Vesico-vaginal fistula, VVF is a medical condition whereby a hole is between the birth canal and the bladder leaving the women in a state of not being able to control their urine. Women with a hole between the birth canal and the rectum, recto-vaginal fistula (RVF) experience uncontrollable leakage of stool. Some women have both VVF and RVF. Some women are born with fistula, which is rare. Other causes include injuries sustained during pelvic surgery and hysterectomies, inflammation and infections in the genital area, and sexual violence. But the leading cause of fistula is prolonged and obstructed labor.  In Nigeria, between 400,000 and 800,000 women is currently living with fistula. The World Health Organization describes fistula as “the single most dramatic aftermath of prolonged or neglected childbirth,” and estimates more than two million women live with fistula worldwide. Nigeria has the world’s highest occurrence of obstetric fistula and the Nigerian government says early marriage is largely to blame. Often, the bodies of young wives are not physically prepared for childbirth. But health workers say other cultural factors contributing to the high occurrence of fistula need to be addressed and focusing on early marriage oversimplifies the problem.

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