A healthcare center in Liberia is operating on women affected by devastating cases of fistula and providing them with the skills they need to go back to work after surgery.

Fistula is common in Liberia. It is a gynecological condition usually caused by complications during childbirth, but it can also affect victims of rape, very young mothers, and those who have undergone female circumcision. The consequences of the condition are not only embarrassing, but can be life-threatening.

"Fistula is an abnormal communication between the vagina and the bladder, or between the vagina and the rectum, and this condition will lead to continuous leakage. Usually it is a result of a difficult delivery," explained Obstetric Gynecologist John Mulbah.

At the Liberian Fistula Rehabilitation Center on the outskirts of Monrovia, women from all over the country undergo surgery and learn new skills to equip them for life after fistula.

"We have made a lot of improvements to the fistula program. We started in 2007 and since this time we have operated on over 600 patients," said Angie Tarr, a program assistant at the center.

She says the shame and stigma that surrounds fistula has discouraged women from admitting that they suffer from the condition. Some are even unaware that their illness has a medical name.

"You are so ashamed and then you shy away. You keep yourself away and friends don't come around," added Tarr.

Following surgery, patients - some of whom are as young as 11 years old - go to a rehabilitation center where they are taught basic skills like pastry-making, hairdressing and needlework.

"After the surgery we encourage you to come to the rehab center. You choose for yourself if you want to do pastry or cosmetology, whatever you like," she explained.

One participant, who wished to remain anonymous because of the stigma of fistula, said she is enjoying the classes.  "I chose the pastry class because I wanted to learn to bake. I enjoy the class because my teacher teaches well," she said.

All materials are supplied and transport to and from classes is paid for. Women who come from villages outside of Monrovia are escorted home by a representative from the center. Tarr said the rehabilitation center restores self-confidence that is often eroded by the effects of fistula and the damage that the condition causes to marriages and friendships.