This 82-page report describes the devastating condition facing women with fistula in Kenya and the wide gap between government's policies to address reproductive health and the reality of women's daily lives. It documents health system failures in five areas: education and information on reproductive and maternal health; school-based sex education; access to emergency obstetric care, including referral and transport systems; affordable maternity care and fistula repair; and health system accountability. It also documents stigma and violence many fistula sufferers face.