Obstetric fistulae are holes (fistulae) that develop between a woman’s bladder and her birth canal and/or between the last segment of her large intestine and her birth canal, when labour becomes obstructed. This happens where her infant does not fit into the birth canal either because the mother’s pelvis is too small or the infant’s head is too large.

In Africa and other developing countries, there are many remote villages where there is little or no obstetric care. Pregnant women may be in labour for days without relief. The infant’s head becomes tightly wedged into its mother’s pelvis, cutting off the blood supply to the soft tissues of her pelvic organs. After a few days, the infant dies. Postmortem degeneration of the infant’s head allows the mother to give birth to her dead infant. Damaged pelvic tissues have created the fistulae. Women with fistulae have absolutely no control over their urine or bowels. They are always wet, their clothing soiled, their stench offensive. They are divorced by their husbands, cast out by their families and ostracized by society.

In response to the high incidence of teenage pregnancy, maternal and child morbidity in the Central Region of Ghana, the Archdiocese of Cape Coast, in January 2000, began working to establish Mercy Reproductive and Child Health Center (MRCHC) and FISTULA Hospital in Mankessim for poor pregnant women and their offspring. This Center itself has been completed in Mankessim; funds are currently being sought to construct accommodation facilities for doctors and quarters that will operate the facilities.

The number of Fistula Patients in the Central Region of Ghana (CRG) is estimated to be 3,000 to 5,000 with an incidence of 200 cases per year. In the CRG 10,000 give birth annually; 50% are teen-agers and 65% of the births do not occur in a clinical facility. The incidence of obstetric fistula correlates with the level of poverty. The CRG is the 4th poorest of the 10 regions in Ghana, surpassed in poverty only by the Northern, Upper East and Upper West regions.

There is only one Fistula Hospital (fully dedicated to treatment of obstetric fistulae) in Africa, in Addis Ababa, Ethiopia, where about 200,000 cases exist. In the West African Sub-region, its incidence is greater than 1200 per year; estimates indicate that Nigeria alone has a total of about 800,000 obstetric fistulae cases. One hospital in Nigeria (Jos) and the Korle Bu Teaching Hospital in Ghana handle some cases of obstetric fistulae, as part of the medical services they provide, but not with dedicated facilities or departments.

Project Objectives:

To set up a Health facility that will:

– Provide maternal and child health care services for pregnant women and children

– Provide obstetrical fistulae repair and treatment services for women afflicted with the condition

– Serve as a Training Center for doctors who wish to work in the field of fistulae repairs and treatment in Ghana and the West African Sub-region

Project Justification:

Women with obstetric fistulae conditions are not treated in general hospitals because of their stench and poverty. They are most often unemployed, poor and outcasts, severely anemic, ashamed of their affliction and lonely. In the Central Region of Ghana within which Mankessim is located, there are about 200 cases per year. There is therefore the need to set up a dedicated, specialized facility to cater for fistulae cases and to provide maternal and child healthcare for women and children.


It is estimated that annually about 3000 to 3500 poor women who have no funds for transportation or hospital fees will benefit from services to be provided by MRCHC and the FH after their programs are implemented. Further, it is predicted that 700 to 800 Cesarean sections (CS) will be needed annually to save lives of mothers and infants. Clients diagnosed for CS will be admitted by the 37th week of pregnancy to be built up for surgery in case an emergency CS is necessary. Although MRCHC programs are designed specifically for the desperately poor, no client will be refused care.

Contact Information:
The Project Coordinator, MRCHC,
Catholic Archdiocesan Secretariat,
P.O. Box 112, Cape Coast, Ghana,
Tel +233-3321-33997, 03321-33471-2,
Fax: +233-42-33473,