Women living with a fistula are frequently relegated to life as an outcast. A husband will turn his wife out of the house, parents will refuse to help her, and co-wives or neighbors will ridicule and ostracize her. In places where a woman’s life is entirely dependent on being part of a family, expulsion can make survival extraordinarily difficult. If she doesn’t find help, she will bear this burden for the rest of her life, and help in many places is unavailable.