In Nigeria, one out of every 18 women dies as a result of childbirth. The country has the second-highest maternal mortality rate in the world.

That's why the Rotarian Action Group for Population Growth and Sustainable Development targeted the northern Nigerian states of Kaduna and Kano with a pilot program aimed at reducing maternal mortality by preventing and treating obstetric fistula, a serious birth injury. From 2005 until 2010, the project, partly supported by a grant from The Rotary Foundation, reduced maternal death by 60 percent in participating hospitals, reached 1 million women of childbearing age, and repaired obstetric fistulas for 1,500 Nigerian women.

"We have to empower women, and women cannot be empowered if they can't make their own choices in antenatal care and child spacing," says Dr. Robert Zinser, CEO of the Rotarian Action Group for Population Growth and Sustainable Development and member of the Rotary Club of Ludwigshafen-Rheinschanze, Germany.