A new research project, led by experts from the University of Nottingham, is enabling survivors of obstetric fistula (OF) to tell their stories on a global platform, about the serious condition which affects nearly half a million women and girls globally.
The Voices for Safe Motherhood: Co‑Creating Advocacy Through Fistula Survivors' Stories, is a global project between the University of Nottingham and the Evangel Vesico Vaginal Fistula (EVVF) Centre, at the Bingham University Teaching Hospital, in Jos, Nigeria.
The 23 May marks the United Nation's International Day to End Obstetric Fistula. OF is a severe but preventable childbirth injury caused by prolonged, obstructed labour, resulting in an abnormal opening between the vagina and the bladder or rectum.
between the vagina and the bladder or rectum.
Women affected often experience continuous leakage of urine (vesico vaginal fistula VVF) or faeces (recto vaginal fistula RVF), leading to profound physical, psychological, and social consequences.
Despite being preventable and treatable, OF remains prevalent in low-resource settings like Nigeria, reflecting systemic gaps in maternal healthcare. Survivors face stigma, poverty, and barriers to care, and their experiences are rarely represented accurately in mainstream media.
Nearly half a million women and girls worldwide are living with OF*. Thousands of new cases occur annually. For every maternal death, 20 - 30 additional women experience childbirth injuries that significantly affect their quality of life and well-being. In 90% of OF cases, the baby dies. Babies who survive such traumatic births can face significant health challenges, such as cerebral palsy and paralysis*.
OF has been virtually eliminated in high-income countries through access to quality maternal healthcare (Wall, 2006; United Nations Population Fund [UNFPA], 2025), but it remains a major public health issue in sub-Saharan Africa and parts of Asia(Ahmed & Tuncalp, 2015; Ahmed et.al, 2025).
In line with the 2026 theme of the UN's International Day to End Obstetric Fistula - 'Her Health, Her Right: Shaping a Future without Fistula' - the purpose of this project is to bring together fistula survivors, health professionals, and leading media organisations to co‑produce survivor‑centred advocacy content that raises awareness, challenges stigma, and promotes prevention, treatment, and reintegration. It responds to a critical gap in how obstetric fistula (OF) is portrayed and understood by the wider public.
The project is led by Dr Hannah Degge, Assistant Professor in Health Promotion and Public Health, and Dr Farzaneh Pazandeh, Assistant Professor of Midwifery of the School of Health Sciences at the University of Nottingham.
Through personal storytelling, this project aims to strengthen the capacity of journalists and content creators to report ethically and sensitively on OF, while empowering survivors to reclaim their narratives."
The team have already hosted a workshop for survivors and media practitioners in Nigeria. Now, using the interviews with survivors, the team will produce impactful multimedia content; audio, video, and story-based pieces that amplify survivor voices and position them centrally in efforts to reduce the incidence of OF.
Survivor case studies
Dorcas, married, age fistula occurred 38 years, 9th pregnancy, type of fistula- VVF and RVF; location -urban area
"…I was given three months after which I was to come back for VVF repairs. After going back home, before I came back, I became the television of the area. Nobody has ever known that there is any disease like that and I myself have never heard of it.. If I see a person coming, I will run and hide in the room. I spend my day in bed and spend the night in bed. My daily food was just crying. I will keep crying. I will get wet all over my body, up to my neck. I will carry the boy and put him somewhere because he too uses to get soaked with urine. Honestly, I didn't find it easy.. For my own, I went to the hospital after spending one day in labor.. When I arrived there, the doctors were arguing among themselves. The world should know so that the doctors and nurses will be reminded that they are dealing with human lives; they should not play with it..The world should be told so that all hospital workers will remember that they have sworn an oath to protect human lives irrespective of the tribe. I think if we follow these steps, things will become easy for us…"
Amina, remarried, age fistula occurred 18 years, first pregnancy; type of fistula-VVF; location -rural area)
"When it is time to start ante natal, there was no money…there was no money. When I was eight (8) months pregnant, he(husband) went and looked for money and gave me. When I went to the hospital, the doctor told me that I should come at the end of the month because there was a problem. I went back home. To go back to the hospital again, there was no money. Up to the time I started labor, I was in labor, there was no money to go to the hospital. I was in serious labor for three days….My advice is that awareness should be created so that anywhere a woman suffering from VVF is, she should be loved, people should not be running away from them because when I got this thing, I was all on my own as everyone was rejecting me. Nobody was coming close to me, none. I was all on my own, alone. My mother rejected me, my husband rejected me, the whole community detest me…Even after I am healed still people see me as someone who shouldn't be in the community. Because of that, I am advising that women should stop giving birth at home. The moment a woman starts labor, she should be rushed to the hospital because if I was taken to the hospital earlier, I may still be having my child. Since that time, I have never had a child again. I am still there without a child. I am pleading that men should love their wives in whatever situation they are in, whether they are sick or they are in good health, women need to be loved"
Mercy, separated, age fistula occurred- 19 years, first pregnancy, type of fistula- RVF, location -urban
"The truth is, when I encountered this problem, I was not able to even step outside. It is like a kind of disease that has affected all of my body and it is not something that you will go about telling people because even those that know are avoiding and running away from me. My own came with uncontrolled faeces. There is faeces everywhere, there is infection. Once the faeces comes out, infection follows. I didn't find it easy, I couldn't sleep, it was pain all over, the stomach, pain all over. I couldn't go out of my room, because of the way I was feeling in my body, I was unable to meet the needs of my child, the father of the child abandoned me…I was left suffering alone, and there was beatings (by husband) too until my parents went and picked me out of my matrimonial home. Now that I am free, I can go out, there is nothing to be ashamed of now… I can advocate for this in the market or in any other place, I can tell people. If it is possible, this can be shared on the television, on Facebook or on any other medium so women can know.. I am saying what has happened to me wanting others to hear, wanting the whole world to know because there are some that are suffering with this kind of problem and are living quietly with it just like the way I wanted to live quietly with it, my plan was not to tell anybody except my mother. I want the others to hear so that they can come to the hospital, they should come to ….hospital and get treated. Everything is done free and after the surgery, everyone will get well. And for those that know someone that is having this type of problem, they should inform them so they can come to the hospital just like I was also told. Someone told me."
