,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #diig  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #bf1 #bjad ,ms4 
,de,lauro 7= h]self1 ,ms4 ,mc,collum1 & 
,ms4 ,lee ( ,cali=nia7 introduc$ !      
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,=eign ,affairs  ,a ,,bill
  ,to provide assi/ance to sub-,sah>an  
,africa to combat ob/etric fi/ula4  #a4 
,%ort title & table ( cont5ts  7a7 ,%ort
 title ,?is ,act may be cit$ z ! ,unit$ 
,/ates ,lead]%ip to ,eradicate ,ob/etric
 ,fi/ula ,act ( #bjad4  7b7 ,table (    
cont5ts ,! table ( cont5ts = ?is ,act is
 z foll[s3  ,sec4 #a4 ,%ort title &     
table ( cont5ts4 ,sec4 #b4 ,f9d+s4 ,sec4
 #c4 ,def9itions4 ,sec4 #d4             
,compreh5sive1 integrat$1 #aj-ye>       
/rategy to combat ob/etric fi/ula 9     
sub-,sah>an ,africa4 ,sec4 #e4          
,prev5tion1 treatm5t1 & monitor+ (      
ob/etric fi/ula 9 sub-,sah>an ,african  
c\ntries4 ,sec4 #f4 ,unit$ ,/ates       
,advisory ,committee = ! ,eradication ( 
,ob/etric ,fi/ula4 ,sec4 #g4 ,report4   

,sec4 #h4 ,au?orization (               
appropriations4  #b4 ,f9d+s ,congress   
makes ! foll[+ f9d+s3  7#a7 ,ob/etric   
fi/ula is a cata/rophic *ildbir? injury 
:i* arises z a complication ( ob/ruct$  
labor4  7#b7 ,an e/imat$ #b to #c       
million wom5 curr5tly are afflict$ by ! 
deva/at+ physical & social effects (    
ob/etric fi/ula--a sc\rge ( epidemic    
proportions4 ,z _m z #acj1jjj new cases 
occur ea* ye>4  7#c7 ,hi/orically1      
ob/etric fi/ula affect$ wom5 9 ! ,unit$ 
,/ates & ar\nd ! _w4 ,advances 9        
ob/etric c>e & access to improv$        
surgical te*niques result$ 9 a dra/ic   
r$uction 9 ob/etric fi/ula by ! e>ly    
#bj? c5tury 9 ! ,unit$ ,/ates4  7#d7    
,today1 ob/etric fi/ula prim>ily affects
 ! poore/ wom5 9 ! poore/ p>ts ( ! _w4  
,x disproportionately affects wom5 9    
sub-,sah>an ,africa & girls--"s z "y z  
#ac ye>s old--:o are subject$ to *ild   
m>riage & ^: bodies are n fully capable 
( h&l+ ! dem&s ( *ildbir?4 ,_m ( ^! "y  
girls & wom5 h be5 subject$ to female   

g5ital mutilation1 :i* c increase ! risk
 = & be a direct cause ( ob/etric       
fi/ula4  7#e7 ,ob/etric fi/ula1 :i*     
usually results 9 fetal dea? by         
asphyxia1 occurs :5 ! tissues t normally
 sep>ate a woman's vag9a f h] bladd] or 
rectum are de/roy$ by prolong$ pressure 
f ! fetal head trapp$ 9 ! bir? canal4   
7#f7 ,ob/etric fi/ula typically occurs  
because a woman does n h access to      
em]g5cy ob/etric c>e or because %e does 
n h ! f9ancial means1 transportation1 or
 access to surgical repair4  7#g7 ,left 
untreat$1 an ob/etric fi/ula afflicts a 
woman ) deva/at+ physical conditions3   
incont95ce1 pa9ful ulc]s1 & con/ant &   
uncontrollable emission ( (f5sive odors4
 ,^! symptoms leave a woman indelibly & 
p]petually /igmatiz$ by h] condition4   
7#h7 ,because ob/etric fi/ula does n    
heal on its own1 wom5 affect$ by ?is    
condition are m>g9aliz$ = ! rema9d] ( _!
 lives4 ,expell$ f _! communities & d5i$
 education & heal? c>e1 ob/etric fi/ula 
victims are left 9 desp]ate economic    

circum/ances4  7#i7 ,victims also suff] 
social o/racism t results 9 involunt>y  
divorce1 exclusion f religi\s           
activities1 deep5+ pov]ty1 malnutrition1
 det]iorat+ physical heal?1 depression1 
& despair4 ,z a result1 victims are left
 def5seless & vuln]able4  7#aj7 ,?is    
social isolation comp\nds already exi/+ 
problems su* z illit]acy & lack (       
economic opportunities4  7#aa7 ,because 
ob/etric fi/ula are n !mselves fatal1   
millions ( wom5 live ) ?is horrific     
condition & h be5 ov]look$ by !         
int]national m$ical community4 ,at      
pres5t1 humanit>ian aid & nongov]nm5tal 
programs treat fi/ula cases on a small  
scale & are n equipp$ to sy/ematically  
prev5t1 treat1 & eradicate ob/etric     
fi/ula4  7#ab7 ,ob/etric fi/ula c be    
prev5t$ :5 wom5 & _! families are       
educat$ ab\t ! bir?+ process & are      
provid$ access to em]g5cy ob/etric c>e4 
7#ac7 ,today1 doctors c surgically      
repair ob/etric fi/ula ) a l[-co/1      
l[-te*nology surg]y4  7#ad7 ,! impact ( 

an ob/etric fi/ula-repair surg]y is     
imm$iate & consequ5tial4 ,wom5 c be     
re-integrat$ into society & are af=d$   
basic human necessities su* z familial  
relation%ips1 heal? c>e1 & ! opportunity
 to e>n a liv+4  7#ae7 ,! prev5tion1    
treatm5t1 & ultimately ! eradication (  
ob/etric fi/ula w advance ! emancipation
 & emp[]m5t ( wom51 /r5g!n families &   
communities1 & improve ! ov]all         
economic1 educational1 & social well-be+
 ( affect$ societies4  7#af7 ,basic     
int]v5tions to id5tify & repair ob/etric
 fi/ula h a*iev$ mean+ful &             
co/-effective results4  7#ag7 ,! be/    
available data sugge/s t exi/+ programs 
c only repair #aj p]c5t ( new ob/etric  
fi/ula cases ea* ye>1 & less ?an #a     
p]c5t ( exi/+ ob/etric fi/ula cases are 
repair$ ea* ye>4  7#ah7 ,! *all5ge is to
 exp& exi/+ pilot programs into a       
scalable1 compreh5sive1 & su/a9able     
campaign to eradicate ob/etric fi/ula4  
7#ai7 ,nongov]nm5tal organizations )    
exp]i5ce 9 ob/etric c>e1 surg]y1 &      

wom5's rights h prov5 effective 9 mak+  
progress t[>ds elim9at+ ! sc\rge (      
ob/etric fi/ula & c be a res\rce 9      
assi/+ indig5\s organizations 9 sev]ely 
afflict$ c\ntries 9 _! ef=ts to treat & 
c>e = wom5 ) ob/etric fi/ula4  7#bj7 ,! 
nature ( ob/etric fi/ula--& ! fact t x  
affects vuln]able wom5 9 poor & isolat$ 
communities :i* (f] little or no access 
to ob/etric c>e--dem&s a compreh5sive1  
coord9at$1 long-t]m1 int]national       
response focus$ on ! prev5tion &        
treatm5t ( ob/etric fi/ula1 includ+--   
7,a7 safe-*ildbir? education & ob/etric 
fi/ula prev5tion1 c>e1 & treatm5t2      
po/-op]ative c>e1 includ+               
rehabilitation1 social re9tegration1 &  
po/-surgical foll[-up2 basic & appli$   
rese>* & cl9ical "w2 & tra9+ ( heal? c>e
 work]s & educators1 p>ticul>ly local1  
grassroots educators & m$ical work]s2   
7,b7 designation ( a univ]sity-bas$     
m$ical c5t] 9 ! ,unit$ ,/ates1 designat$
 z ! ,int]national ,ob/etric ,fi/ula    
,in/itute = ,sub-,sah>an ,africa        

e/abli%$ "u section #e7;d71 responsible 
= m>%al+ surgical & o!r necess>y heal?  
res\rces to effectuate ! campaign aga9/ 
ob/etric fi/ula2 = build+ prev5tion &   
treatm5t capacity 9 sub-,sah>an ,africa1
 includ+ coord9at+ p>tn]%ips )          
sub-,sah>an ,african in/itutions &      
gov]nm5ts2 & = develop+ & manag+        
community education & mobilization      
programs at home & abroad2  7,c7        
developm5t ( heal? c>e infra/ructure &  
deliv]y sy/ems ?r\gh ,c5t]s ( ,cl9ical  
,excell5ce = ,ob/etric ,fi/ula ,c>e =   
,sub-,sah>an ,africa z well z ?r\gh     
coop]ative & coord9at$ public ef=ts &   
public-private p>tn]%ips2  7,d7 /r5g!n+ 
univ]sities1 rese>* c5t]s1 & tra9+      
programs = heal? pr(essionals ?r\gh     
in/itutional capacity-build+ p>tn]%ips2 
7,e7 developm5t & implem5tation ( a     
,unit$ ,/ates ,ob/etric ,fi/ula         
,treatm5t & ,prev5tion ,corps :i*       
recruits & tra9s doctors--especially    
ob/etricians1 gynecologi/s1 urologi/s1  
g5]al surgeons1 &                       

ane/hesiologi/s--nurses1 & o!r          
community-developm5t & public-heal?     
p]sonnel to s]ve regions affect$ by     
ob/etric fi/ula & :i* p>tn]s ,unit$     
,/ates m$ical pr(essionals ) sub-,sah>an
 ,african pr(essionals1 promot+ a jo9t  
ef=t to eradicate ?is deva/at+          
condition2  7,f7 coord9ation ( ef=ts to 
make ! treatm5t ( ob/etric fi/ula a     
high] priority 9 sub-,sah>an ,african   
hospitals1 specifically aim$ at         
ameliorat+ ! paucity ( tra9+ relat$ to  
ob/etric fi/ula treatm5t2 &  7,g7       
coord9ation ( ef=ts betwe5 ! m$ical     
community1 nongov]nm5tal organizations1 
national gov]nm5ts1 & private sector    
organizations1 includ+ fai?-bas$        
organizations4  7#ba7 ,! ,unit$ ,/ates  
has ! capacity to lead & enhance !      
effectiv5ess ( ! int]national           
community's response by--  7,a7 provid+ 
sub/antial res\rces1 m$ical exp]tise1 & 
tra9+1 p>ticul>ly ( heal? c>e p]sonnel &
 community work]s & lead]s2  7,b7 mak+  
,unit$ ,/ates surgeons & heal? c>e      

pr(essionals available to s]ve1 tra91 & 
build work=ce capacity 9 afflict$       
c\ntries ?r\gh a ,unit$ ,/ates ,ob/etric
 ,fi/ula ,treatm5t & ,prev5tion ,corps2 
7,c7 enc\rag+ gov]nm5ts & fai?-bas$ &   
community organizations to adopt        
policies t treat ob/etric fi/ula & its  
causes z a multi-sector1 public-heal?   
problem t pr(\ndly affects wom5's heal?1
 wom5's emp[]m5t1 education1 ! economy1 
& promotion ( /rong & successful        
families2  7,d7 enc\rag+ education ab\t 
heal?y practices1 includ+ education ab\t
 ! heal? risks associat$ ) *ild m>riage 
& female g5ital mutilation2  7,e7 build+
 successful communities by prev5t+      
ob/etric fi/ula & ! ensu+ social /igma  
:i* (t5 sep>ates an ob/etric fi/ula     
victim f h] family2  7,f7 contribut+ to 
public heal? & heal?-c>e deliv]y sy/em  
rese>* to improve ob/etric fi/ula       
prev5tion1 treatm5t1 & re9tegration2    
7,g7 enc\rag+ active involvem5t &       
coop]ation across sectors1 includ+ !    
m$ical & sci5tific communities1 *>itable

 f\ndations1 private & volunt>y         
organizations & nongov]nm5tal           
organizations1 fai?-bas$ organizations1 
community-bas$ organizations1 & o!r     
n-=-pr(it entities2 &  7,h7 engag+ 9    
m$ical diplomacy1 ) a p>ticul> focus on 
! fur!r emp[]m5t & emancipation ( wom54 
7#bb7 ,unaddress$ ob/etric em]g5cies &  
untreat$ ob/etric fi/ula result 9 !     
ne$less1 sy/ematic degradation &        
m>g9alization ( wom54 ,x %\ld be !      
policy ( ! ,unit$ ,/ates to help        
eradicate ?is prev5table & curable      
condition4  7#bc7 ,/rong coord9ation mu/
 exi/ among ! implem5t+ ag5cies ( !     
,unit$ ,/ates to ensure effective &     
effici5t use ( f9ancial1 m$ical1 &      
te*nical res\rces )9 ! ,unit$ ,/ates    
,gov]nm5t ) respect to int]national     
ob/etric fi/ula eradication4  7#bd7     
,ob/etric fi/ula is a m$ical condition  
:i* hi/orically affect$ wom5 ar\nd !    
globe4 ,! ,unit$ ,/ates long ago        
elim9at$ ?is ne$lessly oppressive       
condition because ( access to skill$    

m$ical pr(essionals & m$ical c>e4       
,ob/etric fi/ula c be prev5t$ & repair$4
 ,no woman %\ld suff] a lifetime (      
debilitat+ physical & social            
consequ5ces--z ob/etric fi/ula victims  
d--simply because %e lacks access to    
basic ob/etric c>e4  #c4 ,def9itions ,9 
?is ,act3  7#a7 ,advisory ,committee ,! 
t]m ,advisory ,committee means ! ,unit$ 
,/ates ,advisory ,committee = !         
,eradication ( ,ob/etric ,fi/ula        
e/abli%$ "u section #f4  7#b7 ,cl9ical  
,c5t] ( ,excell5ce ,! t]m ,c5t] (       
,cl9ical ,excell5ce means a ,c5t] (     
,cl9ical ,excell5ce = ,ob/etric ,fi/ula 
,c>e 9 sub-,sah>an ,africa e/abli%$ "u  
section #e7;d77#e74  7#c7 ,corps ,! t]m 
,corps means ! ,unit$ ,/ates ,ob/etric  
,fi/ula ,treatm5t & ,prev5tion ,corps   
e/abli%$ "u section #e7;d77#f74  7#d7   
,in/itute ,! t]m ,in/itute means !      
,int]national ,ob/etric ,fi/ula         
,in/itute = ,sub-,sah>an ,africa        
e/abli%$ "u section #e7;d77#a74  7#e7   
,relevant executive bran* ag5cies ,! t]m

 relevant executive bran* ag5cies means 
! ,dep>tm5t ( ,/ate1 ! ,unit$ ,/ates    
,ag5cy = ,int]national ,developm5t1 &   
any o!r dep>tm5t or ag5cy ( ! ,unit$    
,/ates t p>ticipates 9 int]national     
heal? & humanit>ian activities pursuant 
to ! au?orities ( su* dep>tm5t or ag5cy 
or ! ,=eign ,assi/ance ,act ( #aifa4    
7#f7 ,secret>y ,! t]m ,secret>y means ! 
,secret>y ( ,/ate4  7#g7 ,sub-,sah>an   
,africa ,! t]ms sub-,sah>an ,africa1    
sub-,sah>an ,african1 & sub-,sah>an     
,african c\ntry %all h ! mean+s giv5 to 
su* t]ms = purposes ( ?is ,act by !     
,secret>y4  #d4 ,compreh5sive1          
integrat$1 #aj-ye> /rategy to combat    
ob/etric fi/ula 9 sub-,sah>an ,africa   
7a7 ,9 g5]al ,! ,presid5t1 act+ ?r\gh ! 
,adm9i/rator ( ! ,unit$ ,/ates ,ag5cy = 
,int]national ,developm5t1 %all e/abli% 
a compreh5sive1 integrat$1 #aj-ye>      
/rategy to combat ob/etric fi/ula 9     
sub-,sah>an ,africa t /r5g!ns ! capacity
 ( ! ,unit$ ,/ates to be an effective   
lead] 9 ! movem5t = int]national wom5's 

heal? & emp[]m5t4  7b7 ,elem5ts ,su*    
/rategy %all ma9ta9 suffici5t           
flexibility & rema9 responsive to ! ne$s
 ( wom5 afflict$ ) ob/etric fi/ula or :o
 /& at risk ( suff]+ f ob/etric fi/ula &
 %all include ! foll[+3  7#a7 ,a plan = 
implem5tation & coord9ation ( programs &
 activities "u ?is ,act1 includ+ grants 
& contracts = prev5tion1 treatm5t1 &    
monitor+ ( ob/etric fi/ula "u section   
#e4  7#b7 ,specific objectives1         
multi-sector approa*es1 & specific      
/rategies to treat wom5 :o suff] f      
ob/etric fi/ula & to prev5t fur!r       
occurr5ces ( ob/etric fi/ula4  7#c7     
,assignm5t ( priorities = relevant      
executive bran* ag5cies4  7#d7 ,public  
heal? & heal? c>e deliv]y sy/em rese>*  
on ! prev5tion1 repair1 & rehabilitation
 ( ob/etric fi/ula4  7#e7 ,developm5t1  
implem5tation1 & evaluation (           
evid5ce-bas$ sy/ems ( c>e connect+      
mat]nity & ob/etric fi/ula c>e          
facilities ) local c>e deliv]y &        
community education programs4 ,su*      

sy/ems ( c>e %\ld promote rapid &       
long-t]m prev5tion ( ob/etric fi/ula1   
includ+--  7,a7 ref]ral to pr5atal c>e  
to id5tify & mitigate risk factors =    
ob/etric fi/ula2  7,b7 culturally       
appropriate *ildbir? education1         
prep>ation1 & plann+2  7,c7 access to   
skill$ ob/etric c>e2 &  7,d7 promot+    
prompt detection ( prolong$ labor &     
appropriate action to address x4  7#f7  
,provision t ! r$uction ( heal? & social
 risks :i* increase ! likelihood (      
ob/etric fi/ula %all be a priority ( all
 prev5tion ef=ts 9 t]ms ( fund+1        
educational messages1 & activities      
promot+ a decrease 9 *ild m>riage & !   
adolesc5t pregnancy rate1 prompt        
detection ( prolong$ labor1 & imm$iate  
int]v5tion 9 cases ( ob/ruct$ labor     
?r\gh improv$ access to em]g5cy ob/etric
 s]vices provid$ by p>tn] hospitals4    
7#g7 ,improvem5t ( coord9ation & r$uce  
duplication among relevant executive    
bran* ag5cies1 =eign gov]nm5ts1 &       
int]national organizations4  7#h7       

,projection ( g5]al levels ( res\rces   
ne$$ to a*ieve ! /at$ objectives4  7#i7 
,expansion ( public-private p>tn]%ips & 
! lev]ag+ ( res\rces4  7#aj7            
,maximization ( ,unit$ ,/ates           
capabilities 9 ! areas ( m$ical tra9+ & 
rese>* & application ( ^? capabilities 9
 sub-,sah>an ,africa4 ,su* ef=ts may    
include ! provision ( grants by relevant
 executive bran* ag5cies = in/itutional 
capacity-build+ p>tn]%ips betwe5 ,unit$ 
,/ates & =eign in/itutions1 z well z    
betwe5 9-c\ntry in/itutions1 = ! purpose
 ( mobiliz+ 9-c\ntry capacity1 res\rces1
 & exp]tise to prev5t & repair cases (  
ob/etric fi/ula4  7#aa7 ,priorities = ! 
di/ribution ( res\rces bas$ on factors  
su* z ! size & demographics ( !         
population suff]+ f ob/etric fi/ula1 !  
ne$s ( t population1 & ! exi/+          
infra/ructure or fund+ levels t may exi/
 to treat & prev5t ob/etric fi/ula4     
7#ab7 ,a long-t]m commitm5t to !        
eradication ( ob/etric fi/ula by exp&+  
heal? sy/em capacity & tra9+            

opportunities = doctors & o!r heal?     
s]vice provid]s 9 sub-,sah>an ,africa4  
7#ac7 ,a plan to maximize ,unit$ ,/ates 
ef=ts 9 work=ce tra9+1 capacity-build+1 
& ret5tion relat+ to ob/etric fi/ula    
prev5tion1 treatm5t1 rehabilitation1 &  
rese>*4 ,su* plan %all be coord9at$ )   
exi/+ ,unit$ ,/ates & 9-c\ntry work=ce  
capacity-build+ plans & ef=ts4 ,su* plan
 may include tra9+ ( =eign heal? work]s 
at ,unit$ ,/ates in/itutions &          
tra9-!-tra9] programs4  7#ad7 ,a plan = 
in/itutional capacity-build+ p>tn]%ips  
to /r5g!n univ]sities1 rese>* c5t]s1    
heal?-pr(ession tra9+ programs1 &       
gov]nm5t in/itutes to build ! 9-c\ntry  
capacity ne$$ to eradicate ob/etric     
fi/ula4  7c7 ,report ,n lat] ?an #a ye> 
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,presid5t %all submit to ,congress a    
report t conta9s ! /rategy requir$ "u   
?is section4  #e4 ,prev5tion1 treatm5t1 
& monitor+ ( ob/etric fi/ula 9          
sub-,sah>an ,african c\ntries  7a7 ,9   
g5]al ,! ,presid5t1 act+ ?r\gh !        

,adm9i/rator ( ! ,unit$ ,/ates ,ag5cy = 
,int]national ,developm5t1 is au?oriz$  
to provide grants to or ent] into       
contracts ) an eligible entity describ$ 
9 subsection 7b7 to c>ry out activities 
to prev5t1 treat1 & monitor ob/etric    
fi/ula 9 sub-,sah>an ,african c\ntries 9
 accordance ) ?is section4  7b7         
,eligible entity describ$ ,9 ?is        
section1 ! t]m eligible entity means a  
major1 univ]sity-bas$ m$ical c5t] 9 !   
,unit$ ,/ates4  7c7 ,application &      
selection  7#a7 ,application ,!         
,presid5t %all provide = eligible       
entities to submit applications to !    
,presid5t = grants or contracts "u ?is  
section 9 su* =m & mann] z ! ,presid5t  
may require to c>ry out ! purposes ( ?is
 section4  7#b7 ,selection  7,a7 ,9     
g5]al ,f among ! applications submitt$  
"u p>agraph 7#a71 ! ,presid5t %all      
select an eligible entity to receive    
grants or contracts "u ?is section      
pursuant to a competitive selection     
process4  7,b7 ,crit]ia ,! competitive  

selection process ref]r$ to 9           
subp>agraph 7,a7 %all be bas$ ^u        
selection crit]ia1 :i* %all include--   
7i7 ! bread? & dep? ( m$ical faculty1   
p>ticul>ly ) exp]i5ce 9 ob/etrics &     
recon/ructive pelvic surg]y2  7ii7      
bread? & dep? ( public heal? &          
int]national heal? faculty2  7iii7      
exp]i5ce 9 & capacity to conduct tra9+ (
 ! global heal? work=ce & to /r5g!n     
capacity-build+ & heal? sy/ems2  7iv7   
exp]i5ce 9 build+ in/itutional capacity 
9 sub-,sah>an ,africa1 includ+ ?r\gh    
in/itutional p>tn]%ips2  7v7 will+ness  
to supplem5t am\nts receiv$ "u grants or
 contracts "u subsection 7a7 by engag+ 9
 community p>tn]%ips2 &  7vi7 :e!r !    
applicant1 = purposes ( ?is ,act1 has   
ent]$ into a coop]ative agreem5t ) "o or
 m major1 univ]sity-bas$ m$ical c5t]s 9 
sub-,sah>an ,africa4  7d7 ,use ( funds  
7#a7 ,int]national ,ob/etric ,fi/ula    
,in/itute = ,sub-,sah>an ,africa ,am\nts
 receiv$ "u grants or contracts "u      
subsection 7a7 %all be us$ to e/abli% & 

op]ate at ! eligible entity's m$ical    
c5t] 9 ! ,unit$ ,/ates an in/itute to   
c>ry out p>agraphs 7#b7 ?r\gh 7#g71 to  
be kn[n z ! ,int]national ,ob/etric     
,fi/ula ,in/itute = ,sub-,sah>an        
,africa4 ,! purpose ( ! ,in/itute %all  
be to prev5t1 treat1 & monitor ob/etric 
fi/ula 9 sub-,sah>an ,african c\ntries4 
7#b7 ,adm9i/ration & tra9+ ,! ,in/itute 
%all--  7,a7 s]ve z ! prim>y            
adm9i/rative & m$ical-tra9+ hub = !     
campaign to prev5t1 treat1 & monitor    
ob/etric fi/ula 9 sub-,sah>an ,african  
c\ntries2  7,b7 ensure ! campaign       
describ$ 9 subp>agraph 7,a7 is c>ri$ out
 on bo? a sci5tific & humanit>ian basis2
  7,c7 initiate & ov]see ! tra9+ &      
cl9ical activities ( physicians1 o!r    
heal? pr(essionals1 & educators s]v+ at 
,c5t]s ( ,cl9ical ,excell5ce2 &  7,d7   
ensure a progressive increase 9 heal?   
sy/em & work=ce capacity to prev5t1     
treat1 & monitor ob/etric fi/ula 9 ea*  
c\ntry 9 :i* a ,c5t] ( ,cl9ical         
,excell5ce is locat$4  7#c7 ,en=ce      

cl9ical /&>ds & acc\ntability ,!        
,in/itute %all--  7,a7 promote !        
utilization ( /&>d cl9ical protocols1   
facilitate data collection1 coord9ate   
rese>* ef=ts1 & ov]see & p>ticipate 9   
multi-c5t] r&omiz$ surgical trials2 &   
7,b7 en=ce ! highe/ /&>ds ( cl9ical     
practice & e?ical behavior z describ$ 9 
! publi%$ code ( m$ical e?ics = ob/etric
 fi/ula surgeons4  7#d7 ,develop        
evid5ce-bas$ programs = prev5tion &     
access to em]g5cy ob/etric c>e ,!       
,in/itute %all--  7,a7 develop &        
implem5t compreh5sive & culturally      
appropriate protocols to prev5t !       
=mation ( ob/etric fi/ula1 includ+ !    
developm5t & implem5tation (            
evid5ce-bas$ sy/ems ( c>e1 :i* id5tify1 
track1 & evaluate ob/etric fi/ula       
prev5tion programs2  7,b7 develop &     
implem5t prev5tion programs t--  7i7    
tea* wom5 & family memb]s1 9 a          
culturally appropriate mann]1 h[ to     
id5tify prolong$ labor2  7ii7 in=m wom5 
& family memb]s ( ! risks ( n seek+     

appropriate m$ical c>e2  7iii7 ref] wom5
 & family memb]s to pr5atal1 p]9atal1 & 
po/natal c>e2  7iv7 tea* wom5 & family  
memb]s h[ to mobilize community res\rces
 to assi/ 9 seek+ em]g5cy ob/etric c>e2 
&  7v7 tea* wom5 & family memb]s to     
id5tify symptoms ( ob/etric fi/ula &    
ref] wom5 to treatm5t2  7,c7 assi/      
,c5t]s ( ,cl9ical ,excell5ce 9 develop+ 
localiz$ programs = *ildbir? education1 
prep>ation & plann+1 prolong$-labor     
detection1 labor monitor+1 &            
transportation f villages to local      
hospitals = ob/etric c>e & to ,c5t]s (  
,cl9ical ,excell5ce = ob/etric fi/ula   
c>e1 acc\nt+ = factors su* z            
transportation1 geography1 & scalability
 ( su* solutions2 &  7,d7 seek to p>tn] 
) ,unit$ ,/ates m$ical p]sonnel &       
volunte]s to tra9 & employ local m5 &   
wom5 z community-bas$ labor monitors :o 
c educate & assi/ o!r wom5 at risk (    
suff]+ f ob/etric fi/ula1 !reby emp[]+  
an entire sector ( wom5 9 sub-,sah>an   
,africa ) in=mation & employm5t4  7#e7  

,c5t]s ( ,cl9ical ,excell5ce = ,ob/etric
 ,fi/ula ,c>e 9 ,sub-,sah>an ,africa    
7,a7 ,9 g5]al ,! ,in/itute1 9 coop]ation
 ) ea* m$ical c5t] 9 sub-,sah>an        
,african describ$ 9 subsection 7b71 %all
 e/abli% n less ?an #h c5t]s 9          
sub-,sah>an ,africa to treat & prev5t   
ob/etric fi/ula 9 c\ntries & areas 9 :i*
 ob/etric fi/ula is widespread1 z       
det]m9$ by ! ,in/itute 9 consultation ) 
! ,advisory ,committee4 ,su* c5t]s %all 
be kn[n z ,c5t]s ( ,cl9ical ,excell5ce =
 ,ob/etric ,fi/ula ,c>e 9 sub-,sah>an   
,africa4  7,b7 ,g5]al duties ,ea* ,c5t] 
( ,cl9ical ,excell5ce %all e/abli%      
programs to treat & prev5t ob/etric     
fi/ula at hospitals & to exp& ! networks
 ( su* hospitals4 ! ,c5t]s ( ,excell5ce 
%all be co-locat$ or locat$ )9          
reasonable proximity to hospitals       
capable ( provid+ em]g5cy & r\t9e       
ob/etric c>e1 9 ord] to fulfill its     
duties & to ensure hospitals meet       
em]g5cy ob/etric ne$s4  7,c7 ,specific  
duties ,ea* ,c5t] ( ,cl9ical ,excell5ce 

%all function z localiz$ epic5t]s (     
tra9+ & cl9ical excell5ce = ob/etric    
fi/ula c>e1 & %all--  7i7 be a major    
locus ( m$ical & surgical c>e = ob/etric
 fi/ula pati5ts2  7ii7 be c5t]s = !     
tra9+ ( ob/etric fi/ula surgeons1       
nurses1 & o!r m$ical p]sonnel2  7iii7   
coord9ate & implem5t community outrea* &
 prev5tion programs2  7iv7 p>tn] ) !    
national m9i/ry ( heal? or equival5t    
gov]nm5t body & m$ical educators 9 !    
c\ntry 9 :i* ! ,c5t] ( ,cl9ical         
,excell5ce is locat$ to develop         
c\ntry-specific tra9+ programs =        
surgeons & o!r heal? c>e p]sonnel       
involv$ 9 ob/etric fi/ula c>e2  7v7 be a
 vehicle = exp&+ access to em]g5cy      
ob/etric s]vices 9 affiliat$            
communities2  7vi7 e/abli% a consult+ & 
ref]ral relation%ip ) a hospital 9 its  
geographic vic9ity1 assi/ ! hospital by 
complet+ an initial1 compreh5sive       
assessm5t ( :at res\rces ! hospital w\ld
 ne$ to improve deliv]y ( em]g5cy       
ob/etric s]vices1 & bas$ on ! ne$s      

assessm5ts & subject to ! approval ( !  
,in/itute approve fund+ = ea* hospital  
to und]go appropriate physical r5ovation
 & reimburse ! hospital = em]g5cy       
ob/etric c>e & ces>ean deliv]ies2 &     
7vii7 coord9ate a sy/em ( village 8labor
 monitors0 to help prev5t ob/etric      
fi/ula by id5tify+ pregnant wom5 9 _!   
communities1 monitor+ _! labors1 &      
activat+ an organiz$ em]g5cy-transport  
sy/em to move high-risk wom5 to local   
hospitals ) adequate ob/etric c>e4  7#f7
 ,unit$ ,/ates ,ob/etric ,fi/ula        
,treatm5t & ,prev5tion ,corps  7,a7 ,9  
g5]al ,! ,in/itute1 9 coop]ation ) ea*  
m$ical c5t] 9 sub-,sah>an ,african      
describ$ 9 subsection 7b71 %all e/abli% 
& op]ate a ,unit$ ,/ates ,ob/etric      
,fi/ula ,treatm5t & ,prev5tion ,corps4  
7,b7 ,duties ,! ,corps %all--  7i7      
provide volunte] m$ical s]vices at      
,c5t]s ( ,cl9ical ,excell5ce & tra9     
local surgeons & o!r heal? pr(essionals 
9 te*niques ( ob/etric fi/ula repair & 9
 o!r aspects ( ! c>e ( wom5 ) ob/etric  

fi/ula2  7ii7 seek to e/abli% an enabl+ 
environm5t 9 :i* pati5t c>e c be provid$
 effectively1 consi/5tly1 humanely1 &   
e?ically to wom5 ) ob/etric fi/ula2 &   
7iii7 develop evid5ce-bas$ sy/ems ( c>e 
= ! prev5tion ( ob/etric fi/ula4  7,c7  
,memb]%ip ,! ,corps %all consi/ (--  7i7
 graduates ( ,unit$ ,/ates or ,african  
resid5cy programs 9 su* fields z        
ob/etrics & gynecology1 g5]al surg]y1   
urology1 & ane/hesiology2 &  7ii7 o!r   
doctors1 nurses1 community-heal?        
pr(essionals1 public-heal? pr(essionals1
 & o!r exp]t p]sonnel z ne$$ to fur!r ! 
duties ( ! ,in/itute to prev5t1 treat1 &
 monitor ob/etric fi/ula 9 sub-,sah>an  
,african c\ntries4  7,d7 ,duration (    
s]vice ,memb]s ( ! ,corps %all commit to
 a duration ( s]vice ( n less ?an #bh   
mon?s4  7,e7 ,comp5sation1 o!r b5efits  
,! ,in/itute may provide comp5sation1   
o!r employm5t b5efits1 & loan gu>antees 
to individuals :o agree to s]ve z memb]s
 ( ! ,corps4  7,f7 ,alumni ,corps ,!    
,in/itute is au?oriz$ to e/abli% an     

,alumni ,corps1 compris$ ( =m] memb]s ( 
! ,corps :o h complet$ successfully at  
lea/ "o p]iod ( s]vice describ$ 9       
subp>agraph 7,d7 9 ord] to augm5t m$ical
 p]sonnel at ,c5t]s = ,cl9ical          
,excell5ce4  7#g7 ,annual report ,!     
,in/itute %all submit to ,congress &    
make available to ! public an annual    
report on ! implem5tation ( ?is         
subsection1 includ+ a description (--   
7,a7 ! recruitm5t = & implem5tation ( ! 
,corps2 &  7,b7 ! activities ( ea* ,c5t]
 ( ,cl9ical ,excell5ce1 includ+--  7i7 !
 numb] ( wom5 s]v$ at ! ,c5t]2  7ii7 !  
success rate ( ob/etric fi/ula-repair   
surg]ies1 prev5tion ef=ts1 & o!r        
programs us$ by ! ,c5t] & surr\nd+      
communities2 &  7iii7 o!r deliv]y sy/em 
& quality measures z appropriate4  7e7  
,p]sonnel ,! ,in/itute %all be adm9i/]$ 
by qualifi$1 ess5tial p]sonnel includ+--
  7#a7 a director1 :o reports directly  
to ! head ( ! m$ical c5t] 9 ! ,unit$    
,/ates ref]r$ to 9 subsection 7b72  7#b7
 exp]t lead]%ip to ov]see key aspects ( 

! duties ( ! ,in/itute1 includ+--  7,a7 
m$ical & surgical activities2  7,b7     
prev5tion1 education1 & outrea*2  7,c7  
p>tn]%ips & capacity build+2  7,d7      
em]g5cy ob/etric s]vices2 &  7,e7       
program managem5t2  7#c7 pr(essional &  
adm9i/rative /aff responsible =         
adm9i/ration1 coord9ation1 & campaign   
p]=mance2  7#d7 d$icat$1 full-"t1       
exp]i5c$ surgeons responsible = ! m$ical
 sup]vision & tra9+ ( ,unit$ ,/ates &   
sub-,sah>an ,african surgeons assign$ to
 ,c5t]s ( ,cl9ical ,excell5ce1 & =      
m$ical rese>*1 data collection1 &       
successful implem5tation ( m$ical       
programs 9 sub-,sah>an ,africa2  7#e7   
full-"t prev5tion1 education1 & outrea* 
coord9ators1 responsible = ! ,in/itute's
 outrea*1 education1 prev5tion1 & social
 re9tegration programs z well z = !     
sup]vision & tra9+ ( outrea* & education
 /aff assign$ to ! ,c5t]s ( ,cl9ical    
,excell5ce2  7#f7 an advisory panel =   
surgical outcomes & quality compris$ (  
no few] ?an #ae s5ior practic+ surgeons 

f ! ,unit$ ,/ates & o!r c\ntries--  7,a7
 to ensure a high1 uni=m level (        
surgical c>e2  7,b7 to engage 9 cl9ical 
practice ) ,c5t]s ( ,cl9ical ,excell5ce 
= ,sub-,sah>an ,africa to %>e _!        
surgical exp]i5ce & to provide cl9ical  
ov]sight2 &  7,c7 to liaise ) ,c5t]s (  
,cl9ical ,excell5ce = ,sub-,sah>an      
,africa & ! ,in/itute to ensure ! ,c5t]s
 ( ,cl9ical ,excell5ce are acc\ntable = 
provid+ a consi/5t & high level (       
surgical c>e2 &  7#g7 an int]nal        
ov]sight & /e]+ committee compris$ (    
individuals :o are m$ical pr(essionals1 
public heal? pr(essionals1 int]national 
social welf>e advisors1 economi/s       
specializ+ 9 int]national developm5t1 or
 pr(essors ( law or political sci5ce4   
7f7 ,additional p]sonnel ,! ,in/itute   
may appo9t & fix ! pay ( additional     
p]sonnel z ! ,in/itute consid]s         
appropriate4  #f4 ,unit$ ,/ates         
,advisory ,committee = ! ,eradication ( 
,ob/etric ,fi/ula  7a7 ,e/abli%m5t ,!re 
is e/abli%$ an advisory committee to be 

kn[n z ! ,unit$ ,/ates ,advisory        
,committee = ! ,eradication ( ,ob/etric 
,fi/ula4  7b7 ,memb]%ip  7#a7           
,selection2 qualifications ,! ,advisory 
,committee %all be compos$ ( #ad memb]s 
select$ by ! ,secret>y 7?r\gh a         
competitive process7 f among individuals
 :o are di/+ui%$ s*ol>s1 cl9icians1     
sci5ti/s1 advocates1 & philan?ropi/s &  
:o1 collectively--  7,a7 h k & exp]i5ce 
9 heal? c>e & global heal? policy1      
includ+ int]national heal?1 ob/etrics1  
wom5's emp[]m5t1 human rights1 &        
int]national law2 &  7,b7 h direct      
exp]i5ce abroad especially 9 sub-,sah>an
 ,africa4  7#b7 ,selection ,! ,advisory 
,committee %all be compos$ ( #ad memb]s 
select$ by ! ,secret>y ?r\gh a          
competitive process4  7#c7              
,disqualification ,an individual %all n 
be appo9t$ z a memb] ( ! ,advisory      
,committee if su* individual possesses  
any p]sonal or f9ancial int]e/ 9 !      
dis*>ge ( any duties ( ! ,advisory      
,committee4  7#d7 ,t]ms ,! t]m ( (fice (

 ea* memb] ( ! ,advisory ,committee %all
 be #e ye>s4 ,memb]s ( ! ,advisory      
,committee %all be eligible =           
reappo9tm5t = up to #b t]ms4  7c7       
,meet+s  7#a7 ,initial meet+ ,!         
,advisory ,committee %all hold its      
initial meet+ on ! date t is no lat] ?an
 #abj days aft] ! date ( ! enactm5t (   
?is ,act4  7#b7 ,meet+s ,! ,advisory    
,committee %all meet at ! call ( !      
,*airman or a majority ( its memb]s4 ,! 
,advisory ,committee %all meet no less  
?an twice p] cal5d> ye>4  7#c7 ,quorum  
,six memb]s ( ! ,advisory ,committee    
%all con/itute a quorum = purposes (    
conduct+ bus9ess1 except t #b memb]s ( !
 ,advisory ,committee %all con/itute a  
quorum = purposes ( receiv+ te/imony4   
7#d7 ,vacancies ,any vacancy ( !        
,advisory ,committee %all n affect its  
p[]s1 b %all be fill$ promptly 9 ! mann]
 9 :i* ! orig9al appo9tm5t 0 made4  7d7 
,adm9i/ration  7#a7 ,travel exp5ses     
,memb]s ( ! ,advisory ,committee %all be
 all[$ travel exp5ses1 includ+ p] diem 9

 lieu ( subsi/5ce1 at rates au?oriz$ =  
employees ( ag5cies "u sub*apt] ,i (    
*apt] #eg ( title #e1 ,unit$ ,/ates     
,code1 :ile away f _! homes or regul>   
places ( bus9ess 9 p]=mance ( s]vices = 
! ,advisory ,committee4  7#b7           
,adm9i/rative support ,! ,secret>y %all 
assi/ ! ,advisory ,committee by provid+ 
to ! ,advisory ,committee su* /aff &    
adm9i/rative s]vices z may be necess>y &
 appropriate = ! ,advisory ,committee to
 p]=m its functions4 ,^u reque/ ( !     
,advisory ,committee1 ! head ( any      
,f$]al dep>tm5t or ag5cy may detail any 
( ! p]sonnel ( t dep>tm5t or ag5cy to ! 
,advisory ,committee )\t reimbursem5t to
 ! dep>tm5t or ag5cy ( t employee & su* 
detail %all be )\t int]ruption or loss (
 civil s]vice /atus or privilege4  7#c7 
,exp]ts & consultants ,! ,advisory      
,committee may procure tempor>y &       
int]mitt5t s]vices "u section #caji7;b7 
( title #e1 ,unit$ ,/ates ,code4  7#d7  
,o!r res\rces ,! ,advisory ,committee   
%all h reasonable access to mat]ials1   

res\rces1 /ati/ical data1 & o!r         
in=mation ! ,advisory ,committee        
det]m9es to be necess>y to c>ry out its 
duties f ! ,libr>y ( ,congress1 !       
,dep>tm5t ( ,/ate1 ! ,national ,libr>y (
 ,m$ic9e1 & o!r dep>tm5ts & ag5cies ( ! 
executive & legislative bran*es ( !     
,f$]al ,gov]nm5t4 ,! ,*airman ( !       
,advisory ,committee %all make reque/s =
 su* access 9 writ+ :5 necess>y4  7#e7  
,obta9+ (ficial data ,! ,advisory       
,committee may secure directly f any    
dep>tm5t or ag5cy ( ! ,unit$ ,/ates     
in=mation necess>y to enable x to c>ry  
out ?is section4 ,^u ! reque/ ( !       
,*airman ( ! ,advisory ,committee1 !    
head ( t dep>tm5t or ag5cy %all furni% t
 in=mation to ! ,advisory ,committee4   
7e7 ,duties ,! prim>y duties ( !        
,advisory ,committee %all include--     
7#a7 advis+ ! ,in/itute on an ongo+     
basis 9 c>ry+ out ! duties ( !          
,in/itute2  7#b7 evaluat+ programs &    
activities to eradicate ob/etric fi/ula 
& mak+ recomm5dations reg>d+ ! programs 

( ! ,in/itute2  7#c7 advis+ ! ,dep>tm5t 
( ,/ate & ! ,unit$ ,/ates ,ag5cy =      
,int]national ,developm5t on an ongo+   
basis 9 c>ry+ out programs & activities 
to eradicate ob/etric fi/ula2  7#d7     
monitor+ funds available = programs &   
activities to eradicate ob/etric fi/ula 
to ensure su* funds are us$ effici5tly &
 are acc\nt$ = prop]ly1 includ+ ?r\gh ! 
conduct ( p]iodic audits2 &  7#e7 advis+
 ! ,adm9i/rator ( ! ,unit$ ,/ates ,ag5cy
 = ,int]national ,developm5t 9 an annual
 writt5 report ( ! ,in/itute's p]=mance 
& success 9 c>ry+ out its duties4  7f7  
,actions aga9/ gov]nm5ts fail+ ,to meet 
m9imum /&>ds  7#a7 ,by ,advisory        
,committee ,! ,advisory ,committee--    
7,a7 %all advise ! ,adm9i/rator ( !     
,unit$ ,/ates ,ag5cy = ,int]national    
,developm5t1 bas$ on in=mation provid$  
to ! ,advisory ,committee by ! ,in/itute
 or bas$ on indep5d5t s\rces (          
in=mation1 ( ea* c\nty t by reason (    
corruption1 indiff]5ce1 or              
ineffectiv5ess1 significantly imp$es !  

,in/itute's ability to provide s]vices  
to victims ( ob/etric fi/ula & wom5 :o  
are vuln]able to ob/etric fi/ula2 &     
7,b7 may reque/ ! ,adm9i/rator to       
recomm5d susp5sion ( ! provision (      
,unit$ ,/ates nonhumanit>ian1           
nontrade-relat$ =eign assi/ance to ea*  
c\ntry describ$ 9 subp>agraph 7,a74     
7#b7 ,by ,,usaid ,bas$ on ! advice ( !  
,advisory ,committee "u p>agraph 7#a71 !
 ,adm9i/rator may accept ! advice &1 9  
consultation ) ! ,secret>y1 recomm5d to 
! ,presid5t ! susp5sion ( ,unit$ ,/ates 
nonhumanit>ian1 nontrade-relat$ =eign   
assi/ance to a c\nty describ$ 9 p>agraph
 7#a77;,a74  #g4 ,report ,! ,presid5t1  
act+ ?r\gh ! ,adm9i/rator ( ! ,unit$    
,/ates ,ag5cy = ,int]national           
,developm5t1 %all submit to ,congress on
 an annual basis a report on !          
implem5tation ( ?is ,act = ! prec$+ ye>1
 includ+ an evaluation ( ! effectiv5ess 
& p]=mance ( ! ,in/itute1 ! ,c5t]s (    
,cl9ical ,excell5ce1 ! ,corps1 & all    
relat$ community outrea* & m$ical       

programs4  #h4 ,au?orization (          
appropriations  7a7 ,9 g5]al ,!re are   
au?oriz$ to be appropriat$ to !         
,presid5t to c>ry out ?is ,act--  7#a7  
#aj1jjj1jjj = fiscal ye> #bjae2 &  7#b7 
#ahj1jjj1jjj = ! p]iod ( fiscal ye>s    
#bjaf ?r\gh #bjbd4  7b7 ,availability   
,am\nts appropriat$ pursuant to !       
au?orization ( appropriations "u        
subsection 7a7 are au?oriz$ to rema9    
available until exp5d$4