this largely preventable but lifeshattering medical condition affecting primarily the poorest and most marginalized women and girls has rightly been described as a stark reflection of inequality at its worst its persistence in many developing countries reflects chronic health inequities and healthcare system constraints coupled with broader human rights violations facing women and girls such as poverty socioeconomic and gender inequalities early marriage early childbearing and lack of schooling millions of women and girls need fistula treatment but the lack of availability or access to services by skilled obstetric fistula surgeons prevents them from receiving it in a bid to galvanize momentum to eliminate this medical injury in october the report of the secretarygeneral supporting efforts to end obstetric fistula was released with recommendations that could be implemented primarily at the national level to intensify these efforts within a human rightsbased approach