Eradicating Fistula: The Urgency of Now
As Nick Kristof articulated in his recent Op-Ed on the subject, "perhaps the most wretched people on this planet are those suffering obstetric fistulas."
He's right. As many as four million women in sub-Saharan Africa - joined by another 30 to 50 thousand a year - literally leak urine and feces incessantly through fistulas, gaping perforations in the tissue between bladder and vagina. These fistulas occur during obstructed labor, when the powerful, involuntary muscle contractions repeatedly force the fetus against an aperture that is just too small, sometimes for as long as 72 hours. The flesh between fetus and bone is destroyed by the pressure and rots away, as does eventually the fetus itself.
There is pain, much more than the "regular" pain of childbirth, there is the grief of a stillborn child, but these things heal with time. Fistulas, however, do not.
Once an obstetric fistula forms it heralds a lifetime of disgusting, uncontrollable outflow of waste. Women suffering in this way become the very paradigm of an undesirable - divorced, isolated, even at times abandoned for death. But by far the most profound tragedy associated with fistula is that so frequently, it is children - girls of 13 and 14 - who develop fistulas and are thus condemned, through absolutely no fault of their own, to a lifetime of suffering.
This, unless we intervene. The surgery that corrects a fistula is cheap and low-tech. Doctors and nurses can be trained, pre-fabricated fistula centers can be built and staffed, and local outreach and education could in theory prevent nearly every case. There exists the potential to literally resurrect hundreds of thousands, even millions of women, to prevent them from becoming another wasted asset and to pull them up from despair for a productive and meaningful life. All that is missing is the coordination and collaboration of a broad, compassionate base that can build the political and public will necessary to fight fistula.
Until, perhaps, Monday morning. On Monday, November 16 the NAACP, the World Evangelical Alliance and the Religious Action Center convened the first meeting of a new initiative that has as its objective the eradication of fistula from sub-Saharan Africa. Interfaith and bipartisan - all might describe the diverse attendance, which included liberal and conservative faith, health, and feminist groups - yet it is just this sort of peculiar partnership that has the potential to be heard like no other coalition can.
We are developing a targeted, achievable campaign, the success of which will have a significant and positive impact on the larger status of women in the region. Fistula eradication is feasible, it is attainable, and moreover, it entails living up to the very best of our American precepts and ideals.