There are only a few places in the world where high-quality fistula repair training is provided and space in these programs is limited. For MSF, it is not a one-off training; staff alternate between time spent training and time in the field. Most MSF doctors trained in fistula surgery have returned to Nigeria three or four times to complete their training with Dr. Waaldijk. Now they can be considered trainers themselves; they can continue to use their skills to assist women in need while also preparing others to do the same.