Issue Highlight: Obstetric Fistula

Béatrice de Géa for The New York Times

If you’ve lived in North America or Europe all of your life, chances are you’ve never heard of “obstetric fistula”. Unless you’ve taken a Global/International Health or Women’s health class, or lived in rural Africa, or you’re an avid documentary watcher and you happened to catch this. It’s not that surprising because it is a disease of the voiceless, powerless, faceless of the world: young, poor young women living in rural areas of developing countries.

As you learn more, there’s just something about the name, “obstetric fistula” that makes you wrinkle your nose. After all, the thought of a person leaving a trail of urine and feces wherever they went, enveloped in a constant, terrible stench,  is definitely not the image you want to have right before dinner. Sitting in my comfy chair in a classroom, with my twenties ahead of me as a time to explore, it’s difficult to imagine that there is a room in a village somewhere, where a 13-year old has been struggling with labor pains for the past 5 days.

So, what exactly is obstetric fistula?

According to the Campaign to End Fistula website, Obstetric fistula is a hole in the birth canal caused by prolonged labor, without prompt medical intervention. As the baby’s head presses against the mother’s pelvic bone for a long period of time, circulation is cut from the bladder and/or the rectum tissues. In most cases, the baby dies before delivery. The (barely) woman is left incontinent, doomed to smell like urine for the rest of her life, a shame for herself and her family.

The Stats

According to the UNFPA, 2 million women suffer from this illness in Africa, South Asia and the Arab world. 50,000-10,000 cases arise each week. From many of my classes and readings, Ethiopia kept coming up a lot. It turns out that it has the highest rate of women suffering from OF: over 100,000 girls and women, with some 9,000 new cases each year (1) . The reasons given are that: many of the girls are given or “sold” into marriage (depending on how you look at it at very young ages. Many of them do not get appropriate nutrition, yet work from sun-up to sundown which affects their development. Afghanistan and Congo (DRC) kept coming up as well, as examples of places where women are at risk of sexual violence or a lack of health care support as a result of war(2).

I was discussing with a few friends a few weeks ago, the emotional response I usually have to issues in the world. They urged me to think about more pro-actively, to reflect about how I can contribute if I’m able to do so. If not, to accept the fact that just because I can’t do something, it doesn’t mean I shouldn’t be aware and let others know as well.

So, at the end of class, when one of my classmates was telling me about how she almost wanted to cry but felt that it would have been embarrassing, and how she feels bad about how she’s about to go enjoy their Thursday with her friends, I wanted to share that piece of insight with her. Feeling bad won’t solve a thing. Learning more about it won’t solve a thing either, but it propels you towards action.

To learn more:

http://www.endfistula.org/index.htm

http://www.fistulafoundation.org/index.html

http://www.dmoz.org/Health/Reproductive_Health/Pregnancy_and_Birth/Complications/Obstetric_Fistula/

The next post will cover what some people and organizations are doing about Obstetric Fistula and ways to get involved.

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