We Already Know How to Help These Women
I want to talk today about something difficult to discuss. You don’t hear about it in the news very often, likely because it affects people the West commonly ignores, and might be too overwhelming for the typical 24/7 news cycle.
The problem is a medical one: fistula, or when an abnormal tract forms between two organs or vessels in the body.
There are many types of fistula, and some can even be created on purpose during a surgery; but in general, outside of medicine the term “fistula” refers to a urogenital or obstetric condition – a problem plaguing victims of violent rape and traumatic birth injury.
Fistula is widespread in war-torn regions. Currently the Democratic Republic of Congo’s incredibly high rate of fistula reflects its even more horrific rate of sexual assault. As militant soldiers commit genocide and war using women’s bodies, they leave behind tens of thousands of women with permanent physical and emotional damage, including fistula.
Along with women injured by assault, many more women around the world suffer from fistula as a result of childbirth and, due to lack of resources or inadequate obstetric care, can’t afford the surgery needed to repair their injuries.
Urogenital or obstetric fistula leads to chronic incontinence and, as a result, immobility and shame. Many of these women are stigmatized by their communities even as they mourn a stillbirth. They often avoid water to prevent embarrassing leaks, and thus can become severely dehydrated. They may suffer from kidney problems, infection, and even death.
But while this traumatic health problem is well-documented, it is also arguably under-discussed, particularly when solutions are available.
In many countries, solutions will require changes to political policy and public health funding. For example, to mark the first International Day to End Obstetric Fistula on May 23, Human Rights Watch offered some examples of policy changes needed in Kenya to help end the high rate of fistula. Their recommendations reflect the complex problems that prevent many women from getting a cure.
But there is work we can do as well. Reconstructive surgery typically costs about $300 US, and there are a number of non-profits out there working to help women who suffer from fistula both as a result of genocide and childbirth injury.
No woman should face permanent disability and shame for bringing new life into the world. No woman should live with a stigmatizing injury because a war was waged on her body against her will.
This is especially true when we already know how to mend what has been broken and restore what has been lost.
As I mention above, fistula is well-documented. It’s the subject of the 2009 Pulitzer Prize-winning play Ruined by Lynn Nottage which I briefly discuss here. It is also a part of the book and documentary film Half the Sky. You can view a Global Fistula Map highlighting where fistula is being treated and at what rates.