It typically occurs when a teenage girl cannot deliver a baby because it is too big for her pelvis. After several days of labor without access to a doctor, the baby dies and the girl is left with a hole between her bladder, vagina and sometimes rectum. The result is that urine and sometimes feces drip constantly down her legs. In some cases, she is also left lame from nerve damage.
Women with fistulas stink and leave a trail of urine behind them. They are often abandoned by their husbands and driven out by other villagers.