Peramiho Mission Hospital - Tanzania
One By One has begun investing in critical outreach efforts to find women who are living with fistula in remote hard-to-reach areas, and connect them with the care that they need. In 2010, we entered into a partnership with Peramiho Mission Hospital in Southern Tanzania to carry out intensive outreach in three rural districts that are known to have very high rates of fistula. The fistula team at Peramiho, headed by Dr. Gaudens Komba, has developed a highly effective approach to outreach that includes engaging community leaders to support education efforts, working with communities to educate about fistula and the availability of free treatment, screening women in local health centers to confirm that they have a fistula, and arranging for transportation to Peramiho Mission Hospital for treatment. By mid-2011, Dr. Komba expects to have identified 150 women who will receive life-transforming care. Our partnership with Peramiho also includes supporting a “fistula camp” which will make it possible for all of these women to be repaired with minimal wait time.

Gynocare Fistula Center – Kenya
One By One has entered into a long-term partnership with Gynocare Fistula Center, a new facility in Kenya dedicated to providing comprehensive care for fistula patients and improving maternal health for all women in a very high-need area. Gynocare will serve a five-county region in Western Kenya with a population of over 4 million people. Lack of access to basic and emergency obstetric care in this area results in one of the highest maternal mortality rates in the world and a very high incidence of obstetric fistula. One By One is collaborating with Gynocare Fistula Center to establish an important model for truly comprehensive fistula care. In the five years that One By One has been working with treatment programs, we have learned a great deal from fistula patients and providers of care about the full needs of women who have suffered with this devastating injury. Our partnership with Gynocare is an opportunity to pioneer a program that will incorporate all four components of comprehensive treatment: 1) outreach to find women in remote hard-to-reach areas and connect them with care, 2) free surgical repair, 3) rehabilitation and reintegration services, including income-generation training, so that women can return home fully healed and ready to be productive again, and 4) medical and psychosocial follow-up in order to identify women who continue to have medical or social issues that may require additional attention. Gynocare Fistula Center will open its doors in March 2011, and expects to care for 150 women in its first year of operation.

Afar Pastoralist Development Association (APDA) - Ethiopia
We are continuing to support the tremendous efforts of APDA to bring vital maternity services to the Afar region of Ethiopia. Home to approximately 1.3 million mostly pastoralist people, the Afar region has one of the highest maternal mortality rates in the world and a very high incidence of obstetric fistula. With support from One By One, APDA has been training traditional birth attendants and midwives in an effort to promote safer childbirth for the women in this region. In 2010, One By One purchased a generator for the very first facility in the Afar capable of delivering emergency obstetric care. This was the final piece of equipment needed by the Barbara May Memorial Hospital before opening its doors in 2011. We are very gratified to have contributed to building the capacity of this tremendously important new facility that will save lives and prevent fistula.

Health and Development International (HDI) - Niger
In 2010, we continued to support the highly successful Rapid Maternal Mortality and Obstetric Fistula Prevention Project in the Bankilare region of Niger. In this area where obstructed labor had been the leading cause of maternal death, this project has developed the communication and transportation infrastructure needed to support safe childbirth in the region. They have organized and trained hundreds of volunteers to educate communities about prenatal care, the importance of delivering with a trained birth attendant, and when/how to access transport for emergency care. The impact of this project in the region has been stunning. In the first year, cases of maternal death from obstructed labor were reduced to zero. And the incidence of women developing a fistula from obstructed labor was reduced by 75%. One By One looks forward to creating opportunities for our other partners to learn from the great success of this project.

Bugando Medical Center (BMC) – Tanzania
We have entered the sixth year of our wonderful partnership with BMC. With support from One By One, BMC continues to offer life-transforming treatment for fistula patients free of charge. In 2010, we had the great honor of hosting one of the founders of BMC’s fistula program and a dedicated fistula nurse from BMC during a visit to the United States. The One By One community had the opportunity to meet Liz Mach and Yasinta Mkama and hear them talk about their incredible work caring for fistula patients. We are most grateful to both of these women for all that they do and for their willingness to share their work with us.