to refer a woman living with fistula.

We spent much of the afternoon discussing what the Regional Representatives will do when they find a woman who may have a fistula. The participants offered their ideas on how to provide psychosocial support and involve the woman’s husband and family. To conclude our day, we all took a trip to Gynocare. We toured the facilities and met some of the staff.

We also got the opportunity to speak with some women recovering from fistula repair surgery. Hugs and greets were exchanged, as many of the Regional Representatives knew the patients. It was a joyous conclusion to another day of training.

Introducing One by One's Newest Recruits

Today marked the first day of the first training of One by One’s Regional Representatives for Western Kenya. Thirty-one participants, 27 women and 4 men, have traveled from 20 counties to Eldoret to become trained to do outreach in their communities, refer women with fistulas to Gynocare for free surgical repair, and help provide psychosocial support for these women when they return home.

We began the day with a dynamic introduction by Sarah Omega, fistula survivor and Outreach Manager for One by One, and discussed the goals for the training. Then, each of the participants introduced themselves to their new team of field representatives. We took care of some paperwork, which included a pre-training survey whereby we’ll gain a better understanding of the participants, their knowledge of fistula, and their expectations for the training. After a quick tea and mandazi break, the participants took turns leading a few songs to get everyone energized for the next session. Sarah facilitated a session covering the causes and sequela, treatment, and prevention of obstetric fistula. We also discussed the myths about obstetric fistula that many community members hold, which included the idea that fistulas were caused by unfaithfulness, devils, genetic inheritance, witchcraft, a curse, AIDS, poverty, and not sitting properly (with legs crossed) after giving birth. The Regional Representatives know they will need to work hard to dispel these myths and the stigma around obstetric fistula in their communities.


Then, we went over the importance of community-based outreach and the role each of the Regional Representatives play in creating awareness of obstetric fistula, identifying women in the community with fistulas, spending quality time with these women and building trust, arranging transport for women to travel to Gynocare for treatment, and supporting women when the return home to their community. After a hearty lunch, we gave the 21 participants who were fistula survivors the opportunity to share their story with the group. After each retelling, the other participants offered their words of support and encouragement. Finally, we spent time brainstorming strategies to educate communities about obstetric fistula. Some of the ideas proposed by the participants included: home visits, community meetings (barazas) led by the chief, seminars in churches and schools, youth group meetings, and tournaments.

We concluded an exciting first day of training with a group photo. Check out One by One’s newest volunteers. We’re so excited to have them out in the communities and, soon to be, hard at work to end fistula.

Meet Sarah Omega!

Sarah Omega has been a close friend and partner of One By One for the past year. She is a fistula survivor from Kenya who has dedicated her life to the treatment and prevention of obstetric fistula. Sarah became pregnant after a traumatic sexual encounter when she was 19. The pregnancy resulted in fistula, a condition that she lived with for 12 years. In that time, Sarah was humiliated by coworkers and abandoned by the man who she was supposed to marry. Now recovered, Sarah shares her full story. Since her recovery, Sarah has been an advocate for women living with fistula. Sarah wants women living with fistula to know that life isn't over after getting the condition. She has partnered with One By One and our mission to treat and prevent obstetric fistula. Sarah is a leader in the field of women's advocacy and an amazing person. Recently, Sarah has been working with reporters, telling her story of fistula and her mission of outreach. Her story had been published in a Kenyan newspaper, the Daily Nation! Please read her full story and learn about all that she has done for women living with fistula.
http://www.nation.co.ke/Features/Living/No+woman+needs+to+go+through+what+I+did/-/1218/1208018/-/item/0/-/nf85q5z/-/index.html

Honoring an Outstanding Clinician

Azra Admani scans a fistula patient for One By One's Ultrasound Study

On the 100th Anniversary of International Women’s Day, we want to highlight one woman doing extraordinary work with One By One: Ms. Azra Admani.

Azra is an outstanding ultrasonographer who lives in Mwanza, Tanzania and works at Bugando Medical Center. For the past year, in addition to her full-time duties, Azra has played a critical role on a very exciting research study that we are conducting. Every Monday, Azra spends several hours using her keen ultrasound skills to measure the internal pelvic dimensions of women with fistula and a group of comparison patients. This study will help determine if ultrasound can be used to identify women who are at high risk of experiencing obstructed labor that can lead to fistula formation. If proven to be effective for this purpose, ultrasound may be an important tool for fistula prevention, making it possible to target high-risk women in remote areas and ensure that plans are in place to access emergency care if needed.

Prevention is the key to ending obstetric fistula throughout the world. Azra Admani’s commitment to carrying out this research with great care is making an important contribution to One By One’s efforts to develop innovative and effective prevention strategies. We honor Azra on International Women’s Day for her tremendous work on behalf of girls and women.

A final note: Rep. Carolyn Maloney just introduced the “Fistula Prevention, Treatment, Hope and Dignity Restoration Act”. In her words, this bill would “authorize the President to provide assistance to prevent and treat fistula, including through increasing access to prenatal care, emergency obstetric care, postnatal care, and voluntary family planning; building local capacity and improving national health systems; addressing underlying social and economic inequities such as reducing the incidence of child marriage and increasing access to formal and informal education; and supporting reintegration and training programs to help women who have undergone treatment return to full and productive lives.”

Let’s all thank Rep. Maloney for her commitment to this issue, and support her efforts to persuade the U.S. government to invest in eradicating obstetric fistula worldwide. To echo her call… Spread the word.

Outreach in Rural Kenya

Top Row (from left): Winnie (our translator), Sarah Omega, Emmanuel (the school principal), Heidi, Carolyn; Bottom Row: The school head teacher, Nereah, Catherine

While in Kenya, Sarah took us along on her outreach trip to some rural areas around Eldoret. On our way to a community meeting, we picked up Catherine, a woman that Sarah had met while previously doing outreach in a nearby area. Catherine told us she had heard from a local school principal that one of his students was leaking urine, and had asked us to stop by to see her.

So, we took a detour to Kimilili Deb Primary School, where we met the principal and the head teacher, who introduced us to Nereah, a 17-year old girl with fistula. As a result of her fistula, Nereah has developed a phobia of being around other people. Sarah told Nereah that her fistula could be repaired, something Nereah never knew before. Repair will be life-altering for Nereah as she will be able to sit in class with other students without fear of being ostracized. Thanks to Sarah’s outreach work, we are working with Nereah’s family and school to get her to Eldoret for free treatment.

We then went to the community meeting, where Sarah educated a group of men and women about fistula, and even gave out a phone number where people can reach her, something she does at every outreach event. She told the group that they can call her at anytime if they hear about or find someone living with fistula. As a result, Sarah's message spreads beyond community meetings, allowing her to work through people like Catherine to reach more women who would otherwise never hear about free treatment.

We hope you can join us for our 6th Anniversary Dinner on March 24th to hear more about Sarah's work in rural Kenya. Don't forget to RSVP, if you haven't already.

One By One Community Book Discussion Success!

One By One hosted its first Community Book Discussion focusing on the book Cutting for Stone by Abraham Verghese. Over 40 individuals attended this wildly successful event. We opened the night with Ethiopian-sourced fair trade, organic coffee from Pura Vida (buy Pura Vida through our website and a dollar from every bag of coffee sold goes to One By One!), and wonderful Ethiopian snacks provided by a local Ethiopian caterer, Konjit Fekade.

As the room filled with guests, we started with small group discussions on the book. The room was a-buzz with lively and engaged discussion on Cutting for Stone, Ethiopian culture and society, fistula and maternal health, and One By One’s work in Ethiopia.

These small group discussions were followed by a panel featuring Lydia Assefa-Dawson, a representative from the Ethiopian community who spoke beautifully about her experience growing up as an orphan in Ethiopia; Dr. Laura Hart, a urologist and volunteer fistula repair surgeon who provided her medical expertise from her experience working in the field; and Heidi Breeze-Harris, One By One Co-founder and Executive Director, who spoke about One By One’s programs in Africa. Much like the small group discussions, a lively and varied panel discussion filled the air.

It was inspiring to see the diverse group of community members join in on the discussion and connecting with One By One’s work.

One By One thanks those of you who participated in our first Community Book Discussion and for making it a huge success. For those of you who were unable to join us, we are hoping to plan similar events in the near future, so please stay tuned!

Maternal Deaths Decline

For all of us who care deeply about the rights and well-being of girls and women across the world, it is rare to wake up to good news on the front page of a major newspaper. But on April 13th, this remarkable headline appeared on the cover of the New York Times: “Maternal Deaths Decline Sharply Across the Globe.” So accustomed are we to hearing about the persistent lack of progress in reducing maternal mortality globally, I’m sure that many of us did a double take.And then devoured the article. It describes the new findings, published in the highly regarded scientific journal The Lancet, as “challenging the prevailing view of maternal mortality as an intractable problem that has defied every effort to solve it”, and demonstrating that “money allocated to women’s health is actually accomplishing something.” This is very good news, indeed.

Those of us in the One By One community should be especially heartened by the fact that one of our critical investment areas – increasing the availability of trained birth attendants – is identified as being of one of the key factors responsible for the decline in maternal deaths. We have chosen to support training of birth attendants because we know that they play a vital role in both ensuring that uncomplicated deliveries are clean and safe, and in identifying and supporting women who need to be transferred to a facility that can provide emergency obstetric care that will prevent fistula and save lives.It is great to see the importance of this work being highlighted in this high profile article.

While this long-awaited decline in maternal mortality demonstrates that important progress is being made, there are still hundreds of thousands of girls and women dying each year due to preventable pregnancy-related causes, and vast numbers of others develop devastating childbirth injuries such as fistula. There remains an urgent need to work towards ensuring that all girls and women have access to basic and emergency care during pregnancy and delivery. As Richard Horton, editor of The Lancet so aptly concludes, “ This is a moment to celebrate – and accelerate.” Thank you for supporting our acceleration to end fistula.