“The last 22 years have been years of great pain, loss and very deep sorrows. I lost my baby, later lost my marriage, lost friends, and lost my only family (my parents). Fistula robbed me of everything that I once valued, and I have been left very empty.”

Esther gave birth to her second child, Manuel, less than one year ago. She was encouraged to stay at home to deliver the baby, where she labored for three days with the help of a traditional birth attendant. Fortunately, she gave birth to a lively baby boy. However, after four days she noticed she was leaking urine and was unable to control it.

In her 23 years, Abiar has seen and experienced more sadness than most do in a lifetime. Losing her entire family to civil war in South Sudan in 2011, she married as a way to protect her own life. But soon the worst happened: with no access to health care, food or shelter, she became pregnant.

Janet can't explain how she ended up at the political rally that day, but it changed her life forever.

Christine loved her husband and bore him six children. But after he died, Christine's life changed when she was forced to marry her eldest brother-in-law, who cared very little for her or her children. She became pregnant with her seventh child, enduring a prolonged labor that left her with obstetric fistula. Her new husband shunned her and kicked her out of her home. But then she found hope.

Helen went into labor with her second child about four years ago. She gave birth in her home, where she labored for many hours, completely alone without anyone present to assist her. Her baby was stillborn and she began leaking urine immediately.

The fact that he is blind has never slowed him down, and at 45 years, Pastor Raphael is feeling young and energetic. As a child, Pastor Raphael was unable to finish school as he had tend to the family’s cattle, but he always felt a calling to become a pastor and to serve his community.

Mary's first two pregnancies progressed normally, giving her two healthy children. But she never could have imagined what would happen when it came time to deliver her third child.

Salome's labor began at night. She sought help from her mother-in-law, who immediately called Salome's husband - by cultural norms, the only one who could give permission for Salome to seek help at a hospital. But he had turned his phone off for the night and was unreachable. Her mother-in-law tried all she could throughout the night to help Salome deliver her child. By the time Salome's husband returned the call the next morning to advise that she be taken immediately to the hospital, it was too late. The baby did not survive, and Salome had developed an obstetric fistula.

At the age of 14, Margaret was raped while fetching water at the local stream. She became pregnant as a result, and endured a difficult labor, which resulted in a stillborn baby and an obstetric fistula. An orphan, Margaret had nowhere to go, and nobody to help her through this terrible tragedy – except her sister, Rose.

Seline lives in a small village in the remote region of West Pokot, Kenya. She did not go to school and married young, as is tradition in this pastoralist community. She went into labor with her fourth child about three years ago, preferring to give birth at home with a traditional birth attendant from her village. Only 18% of women give birth in a health center in this region of Kenya, far below the national average of 44%

Conducting patient outreach in rural western Kenya, Jane faces a number of challenges—including threats to her life—as she travels in search of women suffering with fistula. But knowing there are many women who are enjoying life once again thanks to her efforts gives great meaning to her work.

Cellina Nyasugutha is a community health volunteer with Daraja Mbili, an outreach program based in Kisii.

Bernard Owino is one of six county mobilizers with Disciples of Mercy (DOM), an organization that runs a fistula outreach program in Kisumu. Before joining DOM, he worked with orphans and other vulnerable populations in the region for four years as a social worker.

Despite the efforts of one dedicated doctor who rode over an hour by motorbike late in the evening to help save the life of Christine and her baby, the baby did not survive. Her prolonged labor also resulted in obstetric fistula. Her husband abandoned her because he could not stand the smell of her incontinence, but her brothers defied cultural tradition and insisted she and her five children live with them. Then, a radio advertisement changed her life.

Mary waited her whole life to have a child. At the age of 47 she finally became pregnant. But her labor was difficult, and her child did not survive. She developed fistula as a result. She was ostracized by her family and shunned by the entire community, until finally, at the age of 73, she finally accessed a free surgery that would change the rest of her life, and remind her what it felt like to feel "human" again.

Mildred developed fistula after prolonged, obstructed labor with her second child. She endured two difficult months of life with fistula before receiving treatment through our Action on Fistula program.

A terrifying rape resulted in pregnancy and an obstetric fistula for Faith. But today she is healed and looking forward to a future where she can use her experience to help other women in similar positions.