[Congressional Record (Bound Edition), Volume 157 (2011), Part 3]
[Extensions of Remarks]
[Page 3512]
[From the U.S. Government Publishing Office, www.gpo.gov]




 OBSTETRIC FISTULA PREVENTION, TREATMENT, HOPE AND DIGNITY RESTORATION 
                                  ACT

                                 ______
                                 

                        HON. CAROLYN B. MALONEY

                              of new york

                    in the house of representatives

                         Tuesday, March 8, 2011

  Mrs. MALONEY. Mr. Speaker, today, along with Representatives Baldwin, 
Hirono, Moore, and Stark, I am reintroducing comprehensive legislation 
to both prevent new obstetric fistulas and treat existing ones. The 
``Fistula Prevention, Treatment, Hope and Dignity Restoration Act'' 
will bring new hope and opportunities to finally end this preventable 
condition. On the 100th anniversary of International Women's Day, this 
is a fitting bill that will help millions of women achieve their 
maximum potential.
  Pregnancy shouldn't leave a woman with a disability and ostracized 
from her community. Congress should ensure investments for the more 
than two million women worldwide that have obstetric fistula and we do 
what we can to prevent new cases. Fistula results from prolonged labor 
without medical attention due to the pressure created internally from 
obstructed delivery, which kills tissue where a hole between the 
woman's vagina and rectum develops, leaving her without control of her 
bladder and/or bowels for the rest of her life if she goes untreated. 
It often results in the death of the infant. Many women with obstetric 
fistula are abandoned by their husbands and families because they are 
considered ``unclean'' due to leaking excrement. Left without support, 
the women are forced to beg or turn to sex work to survive.
  Fistula was once common throughout the world, but over the last 
century has been eradicated in Europe and North America through medical 
care. For example, New York's hospital for fistula patients, now the 
site of the Waldorf Astoria Hotel, closed in 1895 due to diminishing 
cases. But still in 2011, from Bangladesh to Botswana, women continue 
to face these challenging deliveries and the complications associated 
with them, including obstetric fistulas.
  Fortunately, multilateral organizations such as UNFPA, the United 
Nations Population Fund, and its partners in the Campaign to End 
Fistula, as well as bilateral organizations such as USAID are working 
with partners on a global campaign to prevent and treat fistula with 
the goal of making the condition as rare in sub-Saharan Africa and Asia 
as it is in the United States. Being able to repair a fistula is life 
changing--and it will have a direct impact on a woman and her family if 
she is able to stay in her community, rather than to be shunned. At 
this point, the global community can do just that for about $300 for 
each repair.
  This bill authorizes the President to provide assistance to prevent 
and treat fistula. This legislation allows for a comprehensive, three 
pronged approach of prevention, treatment and reintegration which 
includes: increasing access to prenatal care, emergency obstetric care, 
postnatal care, and voluntary family planning; building local capacity 
and improving national health systems; addressing underlying social and 
economic inequities such as reducing the incidence of child marriage 
and increasing access to formal and informal education; and supporting 
reintegration and training programs to help women who have undergone 
treatment return to full and productive lives. These essential 
investments create a multiplier effect of benefits in the lives of 
women and their communities. The legislation also supports coordination 
among the community working to prevent and treat obstetric fistula 
through the International Obstetric Fistula Working Group. Support for 
monitoring, evaluation, and research to measure the effectiveness and 
efficiency of such programs throughout their planning and 
implementation phases will ensure the most efficient and effective use 
of U.S. foreign assistance dollars.
  I urge my colleagues to support this important, meaningful 
legislation.

                          ____________________