GLOBAL JOURNAL OF MEDICINE AND PUBLIC HEALTH 1 www.gjmedph.org Vol. 2, No. 3 2013 ISSN#- 2277- 9604 Assessing fistula and obstetrical surgical capacity in South Kivu, DRC Stephen C. Morris 1* , Nadine Semer 2 , Lauri Romanzi 3 , Michael VanRooyen 4 , Julia VanRooyen 5 ABSTRACT The Democratic Republic of Congo has suffered from decades of conflict and poverty. The Eastern DRC, in particular, continues to be a region dominated by instability, resulting in a fragmented health system. Governments and agencies interested in working towards improving health in the region are often challenged by an absence of knowledge of health metrics, limited capacity for health care delivery and overwhelming needs. The Harvard Humanitarian Initiative and Engender Health needs assessment, outlined in this report, demonstrates an effort to better understand the current state of surgical capacity in the region with an emphasis on needs and opportunities related to fistula repair. Keywords: obstetric fistula, assessment, surgical, INTRODUCTION Background Decades of civil unrest, armed conflict and weak or absent governance have resulted in unique public health consequences and inconsistent access to health services for the population of the Eastern DRC 1,2 . The combination of poor nutrition, severe sexual violence and restricted access to obstetrical care have resulted in a high number of complicated gynecologic and obstetric problems such as fistula and uterine prolapse 3,4 . The exact prevalence of these medical problems is unknown and will likely remain so given the difficulty of population research in the area. Much has been done to address these problems, in particular by Panzi Hospital in Bukavu, but continued violence, and inadequate access to health care results in continued new cases 5-6 . There is widespread belief among the public health and health care community that many patients remain untreated. Current Structure of Health System In Eastern DRC the Ministry of Health (MoH) maintains nominal authority over all aspects of health care delivery, but given governance restraints and limited resources, a great deal of control has been delegated to other bodies, such as the World Health Organization (WHO), and various non-governmental organizations (NGOǯs) and religious organizations 7 . GJMEDPH 2013; Vol. 2, issue 3 1 Acting Instructor of Medicine University of Washington School of Medicine Affiliate Harvard Humanitarian Initiative 2 Affiliate Harvard Humanitarian Initiative 3 Associate Professor of Gynecology New York Presbyterian Hospital- Weill Cornell Medical College Affiliate Harvard Humanitarian Initiative 4 Professor of Emergency Medicine Brigham and Women’s Hospital Harvard Medical School Director Harvard Humanitarian Initiative 5 Fellow Harvard Humanitarian Initiative *Corresponding Author Acting Instructor of Medicine Division of Emergency Medicine, Department of Medicine University of Washington School of Medicine Affiliate Harvard Humanitarian Initiative 446 27 th Ave East Seattle, WA, USA 98112 stephenmorrismd@gmail.com Conflict of Interest—none Funding—none