Darius Maggi, M.D. founded the West Africa Fistula Foundation (WAFF) in 2004. In 2008, the West Africa Institute (WAI) was established as an umbrella organization for WAFF and various other programs. 

Upon retiring from an accomplished 22-year career as an OB/GYN in Denison, Texas, Dr. Maggi went to Ghana in 2000 in search of a way to assist women with obstetric fistula, a complication of obstructed labor virtually unseen in the developed world.

In November, 2002 Dr. Maggi traveled to Sierra Leone and at that time was inspired to dedicate his retirement to performing as many fistula surgeries as possible.

Since 2002, WAFF has examined over 1,400 patients and performed more than 650 successful surgeries. Originally located in the capital city of Freetown, WAFF moved to Bo in 2008. This central location provides greater access for women living in rural parts of Sierra Leone.