Throughout Africa, millions of women do not have access to proper medical care during their pregnancy, due unfortunately, to lack of medical facilities, shortage of doctors and nurses; lack of medications; or the inability to get to a clinic in time to be helped.

A horrendous condition, vesico vaginal fistula, is found in young women who have experienced a prolonged obstructed labor without any medical assistance. Simplistically put, the wall between the bladder and vagina is damaged by the prolonged pressure of the baby's head and a fistula or hole develops. Consequently, the woman is constantly leaking urine. Sometimes, the rectal wall is also affected and there is no control of feces. The woman is often ostracized by her husband and her family; she becomes an outcast in society.
In the West African country of Niger, there are countless young women with this problem. According to United Nations statistics, there are approximately 14 million people in Niger, with 485 doctors and not enough doctors who are trained to repair fistula patients. For the women affected by fistula, this is a desperate situation with little hope to be able to be restored to a normal life.

It is estimated that for some 200,000 women in Niger, life is filled with humiliation, horrible discomfort and shame of their inability to control their urine and feces. Most of these young women spend their lives isolated, in extreme poverty and ostracized by society.

During our 6 years in Niger, besides performing fistula surgeries, we donated close to 5 million dollars of equipment, medicines and supplies; our doctors taught Nigerien Ob/Gyn Residents how to perform laparoscopy surgery, and donated the laparoscopy equipment; we brought a vocational training program to the fistula women at the National Hospital; a program for educating the fistula women at the hospital was begun with bi-weekly sessions by a Nigerien mid-wife; an Anesthesia program was begun at the National Hospital; World Health's Safe Surgery program was introduced to the National Hospital, making the hospital the first French speaking institution in West Africa to have this program; a Nursing program was started at the National Hospital; a music program, to teach English, was created at a local Niamey High School...the first of its kind in Niamey; over 1,000 English books were donated to the revitalized English Club at this same High School, CES Rive Droite; and the Club's drip irrigation garden, run solely by the students, was supported by IOWD. Teaching organizational skills, leadership skills and health information was emphasized throughout this unusual school program with IOWD volunteers.

We are proud of our relationship with the Government of Niger during our time in Niger and honored by the recognition of President Tandja when he presented IOWD Directors with Medals of Honor, the highest medal a foreigner can receive.

As of our last trip to Niger in April 2009, IOWD surgeons and Dr. Abdoulaye Idrissa had performed over 1,000 surgeries. With the assistance of dedicated IOWD and Nigerien nurses, Operating Room technicians, Anesthesiologists and Anesthetists, fistula patients have had their health and their dignity restored!

Due to a coup d' etat, followed by political instability, and innumerable kidnappings and killings of Westerners, IOWD has ceased our program in Niger.