“From the beginning, my family did not discuss marriage with me, because a woman has no opinion in such matters,” said 27-year-old Awatif, pictured here.

Awatif was married and pregnant with her first child at the age of 16. She laboured at home with a midwife for two days before her husband took her to the nearest hospital—a four-hour drive from their town of Furbaranga, West Darfur. Sadly, her baby did not survive the journey.

“After seven days at the hospital, I felt severe pain and paralysis in my right leg. I knew there was something wrong with my urine,” says Awatif. “At that time, I had no idea about fistula.” When she returned to Furbaranga, the family spent 40 days trying to raise money to cover the cost of treatment. Eventually, her father sold his cows to pay for the repair surgery, but it failed.

During a second attempt to seek treatment in Nyala, Awatif’s vehicle was hijacked at gunpoint. All of the family’s money and belongings were stolen, and two men were killed.

Meanwhile, Awatif’s husband began leaving home for long periods of time. Eventually he stopped coming home altogether. She believes the fistula greatly influenced his absence.

In April 2007, Awatif graduated from a midwifery school in West Darfur. The following month, after living with fistula for nine years, she received free surgical treatment during a UNFPA-supported outreach campaign in Zalingei, West Darfur. Since then, she has been spreading the word in her region that fistula is preventable, and encouraging those affected to seek treatment.