The late Tip O'Neill, former speaker of the U.S. House, coined the phrase "all politics is local," by which he meant that politicians become successful by addressing the everyday concerns of the voters who elected them to office. In the same way, I believe that many of the "global" health care challenges we face can best be addressed by developing simple, cost-effective solutions for local implementation. Simple solutions can bring dramatic results, and local implementation means the solutions are also in tune with cultural preferences and economic realities. In other words, when it comes to improving people's lives, all health care is local.
In the United States, obstetric fistula is virtually unknown. This isn't the case in in the developing world, where obstetric fistula affects more than two million poor women and girls, Some 50,000 to 100,000 new cases occur each year.
When labor lasts up to five days, the pressure from the baby's head in the birth passage can cause maternal tissue to die. This leaves the mother with a hole through her bladder or rectum that leaks urine and, sometimes feces, for the rest of her life. Ninety percent of women living with fistula will lose their babies during childbirth When left untreated, fistula can lead to major infections, disease and even death. And those who do survive will often be ostracized by society -- unable to board a bus, enter a hospital, pray communally or share a meal.
Before 20th Century medical advances, fistula was common in Europe and the United States. Today, fistula is almost unheard of in countries where obstetric care is widely available. Reconstructive surgery can repair the injury, with success rates as high as 90 percent. Complete treatment costs about $420, including surgery, post-operative care and rehabilitation support.
This is a serious issue that affects women around the world. Organizations like One By One are working to end obstetric fistula and improve the lives of women and girls suffering with this devastating injury. One by One has developed a successful, replicable model focused on outreach and education. The organization finds women suffering in isolation and arranges for surgical repair of existing fistulas and supports the women as they return to their communities.
I am especially proud of the work that we have been doing in Mwanza, Tanzania, where Philips Healthcare and One by One has been conducting a joint clinical investigation with researchers at Bugando Medical Center and the Andrew Levitt Center for Social Emergency Medicine to assess the potential of enhanced diagnostic imaging in preventing obstetric fistula. Using portable, low-cost, high-quality ultrasound devices equipped with specially designed transducers, the team is evaluating whether obstetrical measurements can predict those at high risk for fistula -- preventing it before it happens.
Like One By One, I believe that affordable access to safe childbirth is a basic human right, and that healthy mothers are vital to strong families and communities. That is why strategic partnerships and collaboration between companies such as Philips, governmental agencies, NGOs and local communities are essential for ending treatable medical issues like obstetric fistula.
Our organizations are not the only ones that can affect change. Everyone can help address this problem. Right now, One By One is conducting its 2013 Annual Appeal, Change a Woman's Life. The World Health Organization has called fistula "the single most dramatic aftermath of neglected childbirth," and the upcoming holiday season is a great time to add your support -- for ending this senseless waste of lives and futures.
Again, all health care is local.
This article is part three of a three-part series outlining the work being done locally around the world to expand access to care. Learn more about the life-saving work also happening in Uganda and Guatemala.