Why should social workers care about vaginal fistulas? Why should we turn our attention to a health problem mostly experienced by materially impoverished young Black women, especially those in Africa? Using a critical perspective, which we define, we argue that vaginal fistulas are much more than a gynaecological health issue but symptomatic of the gender-, race-, class- and age-based oppressions many young Black women in the ‘Third World’ suffer. Affecting very few White western women but plenty of subjugated Black women forced to live in chronic poverty, and exposed to multiple levels of control from early in their lives, vaginal fistula sufferers often have little, if any, access to adequate health services. Our aim is to put vaginal fistulas on the global social work agenda. It is a call to work towards ending a problem that produces much shame and suffering for far too many women.