Obstetric fistula is a debilitating condition caused by prolonged labour without medical intervention. The woman is left with a hole in the birth canal which causes chronic incontinence and, in most cases, a stillborn baby. The smell of leaking urine or faeces is constant and humiliating, often driving even loved ones away. Left untreated, fistula can lead to serious medical problems, including ulcerations, kidney disease, and nerve damage in the legs. Due to the lack of medical help and health education to avoid and treat the condition, women and girls needlessly suffer a life time of pain, discomfort and discrimination. In Ethiopia there are an estimated 100,000 women suffering with untreated fistula, and another 9,000 women who develop fistula each year. This project will build on one of SafeHands for Mothers’ films, “Fistula Pilgrims”, to raise awareness on this issue in Ethiopia. The documentary was written, produced and directed by award-winning photographer and film-maker, Nancy Durrell McKenna in partnership with the International Federation of Obstetrics and Gynaecology (FIGO). It tells the story of Telanish, a young girl in Ethiopia who was married at 10, pregnant at 11 and gave birth to a stillborn child at 12. As a result of a long and obstructed labour, she has a fistula and is left incontinent, an outcast from her community, until learning of the possibility of fistula repair. “Fistula Pilgrims” promotes the need to prevent fistula by avoiding early age marriage and ensuring women with difficult labours receive prompt medical care, as well as the benefit of fistula repair procedures, so that young women like Telanish can be spared a lifetime of misery. To watch “Fistula Pilgrims” please visit: http://www.safehands.org/index.php?option=com_content&task=view&id=14&Itemid=29 The main activities of the project will be: • Translation of the documentary into 3 local languages • Purchase of solar powered DVD players that can be used in the most remote villages of Ethiopia, reaching out to the most vulnerable populations. Please visit our website on the above link to see the effectiveness of using Solar powered DVD players • Film screening and discussion sessions in community, local health clinics and mini-fistula hospitals • Production of basic information education and communication material based on the documentary in 3 local languages (5000 laminated 2 sided facts sheets on Fistula and available help) The main outputs will be: • Improved skills of Health Extension Workers (HEWs) to educate the community on fistula and its causes • Improved skills of HEWs to educate the community of harmful traditional practices such as child marriage and female genital mutilation that contribute to fistula • Improved awareness of fistula repair services by fistula patients • Reduced stigma towards women suffering from fistula This project will be based in Ethiopia around Awassa, Bahir Dar, Mekele, Harar, Yirgalem, and Metu. Beneficiaries will be: • 300 HEWs who will become more informed about the nature and consequences of fistula and the harmful social practices that lead to it • 150,000 women and girls in 150 kebeles (villages) who will see “Fistula Pilgrims” and be more likely to access delivery care / seek help in the event of danger signs • 250,000 men, women and village and religious elders who will see “Fistula Pilgrims” and demonstrate positive behavioural/attitudinal change on the issue • 500 women with fistula referred for fistula repair SafeHands for Mothers will work with: Family Guidance Association of Ethiopia (FGAE)-the oldest reproductive health and family planning organization in Ethiopia; Health Extension and Education Centre (HEEC) of the Ministry of Health; The mini-fistula hospitals in the target regions; UNFPA and Population Council.