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Obstetric fistulas were common in the United States generations ago. L. Lewis Wall, an obstetrics surgeon and president of the Worldwide Fistula Fund (WFF), told Christianity Today that due to modern health care, fistula has been "lost from the collective memory." (See "Jesus and the Unclean Woman.")

A fistula develops when bladder or rectal tissue is damaged during obstructed labor. In most instances, the mother is unable to deliver her baby because her pelvis has not fully grown. Typically her child dies, and unless surgery is performed, the woman remains incontinent for the rest of her life. Medical experts estimate that more than 90 percent of the 2-3 million women who need the surgery live in the developing world.

WFF is the first American organization focused solely on fistula. Wall and WFF vice president Steve Arrowsmith have performed thousands of fistula repairs since the 1980s. Arrowsmith has a sense of humor about his expertise. "I used to tell everybody I was one of the top five fistula surgeons in the world. There were only four of us, but I was definitely right up there in the top five."

Australian physician Catherine Hamlin and her late husband, Reginald, were the modern pioneers of fistula surgery. In 1974, the Christian couple founded Ethiopia's Addis Ababa Fistula Hospital, which has provided free surgery to more than 34,000 women. (Hamlin, who turns 86 this month, still performs surgeries.)

Fistula surgeries are also regularly performed aboard Mercy Ships' Africa Mercy, a nonprofit floating hospital where Arrowsmith serves as surgery coordinator.

Launching a Campaign

Intensive media attention has brought the need for fistula surgery to a worldwide audience. Both the BBC and Oprah have aired programs on the topic. ...

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