In 1992 a unique maternal health demonstration project was initiated. This project was developed in South Eastern Nigeria, where the maternal mortality and morbidity is one of the highest in the world.

An untrained TBA at a delivery house.

The project was a balanced one of prevention and curative care programmes. The prevention programmes were designed to reduce maternal mortality and morbidity, by training Traditional Birth Attendants (TBA's) in the villages to recognise and refer high risk mothers, by improving the care given to mothers in rural maternity centers by the nurse/midwives and by introducing a safe and efficient means of transporting mothers with obstetrical emergencies to the district hospital. This model of maternity care has been evaluated and shown to be sustainable, reasonably inexpensive and effective in reducing deaths and injury by two-thirds.

A separate treatment and rehabilitation centre, for the young mothers with obstetric fistula was completed. This center is only the second established in Africa, the other was established in Ethiopia in 1975 and only the third in history, the first being set up in 1875 in New York City. It is now well established and is currently treating about 200 patients per year. There is an urgent need for more such centres.

17 year old Grace needed many operations over three years to cure her and return her to her family and village