Approximately two million women worldwide suffer from an obstetric fistula, one of the most serious consequences of obstructed labour. A fistula is a hole between the vagina and the bladder or rectum, through which urine or feces leaks continuously. The injury has almost disappeared in developed countries where there is near universal access to obstetric care.

Women with fistulas are often outcasts from their communities because of the smell associated with the leaking of urine and feces, and in some cases they are abandoned by their husbands. Surgery to repair the fistula can help them to start a whole new life: just like a butterfly, many women who were previously living secluded lives begin a fresh start after their operation. But opportunities for women to have their fistula repaired are slim, as many hospitals or health clinics do not have the proper instruments or knowledge and skills to carry out the specialized procedure.

In addition to offering maternal health services to prevent delivery complications in numerous countries, in 2010, MSF staff operated on and treated about 1,000 women suffering from obstetric fistula. Surgeries are performed in what teams called “fistula camps,” where fistula surgery services are set up next to an existing hospital and include a special women’s village recovery area. These photos were taken in a fistula camp in Boguila, Central African Republic (CAR).

[All photos: © Sarah Elliott/MSF ]