Traumatic fistula is a devastating but under recognised outcome of sexual violence, representing both a severe physical injury and a profound violation of human rights. Unlike obstetric fistula, which arises from prolonged obstructed labour, traumatic fistula results from direct genital trauma, often associated with rape, sexual torture, or extreme gender-based violence (including sorcery accusation-related violence) (United Nations, 2020).This condition involves an abnormal opening between the vagina and the bladder or rectum, leading to chronic incontinence, infection, and social isolation. Survivors frequently endure lasting psychological distress, stigma and rejection by their families or communities (Grose et al., 2021).
Globally, the true incidence and prevalence of traumatic fistula remain poorly understood.Most available data originate from clinical reports, small case studies, or humanitarian settings in Sub-Saharan Africa, the Great Lakes Region, and parts of South Asia where sexual violence has been used as a weapon of war (Longombe et al., 2008).However, comparable data from non-conflict and community contexts are sparse. The absence of standardised definitions and the frequent conflation of traumatic and obstetric fistula further obscure prevalence estimates (United Nations Population Fund, 2018. Limited surveillance, under-reporting, and sociocultural barriers compound this data gap, leaving the global burden largely invisible in health and policy discourse (Söderqvist et al., 2022).