Pursuing the Path to Peace:
Obstetric Fistula in Ethiopia
Future Choices Producer, Fran Snedeker
with Allison Shigo,
Co-producer of “A Walk to Beautiful”
One hundred years after obstetric fistula was eliminated in developed countries, this birth injury remains a major peril to millions of young women and girls in sub-Saharan Africa, South Asia and some Arab States. In September 2009 Future Choices travels to Ethiopia via Engel Entertainment's award-winning documentary to follow five Ethiopian women on their "Walk to Beautiful."
Allison Shigo, co-producer of the documentary film, “A Walk to Beautiful,” reveals the causes of obstetric fistula, introduces us to Wubete, Ayehu, Yenenesh and others who have escaped their banishment and made their way to the special hospital in Addis Ababa for treatment of their fistula. In the course of our journey across Ethiopia with Allison Shigo we learn:
- what causes obstetric fistula to occur.
- that it is an affliction of poor, uneducated women.
- what happens to women afflicted with obstetric fistula.
- that obstetric fistula is fully preventable.
- that usually fistula repair is an inexpensive, relatively simple medical procedure for trained physicians.
- that the UNFPA, EngenderHealth, Worldwide Fistula Fund, the Fistula Foundation are among the NGOs expending extraordinary efforts to help save women from obstetric fistula.
- that Nicolas Kristof's 2003 OpEd column about the founder of the Addis Ababa Fistula Hospital draws a poignant picture of women who have been rescued from obstetric fistula.
- that we all have a role in spreading the word and raising awareness about this issue.
See Future Choices video about "A Walk to Beautiful" in three parts:
Part 1 |
Part 2 |
Part 3 |
| Women with fistula show extraordinary courage and dignity despite humiliation of continuous leaking. |
Allison co-produced the award-winning film, A Walk to Beautiful, winner of the International Documentary Association award for Best Feature Documentary 2007 and nominated for an Emmy Award. |MORE
EngenderHealth Addresses Obstetric Fistula 
Obstetric fistula, a debilitating complication of childbirth, persists in many developing countries. The Fistula Care Project is helping to strengthen fistula management and prevention services worldwide. For more information about the Fistula Care Project, please visit www.fistulacare.org .
Sifa’s Story
Program Background
The Fistula Care Project is a five-year cooperative agreement funded by USAID and managed by EngenderHealth. The Project works...|MORE
Fast Facts about obstetric fistula
• For every woman who dies from pregnancy-related complications, 20 women survive but experience terrible injuries and disabilities.
• In Ethiopia, there are 59 OB/GYNs and 1,000 midwives for a population of 77 million.
• Number of patients treated at the Addis Ababa Fistula Hospital every year: 1,200
• Number of obstetric fistula cases occurring in Ethiopia alone each year: 9,000
• More than 99% of The Addis Ababa Fistula Hospital patients are illiterate.
See further
Obstetric fistula is an injury resulting from obstructed labor
Fistula results from obstructed labor, in which the infant is too large or in the wrong position to pass through the woman's pelvis. Girls who become pregnant before their bodies are fully developed or women whose growth is stunted from malnutrition often have small pelvises that make them prone to obstructed labor, the Times reports. If prolonged, obstructed labor not only is life-threatening to the woman and the infant, it can injure tissue when the woman's bladder, uterus and vagina are crushed between the pelvic bone and the infant's skull. This injured tissue can develop a fistula, a hole that results in a constant urine stream through the vagina and, in some cases, nerve damage in the legs. Some women also suffer damage to the rectum, which can result in stool leakage. |MORE
What happens to women afflicted with obstetric fistula
If the misery of uncontrolled leaking of urine (and sometimes feces) isn't enough, these women and girls are ostracized and disdained by their families and communities. Without being cured, women with fistula commonly spend the remaining years of their lives in shame and isolation, literally waiting to die. |MORE
Obstetric fistula is preventable
Prevention, rather than treatment, is the key to ending fistula. Making family planning available to all who want to use it would reduce maternal disability and death by at least 20 per cent. Complementing that with skilled attendance at all births and emergency obstetric care for those women who develop complications during delivery would make fistula as rare in the South as it is in the North. These interventions are part of UNFPA's overall strategy to make motherhood safer. Addressing social issues that contribute to the problem - such as early pregnancy, girls' education, poverty and women's empowerment - are important areas of intervention as well. |MORE
Uncomplicated fistula cases can be repaired with a fairly simple operation.
An uncomplicated fistula surgery is essentially the mending of a hole in the bladder or rectum. It can usually take place through the vagina without a major incision. Success rates can be as high as 90 per cent for experienced surgeons working in well-equipped facilities. But the operation is delicate, and specially trained surgeons and support staff are required. Two or more weeks of post-operative care is also essential.
Some women are so debilitated when they arrive for treatment that they need weeks or months of care before they are strong enough to undergo the operation. Sometimes women have also suffered nerve damage and need extensive physical therapy. Counseling to address emotional trauma and social support is often necessary for complete healing.
Nicolas Kristof's 2003 OpEd column about the founder of the Addis Ababa Fistula Hospital
We in journalism tend to write about scoundrels, but today let me instead hail a saint for our age.
Dr. Catherine Hamlin, 79...|MORE
What we can do about obstetric fistula
We can all lend support to women suffering from obstetric fistula by spreading the word about this affliction. A variety of creative ways to get involved are outlined in the WALK TO BEAUTIFUL Take Action Guide.
For further information about obstetric fistula, go here.
When is Future Choices aired in your community?
See Local TV schedule for time and channel in each participating community in Westchester County.
This page last updated January 3, 2010 17:24 .