Despair & Hope: Faces of Fistula

The fertility rate and number of teenage pregnancies in Madagascar is extraordinarily high - statistics say more than 1/3 of girls aged 15-19 have had children or are currently pregnant. Combine these factors with the prevalence of grinding poverty and a vast inaccessible landscape and impassable roads, it is easy to see why obstetric fistula is such a serious issue in Madagascar. For many of these girls this is their first visit to the hospital, most if not all come with their mothers. This series of portraits was taken on assignment with The Fistula Foundation who identify, educate and treat women suffering incontinence and social exclusion because of fistula, a hole in the birth canal caused by prolonged childbirth often associated with poverty and poor medical facilities, and in many cases results in a stillborn baby.