Last month, at the 3^rd International Conference for the Society of Obstetric Fistula Surgeons in Dakar, Senegal, 300 participants from more than 30 countries outlined some concrete ways to prevent and treat obstetric fistula and assist women who have a fistula regain their health and rebuild their lives. The recommendations included:

• Recognizing that all pregnant women are at risk of developing an obstetric fistula and need skilled assistance during birth; and while midwives are properly trained and capable of providing this assistance, they need motivation and support systems to work in rural areas where they are needed most
• Standardizing the classification of obstetric fistula, surgical techniques used to correct the condition, and language used by obstetric fistula surgeons
• Approaching the social reintegration of women after treatment as a transition that requires support from families, communities, local leaders, and institutions, but realizing that transition centers do not work for all women. Women’s participation should be based on informed consent and their own assessment of their psychological, social, and economic needs.

The Mali Fistula Care Project sponsored four attendees, including the IntraHealth project coordinator, the fistula surgeon at Gao Hospital, the president of the Malian Midwives Association, and the National Fistula Point Person at the Ministry of Health. The Malian participants were encouraged that many of these recommendations have already been incorporated into the Mali Ministry of Health’s National Obstetric Fistula Strategy.

The Mali Fistula Care Project is led by EngenderHealth and managed by IntraHealth International. It is funded by USAID.