Walk through certain rural communities in Nigeria, and you might meet a woman who has not smiled in years. She carries herself quietly, often keeping to the edges of a crowd. It is not shyness. It is the shame and discomfort of vesicovaginal fistula, or VVF, a childbirth injury that leaves her leaking urine constantly. For her, this is not just a medical condition; it is a sentence that has stolen her dignity, work, relationships, and often, place in society.

VVF happens when prolonged, obstructed labour goes untreated. As the baby’s head presses for hours against the birth canal, it cuts off blood flow to delicate tissues. Those tissues die, and a hole forms between the bladder and vagina. Without surgery, the woman will leak uncontrollably for the rest of her life.

In a functioning health system, these cases are rare because skilled attendants step in with timely caesarean sections. But in too many Nigerian communities, that help comes too late, or not at all.

A crisis hidden in plain sight

UNFPA estimates around 13,000 new cases occur here every year, yet only a fraction receive treatment. Many women never even reach a hospital where their condition can be recorded, so the real figures may be much higher. Behind every number is a girl married too young, a family too far from a clinic, or a community without the means to get an expectant mother the care she needs. This should not read headlines in 2025, but it is as we see it.

For decades, VVF has been a quiet tragedy, until recently.

In March 2025, the federal government announced that 154 healthcare facilities across the country will now provide free emergency obstetric care, including 18 designated centres offering free VVF surgeries. These are not empty promises; in August, 30 women at the National Obstetric Fistula Centre in Abakaliki were discharged after successful free repairs. Supported by government agencies, UNFPA, and NGOs, these programmes now often include not just the surgery, but meals, transportation, and even skills training for recovery and reintegration. 

Also Read: Many new mums suffer postpartum depression in Nigeria. Help is closer than we think

Turning the tide with prevention and care

Repairing VVF is life-changing, but the real victory is prevention. That starts with ensuring every woman has a skilled attendant at birth, access to emergency obstetric care, and a working referral system that can get her to a facility fast. It means enforcing laws against child marriage and helping girls stay in school so their bodies are ready for safe childbirth. It means making family planning affordable and accessible, and making sure communities understand the warning signs of unsafe labour.

Countries that have invested in midwives, well-equipped rural clinics, and emergency transportation have seen VVF cases almost disappear. Nigeria can do the same; the medical knowledge is here, and the infrastructure is slowly catching up, but it needs to speed up.

VVF is not a mysterious disease; it is a clear sign that the health system failed when it mattered most. The fact that it is preventable makes every untreated case an avoidable tragedy. But now, for the first time in years, there is momentum. Clinics are open, surgeries are happening, and women are walking home dry and smiling again.

If Nigeria sustains this energy, invests in prevention, and refuses to let geography or poverty decide a woman’s fate, VVF could become a story we tell our children as history, not as a daily reality. And that is a future worth fighting for.

Cynthia Nwanonyiri