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Pelvic organ prolapse (POP) is a common condition, usually caused by childbirth. For women in the United Kingdom, POP can be diagnosed easily and treated early. But in Ethiopia, where women in rural areas have little access to healthcare, this condition can worsen if left untreated, resulting in Advanced Stage Pelvic Organ Prolapse.
Prolapse, in its basic form, is when a woman’s pelvic floor muscles are weakened due to stretching or tears, allowing the pelvic organs such as the bladder, uterus or rectum to descend into the vaginal canal.
There are different types of prolapse, with doctors using a grading system – from stage 1 to stage 4 – to define the extent.
Advanced stage POP occurs at stage 3 and stage 4. This is when one or more of the pelvic organs protrude, causing significant discomfort, pain, and disruption in daily life. Women with this condition require surgical treatment.

Diagram credit: Clearblue





For more than 10 years, Yali lived with the pain caused by advanced pelvic organ prolapse.
As a widow and mother of six, Yali continued to manage her daily responsibilities but her condition affected her quality of life and local health services were unable to provide the treatment she needed.
When a Project Zero team arrived in her community, Yali was identified and connected to specialist care at Hamlin’s Metu Hospital.
After surgery, she returned home smiling, healthy and free from pain. “If it weren’t for this project, I would be suffering… I feel completely healthy now.”

Pelvic organ prolapse affects millions of women globally. In Ethiopia, however, studies find the prevalence of POP particularly high at almost 23%, or 1 in 4 women.
This can be attributed to a range of causes. In Ethiopia, women are more likely to give birth at an early age, and also have high fertility rates. Childhood malnutrition, the challenge of accessing nearby healthcare services in rural areas, and women undertaking arduous physical work, particularly in agriculture, are also contributing factors.
Women presenting at hospitals are often experiencing advanced stage POP and complications including infections and ulceration. Kidney obstruction and an inability to pass urine can result in damage to the kidneys if a prolapse is left untreated.
According to research, women may also be reluctant to seek help, due to their personal fear of disclosing the problem and potentially experiencing stigma or losing social value as a result.

All six Hamlin Fistula Hospitals provide a range of gynaecological treatments to women, including obstetric fistula and advanced POP surgery.
For women like Hosana, this has been life-changing.
Many of the women benefiting from this life-altering treatment often lack the financial means to cover its cost. Their treatment is offered free, thanks to generous donors from around the world.