Sun drenched cafés, open air cinemas, and the burst of applause roaring from a pack of rabid football (soccer) fans – even I can’t believe I am leaving Berlin at peak season. But duty calls.

After months of deep thought, broad conversation, and thorough strategic consideration, we at OperationOF are ready to take our little venture to the next level. For us, this means condensing the idealistic clouds of our Concept Phase into a tangible base of test cases that will define our Pilot Phase. In this pilot phase we will put some of our concepts into action, testing specific techniques in different environments to see what really works and what needs improvement. A successful pilot will not only teach us volumes, but it will also allow us to develop and refine a set of programs applicable to a broad set of situations. The design and implementation of the pilot is really the key to developing a highly scalable approach to treating fistula. (The first pilot program is focused exclusively on treatment, but subsequent iterations include and will eventually focus exclusively on prevention.)

Our concept is to build highly efficient and sustainable capacity to treat women with obstetric fistula. This means getting local African doctors the training and equipment they need to address the enormous and pent-up fistula demand. It also means working closely with hospital administrators to ensure that their organizational resource base and processes are sufficient to serve our cause without abandoning all the other good working being done by the hospital. In an environment of mind-boggling lack of medical capacity and infrastructure, it is important to design structures that keep hospitals balanced while also serving our cause.

With all that in mind, we decided to launch our first pilot in East Africa and will spend summer gathering information and evaluating potential pilot sites. Besides meeting with proven capacity builders in Kenya, Uganda, and the Democratic Republic of the Congo, we will be reviewing various hospitals in Uganda and Rwanda. Throughout the trip, we will also engage with various women’s empowerment organizations.

Besides gathering information and gauging fit, we will model capacity building/expansion and process improvement techniques for centers currently treating fistula as well as those with little or no presence in the space. We break the potential sites into two groups, which we describe as follows:

• Greenfield (less than 75 surgeries per year); and
• Expansion (more than 75 per year).

Throughout the trip, we will work to update the blog and send reports from the road, so check back often, or subscribe to stay updated!