Raising Awareness about the Life-Shattering Condition of Obstetric Fistula

If you had asked me a few days ago what an obstetric fistula was, I’d have shrugged my shoulders and told you, “I don’t know.” Thanks to advances in modern medicine and in obstetric and midwifery care, fistula has been eradicated in North America for over 100 years. Although the condition has been long since forgotten here, there are at least 2 million women in Africa, Asia and the Arab region living with fistula, and some 50,000 to 100,000 new cases develop each year. These estimates are believed to be low.

Obstetric fistula is an injury of childbearing that has been relatively neglected, despite the devastating impact it has on the lives of girls and women. It is usually caused by several days of obstructed labor, without timely medical intervention — typically a Cesarean section to relieve the pressure. The consequences of fistula are life shattering: The baby usually dies, and the woman is left with chronic incontinence. Because of her inability to control her flow of urine or feces, she is often abandoned or neglected by her husband and family and ostracized by her community. Without treatment, her prospects for work and family life are greatly diminished, and she is often left to rely on charity.

When a woman (especially a young woman who’s pelvis is not fully developed) experiences an unusually long labor (several days long), the soft tissue of the pelvis experiences lack of blood flow between the baby’s head and the woman’s pelvis bone. The lack of blood flow causes the tissue to die and a hole forms either between the woman’s vagina and bladder or vagina and rectum (or both), resulting in the leaking of urine, feces or both.

The vagina can also become perforated by violent rape.

A Walk to BeautifulPBS recently aired a NOVA program called “A Walk to Beautiful,” produced by Mary Olive Smith, about women in Ethiopia living with fistula. You can watch the entire documentary online.

The women profiled in “A Walk to Beautiful” are treated as virtual lepers in their villages, where they are shunned by family and made to live alone. One women admits to contemplating suicide.

Through chance they learn that there are other women who share their affliction, and that the Addis Ababa Fistula Hospital exists to help them—if they can manage to walk for hours to the nearest road, find public transport to the capital, and then search out the hospital in a strange and forbidding city. Once there, they enter a haven that they never imagined, surrounded by women like themselves and a medical staff of Western and African doctors who treat them like human beings, not outcasts.

It’s an eye-opening story of hope and triumph over adversity. What’s rather shocking is that the cost of fistula repair surgery and rehabilitative care is only $300, though many women don’t know that treatment is available (or are even told by doctors that there is nothing they can do to correct fistula), they have no way of getting to a fistula hospital or, in many cases, they simply cannot afford it.

Though not a part of the documentary, Sarah Omega Kidangasi has her own fistula story to tell. She became pregnant as a result of a rape when she was a 19-year-old Kenyan schoolgirl and then developed fistula after a prolonged labor. Her baby was stillborn (as so many are who’s mothers endure prolonged labor) and, upon returning to her village, her uncontrollable leaking urine made her into a social outcast.

Sarah had been living with fistula for 12 years when the pressure of her situation began to consume her, “I suffered rejection, isolation. I lived the lonely life,” she said. “Life with fistula traps you. It makes it impossible for you to interact with others. I was suffering from depression. Many times, I considered suicide.”

In 2007, she was taken by a neighbor to a teaching hospital for fistula surgery as well as psychiatric support. “The surgery really changed my life,” said Sarah. “That was the moment I could offer a genuine smile.”

Sarah has now set her sights on spreading the word about fistula and getting maternal care on the international health agenda. This week she will tell her story to members of Congress to raise awareness about the condition that is affecting the quality of life for millions of women. “I’m going beyond our African culture and tradition, going public and telling my story, so that the victims know that there’s help,” she said. “Fistula can be repaired.”

To learn more about fistula and how you can help, please visit the Campaign to End Fistula.

Other information can be found at:

United Nations Population Fund – Obstetric Fistula: A Tragic Failure to Deliver Maternal Care
The Fistula Foundation

All Africa – Liberia: Living With Fistula
NPR – Film Captures Ethiopian Women’s Medical Sagas

Blog posts about Fistula:

Kimberly at Go Green Travel Green wrote Fistula Horror Stories: Socially Conscious Travel & Human Rights
Yolanda at Perfectly Imperfect wrote about A Walk To Beautiful
Trisha at Ideas for Women wrote Obstetric Fistula – the Tragedy of a Nightmare Within a Nightmare

Cross-posted at BlogHers Act

24 thoughts on “Raising Awareness about the Life-Shattering Condition of Obstetric Fistula”

  1. I remember seeing the founder of the Ethiopian Fistula Hospital speak on Oprah when I was pregnant and being horrified over the stories of the women and when I was in labor and found out my baby was stuck, the images of these women came flooding back to me and made me thankful for the gift of birthing in a US hospital but even more sad for those women. I still think about them. I’m glad to see there is a documentary out about it now.

  2. I also saw that episode of Oprah about fistulas a year or so ago. It was about a woman doctor who created a center where these young women could be operated on and go back to a normal life. It was absolutely beautiful, with each woman leaving with a new dress, to symbolize her new life. This operation transformed them from reeking outcasts of society into normal women again. I cried throughout the whole episode, realizing that I was so lucky to live where I do.

  3. i also remember that Oprah episode, and when i had my son i was so thankful for the type of medical care that was available to me… here’s another link for you, Amy – http://www.savethemothers.org/ – this is an organization run by a Canadian doctor, dedicated to helping women with childbirth complications including fistula. Jean has written an incredible book that talks about birthing issues in developing countries where she has worked – it’s a powerful read.

  4. a very well-written post, good for you for bringing it to the forefront of discussion for your readers. there was an article about this a few years ago in the new york times, and i found the whole thing so horrible…that it was so repairable and yet so many women were living with it and suffering immensely.

  5. Wonderful post! I first learned about fistula when the Fluff Factory Auctions ran about 7 months ago. Then the documentary came on and it brought it all home. it is just a really, really sad and horrific situation.

  6. One more educated by Oprah here. There are a few episodes I will remember for the rest of my life, and that is one of them. Thank you for bringing this issue up on your blog.

  7. Another educated by Oprah. Never heard of fistula until I saw her show and many months later I was in a position to donate to the Fistula Founation. I too saw “A Walk To Beautiful” a few weeks ago on PBS. Thank you for spreading the word about this charity, Amy. It broke my heart to see these young girls’ lives ruined.

  8. This is very interesting! I heard that Oprah did a show on it, but I never have time to watch TV beyond Bob & Signing Time. But honestly, your short article really summed it up! Amy, thank you for sharing your knowledge and expanding mine.

  9. Also saw it on the Oprah show. Thanks for sharing and raising awareness through your post. My daughters who do not watch Oprah, will now be able to see “A Walk To Beautiful”.

  10. Lisa Ling or Lang (you know what I mean) did a report on this. It was on Oprah, I can see others saw the show as well. Sad. Thanks for raising awarness and letting more people know about this very severe and devestating issue.

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  15. Dr Catherine Hamlin’s first book is titled “Hospital By The River” and tells how the doctors started their trip to Ethiopia and first developed the hospitals. Thought you might be interested to read this book, too.

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