About this page

GiveWell aims to find the best giving opportunities we can and recommend them to donors. We tend to put a lot of investigation into the organizations we find most promising, and de-prioritize others based on limited information. When we decide not to prioritize an organization, we try to create a brief writeup of our thoughts on that charity because we want to be as transparent as possible about our reasoning.

The following write-up should be viewed in this context: it explains why we determined that we wouldn't be prioritizing the organization in question as a potential top charity. This write-up should not be taken as a "negative rating" of the charity. Rather, it is our attempt to be as clear as possible about the process by which we came to our top recommendations.

Published: 2011

Note: In February 2012, the Fistula Foundation submitted additional documents (listed below), which we have not yet reviewed:

• Letter to GiveWell (PDF)
• Grant Analysis (PDF)
• Social and Economic Consequences of Fistula (PDF)

What do they do?

The Fistula Foundation focuses on the cause of obstetric fistula. (For more on this issue, see our overview of obstetric fistula.)

• In 2010, the Fistula Foundation awarded approximately half of its support to the Hamlin Fistula Hospitals in Ethiopia, and approximately 50% to hospitals and health organizations working in 13 countries in Africa and Asia (details below).
• Previous to 2009, the Fistula Foundation provided funding to only the Hamlin Fistula Hospitals in Ethiopia. In 2009 the Fistula Foundation began funding other hospitals performing fistula surgeries throughout the developing world. In 2009, the Fistula Foundation provided funding for four additional fistula programs in hospitals in Afghanistan, Angola, the Democratic Republic of the Congo and Somaliland, as well as funding to the charity Direct Relief International to provide supplies to three additional hospitals in Africa.1
• It is our understanding that in 2009 the Fistula Foundation's funding ability surpassed the needs of the Hamlin Fistula Hospitals in Ethiopia. This is also suggested by the fact that the Fistula Foundation funding to the Hamlin Fistula Hospitals in Ethiopia decreased in 2009.2 Since our aim is to focus on the impact of additional, as opposed to existing, donations, we have focused on the second, newer set of programs.

In 2009, the Fistula Foundation's grant funding was divided among 5 recipients: 3

In 2010, the Fistula Foundation made grants to a number of new recipients, including Hope Foundation in Cox's Bazaar in Bangladesh, University Teaching Hospital in Yaonde in Cameroon, Aira Mission Hospital in Ethiopia, Central Maternity Hospital in Zinder and Niamey National Hospital Fistula Pavilion in Niger, Family Life Center Fistula Hospital in Mbribit Itam in Nigeria, Kedougou Hospital in Senegal, and the National Borama Fistula Hospital in Somaliland.4

Fistula Foundation grants (2010)5

Review

We reviewed the Fistula Foundation's website and spoke to Kate Grant, Executive Director of the Fistula Foundation, three times over the phone as well as exchanging emails. Ms. Grant provided us with applications submitted by the organizations that have received funding from the Fistula Foundation (aside from the Addis Ababa hospital) and other supporting documentation.

In reviewing these materials, we focused on the following questions, based on our questions for surgery charities:

• Do Fistula Foundation grants cause additional surgeries to take place that would not have taken place otherwise?
• Are these surgeries successful? Has this information been checked for accuracy?

Based on what we have seen, we cannot answer the above questions with confidence.

As mentioned above, the Fistula Foundation's grant-making operations are relatively new and we are interested in more information as it becomes available.

Sources

• CEML Hospital. Grant application for the Fistula Foundation. The Fistula Foundation asked us to keep this document confidential.
• CEML Hospital. Interim report to the Fistula Foundation for grant commencing July 1, 2009. We have not received permission to post this document.
• CEML Hospital. Summary report of surgeries for the Fistula Foundation. This document is confidential as it contains patient information.
• CURE International Hospital. Grant application for the Fistula Foundation. The Fistula Foundation asked us to keep this document confidential.
• Fistula Foundation. Accomplishments & history. http://www.fistulafoundation.org/whatwedo/mission.html (accessed February 8, 2011). Archived by WebCite® at http://www.webcitation.org/5wLPXxlb4.
• Fistula Foundation. Budget (2009-2010). We have not received permission to post this document.
• Fistula Foundation. Grant application template. We have not received permission to post this document.
• Fistula Foundation. IRS form 990 (2009) (PDF).
• Fistula Foundation. Program detail (2005-2009). We have not received permission to post this document.
• Fistula Foundation. Fistula Foundation value of grants (2010) (DOC).
• Grant, Kate. Fistula Foundation Executive Director. Email to GiveWell, November 11, 2009.
• Grant, Kate. Fistula Foundation Executive Director. Letter to GiveWell, October 5, 2009. We have not received permission to post this document.
• Grant, Kate. Fistula Foundation Executive Director. Letter to GiveWell, March 26, 2010. We have not received permission to post this document.
• Grant, Kate. Fistula Foundation Executive Director. Phone conversation with GiveWell, July 21, 2009.
• Grant, Kate. Fistula Foundation Executive Director. Phone conversation with GiveWell, September 17, 2009.
• Grant, Kate. Fistula Foundation Executive Director. Phone conversation with GiveWell, February 3, 2011.
• Panzi Hospital. Grant application for the Fistula Foundation. The Fistula Foundation asked us to keep this document confidential.
• Panzi Hospital. Project report (January 2010). We have not received permission to post this document.

• 1.

  "The Foundation made its first grants outside of Ethiopia to support the work of outstanding partner organizations in developing countries in Africa and Asia treating otherwise forgotten women. We provide grants to support fistula treatment, medical staff training and hospital construction to the following organizations:
  Democratic Republic of Congo: Panzi Hospital
  Afghanistan: CURE International Hospital in Kabul
  Angola: Central Evangelical Medical Center in Lubango
  Liberia, Kenya and Tanzania: Direct Relief International (DRI) providing supplies to hospitals in these countries
  Somaliland: Edna Adan Maternity Hospital in partnership with DRI."
  Fistula Foundation, "Accomplishments & History."

• 2.

  Fistula Foundation funding for the Hamlin Fistula Hospitals in Ethiopia:

  • 2005: $1.6 million
  • 2006: $1.4 million
  • 2007: $1.7 million
  • 2008: $2.0 million
  • 2009: $1.1 million

  Kate Grant, email to GiveWell, April 2, 2010.

• 3.

  Data from Fistula Foundation, "IRS Form 990 (2009)." There is a $200,000 gap between amounts listed as granted to specific organizations and total amount granted. Grants to the Panzi Hospital are not listed in the IRS form. The Fistula Foundation told us in an email on April 2, 2010 that these grants totaled $200,000. Note that the same email gives other grant amounts as well and the amount granted to the Addis Ababa Fistula Hospital in Ethiopia differs by a small percentage (about 4%) between the two sources. We chose to use the IRS form as the main source for grant amounts as it is an official, published document.

• 4.

  "A record fundraising year in 2009 enabled the Foundation to help more women in more places than ever before. The Foundation is now supporting fistula treatment at the following stellar hospitals:
  Afghanistan: CURE International Hospital in Kabul
  Angola: Central Evangelical Medical Center in Lubango
  Bangladesh: Hope Foundation in Cox's Bazaar
  Cameroon: University Teaching Hospital in Yaonde with WAHA- International
  Democratic Republic of Congo: Panzi Hospital
  Ethiopia: Aira Mission Hospital
  Kenya: Nyanza Regional Hospital in partnership with DRI
  Niger: Central Maternity Hospital in Zinder and Niamey National Hospital Fistula Pavilion with WAHA - International
  Nigeria: Family Life Center Fistula Hospital in Mbribit Itam
  Senegal: Kedougou Hospital with WAHA - International
  Somaliland: Edna Adan Maternity Hospital in partnership with DRI and National Borama Fistula Hospital
  Tanzania: Bugando Medical Center; Kenya: Jamma Mission Hospital; Liberia: Liberia Fistula Project; Uganda: Soroti General Hospital — Delivery of Essential Supplies for fistula repair."
  Fistula Foundation, "Accomplishments & History."

• 5.

  Chart was prepared by the Fistula Foundation. Fistula Foundation, "Fistula Foundation Value of Grants (2010)."