During a visit to the fistula repair department at Mohammed Murtala Hospital in Kano, Nigeria, in 2006, I met 35-year-old Azalee. She had been living with a fistula for 12 years. Unable to find a job, she’d been forced to earn her living as a sex worker. She was now suffering from all the complications mentioned above. I still remember how devastated she was when she was told that it was too late for her to be repaired.