Thirty-two-year-old Joy Emmanuel lived with fistula for half of her life. Long after giving up hope of a remedy, she heard on the radio that women could receive fistula surgery at the Faridat Yakubu Fistula Center, in Gusau, Nigeria. The Nigerian National Strategic Framework for fistula prevention and control estimates that between 400,000 and 800,000 women are affected. Nearly half of worldwide fistula cases occur in Nigeria, with between 50,000 to 100,000 new cases each year. USAID is working to address the challenge of obstetric fistula in five states in northwestern Nigeria. During the project’s first three years 2,822 women received fistula repair surgery.