The Fight Against Fistulas

Imagine this scenario: A pregnant woman labors for days and
nights without medical care, knowing her child is likely to be
stillborn. As a result of the painfully traumatic labor, part of
the mother’s vaginal tissue is pressed between her pelvic bone and
the baby’s head. The blood supply to the tissue is cut off and the
tissue dies, leaving a hole, or fistula, between the vagina and
either the bladder or the rectum. She becomes incontinent and is
banished from her home.

The first fistula hospital opened in New York City in 1850, back
when fistulas were common in the United States. By 1895 the
hospital had closed its doors because basic medical care and
improved technology had made the disorder practically unknown.

But fistulas are still prevalent in the developing world, in
part because of female genital mutilation. Although accurate counts
are hard to come by in the regions where the problem is common, the
United Nations estimates that about 2 million women live with
obstetric fistulas, causing lifelong incontinence and terrible
health problems. And because of the severe social stigma
surrounding the condition — women with fistulas are considered
‘dirty’ because of constant urine and/or stool leakage — their
husbands typically abandon them and they have difficulty securing

Fortunately, fistulas are preventable, and when they occur
they’re treatable with a simple reconstructive operation that costs
between $100 and $400. But most women suffering from fistulas don’t
have access to reconstructive surgery, or cannot afford it. Leading
the fight to treat and end fistulas, Catherine Hamlin, M.D.,
co-founded the Addis Ababa Fistula Hospital
( in Ethiopia in 1974. Hamlin and her staff
have treated more than 25,000 women.

‘In Ethiopia alone, more than 8,500 women will suffer from new
fistulas this year,’ Hamlin told an audience in Los Angeles during
a recent visit. ‘We can help these women all over Africa and the
developing world, but we need support.’

A sign of growing support came in 2002 when the U.N. Population
Fund announced its global ‘Campaign to End Fistula’ in 18
developing countries. But when George W. Bush cut off $34 million
earmarked for the population fund because of concern that it was
promoting abortion, monies for preventing and treating fistulas
also got cut. The ’34 Million Friends’ campaign
( was launched by Jane Roberts and Lois
Abraham with the aim of getting people to donate $1 each to replace
the money Bush cut. It has already funneled some funds to fistula

From Ms. (Winter 2003/04). Subscriptions: $45/yr.
(4 issues) from 1600 Wilson Blvd., Suite 801, Arlington, VA

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