• provide surgical remedies for those suffering from existing obstetric fistulas
• offer education and resources to decrease the occurrence of new fistula cases
• teach family planning, literacy and vocational skills
• assist fistula patients to reintegrate into their communities
• train Sierra Leoneans as healthcare professionals

By carrying out this goal, WAFF hopes to:

• empower fistula patients to improve their quality of life
• eliminate obstetric fistula
• lower the rate of infant and maternal mortality

All services are provided free of charge due to donors’ generous support.

What is a fistula?

Vesico vaginal fistula (VVF):

• an abnormal opening between the bladder and the vaginal wall
• most often caused by obstructed labor which occurs when the baby’s head is unable to pass through the birth canal and is jammed in the maternal pelvis
• pressure from the obstruction causes a loss of blood to the surrounding tissues, leading to necrosis
• a hole develops in place of the dead tissue resulting in constant leakage of urine 

Recto vaginal fistula (RVF):

• similar to VVF except the opening is between the rectum and the vaginal wall
• patients with RVF most often have VVF as well
  

The physical effects may include:

• damage and destruction of urethra
• renal failure
• painful chemical burns due to constant exposure to caustic urine
• loss of menses, infertility and/or cervical damage
• painful inflammation of the pubis symphysis (the joint at the front of the pelvis between the two pelvic bones)
• nerve damage leading to foot drop (difficulty in lifting the top of the foot, causing pain, limping and numbness)

The psychosocial effects may include:

• social ostracism
• abandonment by husband and family
• impoverishment due to inability to provide for oneself without support
• depression and suicide

The underlying causes include:

• inadequate availability of maternal and infant healthcare
• lack of access to education
• the widespread use of untrained traditional birth attendants instead of certified midwives and/or medical professionals
• a tradition of early marriage and/or pregnancy before full physical development (12-18 years)
• unplanned pregnancy due to rape and other forceful sexual encounters