When she was three months pregnant, Breeze-Harris saw a special on Oprah about women with obstetric fistula, a traumatic childbearing injury that results from unrelieved obstructed labor. Fistula is a hole in the birth canal that causes women to leak waste uncontrollably, and it affects women in developing countries who don't have access to hospital care. After researching the condition, Breeze-Harris began advocating locally, and in March 2005 cofounded the nonprofit One by One, which is dedicated to treating and ending fistula.

Cookie: How did you get from seeing the piece on Oprah to founding your own nonprofit?

HBH: I have a background in nonprofit work and have lived overseas, but more recently I had been working as an artist. When I first heard about obstetric fistula, it woke up an old part of myself. I thought, This whole thing about the women and the girls getting the short end of the stick—I'm just so over it! I realized I was either going to complain to the point where people were irritated with me, or I could do something about it. I started talking to everyone I knew, saying, "It's so cheap to treat it and probably even easier to prevent it." I went online and went to the library and did a ton of research and really started thinking about what I could do to help.

Cookie: How did you move from advocating to fundraising for fistula?

HBH: Well, it was very serendipitous. Katya Matanovic [cofounder of One by One] and I are best friends, and in 2004 we decided that we wanted to try to go to one internationally focused event a month, because we felt a bit out of touch with global issues. So the month I learned about fistula, we got an invitation to hear Kathy Bushkin, the executive vice president of the United Nations Foundation [the foundation is a private nonprofit that supports the U.N.], speak. And she mentioned the U.N. Population Fund, which I had found through my research because it runs the Campaign to End Fistula, the broadest such program in the world.

I went up to her afterward and said, "It's not like I'm anyone from Adam, but I really think there's a way to do something about this. I want to help." Kathy called one of her contacts who worked at the U.N. Foundation, and we spent a year on the phone asking questions like "How would an individual work with the U.N.?" and "How do we get assurances that the money we raised was going to the right place?" The first year, when I was pregnant, it was really just being on the phone with them and strategizing with Katya about what this thing was going to look like.

Cookie: How did you officially launch One by One?

HBH: In March 2005 we launched One by One formally under the fiscal sponsorship of the U.N. Foundation. With its 501(c)3 status, it gave us the capacity to take the money in, with the understanding that every cent we raised would go to the U.N. Foundation and be held in trust, with no overhead, for the Campaign to End Fistula. That is how we were able to start. It handled the website and credit-card processing and allowed us to hit the ground running.

And what happened was, it just exploded. We were amazed at how quickly people walked through the door, wanting to give money but also wanting to give in other ways. There are very few places in a global-health context that would take anything more than their checks. Our organization gave them an outlet where they could understand where their money was going and how it—and their ideas and skills—could help. Doctors volunteered to perform surgeries; architects offered to help build clinics; pharmaceutical-company employees wanted to donate supplies.

Cookie: And One by One is an independent nonprofit now, right?

HBH: Yes, we're no longer under the umbrella of the U.N. Foundation. While we are still committed to the work of the Campaign to End Fistula and we have given them two good-size grants, we are now able—with our own board's approval—to choose other programs to receive funding as well. It's an important piece of growth.

One of the reasons we became our own nonprofit is we realized that a lot of deserving programs were underfunded. The Campaign to End Fistula is great because it looks at treatment, prevention, and rehabilitation, and we wanted to fund other programs that did that as well. This means we make grants to clinics and look at organizations dealing with everything from girls' education to curbing child marriage. The goal is to end fistula, not just treat it, because if I'm going to use social capital to get people to donate, I don't want to tell them they have to donate every year of their lives. Treatment and prevention are the key.

Cookie: What do you see for the future of the organization, and what have been some of the highlights of your work for One by One?

HBH: Our primary purpose is still to help as many women as we can who are suffering from fistula, but we also want to help people in the developed world feel like they can contribute. We want people to believe that their $10 can make a difference even when Warren Buffett—and I think it's amazing that he is—is giving $10 billion. That's the concept of One by One. We started giving circles in which 10 people give $30 each—enough to cover the cost of one fistula surgery.

One of the best moments for me was when an 8-year-old who lives down the street walked up with her piggy bank and dumped out the change in front of me. It was about two dollars, and she said, "I know it's not much, but I want to help." I told her that two dollars can buy a transfusion bag that can save someone's life. And she said, "I get to save somebody's life?"

I took her money, put it in an envelope, and sent it to a surgeon in Ethiopia, and I said, "You might want to tack this onto your bulletin board, because it's the purest two dollars you're ever going to get." To be able to say to a little girl that two dollars matters and to honestly know that it does—that's where the game is won.

Cookie: You yourself had a very difficult labor. Did that make you feel even more committed to the cause?

HBH: I did, ironically, have an obstructed labor, like women who have fistula. I wanted to have a natural birth, but that just wasn't in the stars for me. My son, Coleman, was hung up on the left side of my pelvis, and he just never came down. After 30 hours of labor, they did an emergency C-section. Coleman was healthy, but I had internal bleeding and had to go into surgery when my son was nine hours old. Fortunately, I had great medical care. But I wonder if I had lived somewhere else, what would have happened to me? It made me think of women in Africa and other places, going through three or four days of obstructed labor before the baby dies, and then being told it's their fault and often getting cast out of their communities. I had already started my research, but that made me even more passionate about working to end fistula.

Cookie: How do you balance being a mom with your work for One by One?

HBH: I try to find the balance between doing something important in the world and being a good wife and parent. I'm certainly not alone in trying. I have a very supportive family as a whole. Today my nanny is ill and we're trying to leave on vacation and I lost my car-pool buddy, so I said to my husband, "Jack, I really need you to come home today and work from there—I need you," and he did. He's a terrific husband, and he really believes in this project. I think it's also about having great friends who remind me to check my priorities—they'll call up and say, "Have you exercised? You're not the youngest thing on the planet." Sometimes I take a week off from One by One to just focus on Coleman. I have an amazing son and husband and a great brother and wonderful friends, and I wouldn't be where I am now without them.