VVF stands for vesico-vaginal fistula. Primarily these ﬁstula are caused by obstructed labor and although there are other causes, this is the most common reason. I have heard it said that the most dangerous thing a woman in Africa can do is to have a baby. I believe this to be true. There is a lack of physicians and trained professionals to help if a women comes into distress during labor. Because of this fact a woman can be in labor for four or ﬁve days or even a week or more. If the baby is malpositioned or if the woman's pelvis is too small, the baby becomes stuck. There is nothing she can do. After a day or two of being in labor the baby dies in the womb. It may still take a day or two or three or more for the baby to pass through if the women does not have access to a doctor who can perform a caesarean. After the baby is delivered, usually stillborn, the pressure it had put on the vagina and the bladder or ureters or rectum has caused the tissue to break down and leave these ﬁstula, basically a hole. Because of this, these women are left leaking urine, and for some, stool as well.
Because of the constant leaking the woman smells. Add the urine and stool to the heat of the African sun, it is not pleasant. The women become outcasts. Their husbands usually leave them and try to return them to their families. If they are not wanted there then they are alone. Many can not work because when they try to sell their goods no one wants to come close due to the smell. Please pray that those in Sierra Leone who are afflicted with VVF find their way to the center for help.