Although surgical repair of fistula is associated with improvements in women’s quality of life and mental health, researchers have found even after being treated surgically to repair their fistula, many women still have difficulty engaging in family and community life. Tracy Gladstone, Ph.D., Senior Research Scientist and Director of the Stone Primary Prevention Initiatives at WCW, traveled to Gondar, Ethiopia where she trained nurses to implement a new evidence-based depression prevention program being piloted at the University of Gondar Fistula Center. After initial planning meetings in Spring 2014, Gladstone and her team conducted onsite interviews in December with clinicians as well as patients who shared their knowledge about fistula; they talked about their current social support and coping strategies and expressed an interest in learning skills to manage their worries and feel better. After developing a protocol, Gladstone returned to Ethiopia in March 2015 and trained the clinicians (pictured below), providing follow-up support via web-based communications as the hospital team readied for implementation. This spring, data from the first two cohorts who took part in the cognitive behavioral therapy program, and from the clinicians who led the initiative at the hospital, have resulted in promising positive outcomes—depression symptom scores decreased substantially. Further program details will be included in the Fall/Winter issue of the Research & Action Report.
