Do you know what an obstetric fistula is? I sure didn’t before I lived in Niger. It’s not really a term we hear often in North America. This is primarily because most of us have access to pretty great health care, but also probably because most of us don’t give birth before we are in our late twenties.
This is a childbirth injury, often suffered by a teenager in Africa or Asia whose pelvis is not fully grown. She suffers obstructed labor, has no access to a C-section, and endures internal injuries that leave her incontinent — steadily trickling urine and sometimes feces through her vagina.
She stinks. She becomes a pariah. She is typically abandoned by her husband and forced to live by herself on the edge of her village. She is scorned, bewildered, humiliated and desolate, often feeling cursed by God.
Kristof goes on to introduce Dr. Lewis Wall, the founder of the Worldwide Fistula Fund and the man who “has been campaigning tirelessly year after year to build a fistula hospital in West Africa.”
Landlocked in the middle of West Africa, and with the highest rate of child marriage in the world, it’s pretty exciting that Danja, Niger was chosen to be home to that hospital. When I was a short termer in Niger for 2010/2011 I actually got to see the fistula hospital. Though at that time the area in the picture below was still under construction.
I emphasize the short term part because there is a big difference between those of us who spend a year or less in a country other than our motherland and those who call it their new homeland. For one thing, I only had to experience one year with a terrible internet connection.
But there’s a much bigger difference between my experience and the experience of local and expat friends I left behind.
For me, seeing the fistula clinic was like seeing an amazing idea come to life. Something I had started studying since my arrival in Niger and a solution to a big problem. And it was a beautiful idea. Like the way the women were given a new dress after the surgery to symbolize their new status, back from the life of a pariah.
But for the people in Niger the healing of fistula is far more than a beautiful idea. It was a part of their life, and part of their friends’ lives. And like anything in life, it is more complicated than it may seem.
In several of her blog articles about Niger, Anthropologist Ali Heller critiques “the way fistula is branded, packaged, and sold to Western audiences,” even by well meaning journalists like Kristof. She refers to Kristof’s description of a woman named Hadiza in his article Where Young Women Find Healing and Hope, Hadiza also happens to be a woman Heller knows personally:
I know Hadiza. And I know Hadiza’s story.
This was not it.
I doubt that this is any woman’s story. Still, it is the story of fistula, born from a marketplace that craves worst-case scenarios, lurid tales in which girls are victimized by lecherous and cruel African men, abused, neglected, and eventually dismissed and discarded. Tales in which girls must be saved. And we Westerners – our goodwill, our dollars – must save them.
According to Keller, most of these women are not abandoned by their husbands and families, some are even able to disguise their situation through meticulous hygiene regimes. Keller also explains that even the surgery is not always a 100% effective cure.
Unfortunately the story of “the girl with the fistula” has become another piece of what some journalists are calling “Poverty Porn.” Glendora Meikle claims that Poverty Porn is due to our constant desensitization and growing donor/compassion fatigue, an issue I’ve touched on in a previous post: “quality-of-life issues elicit little more than a yawn. If no one’s dead or dying, there are more compelling causes beckoning.”
In another of her articles on fistula sensationalism Keller questions why the frustration and discomfort of life with a fistula isn’t enough to get our attention.
For most women, their stories lack the dramatics of those highlighted by fistula campaigns or articles. And yet, life with fistula is difficult. It is physically uncomfortable and emotionally taxing. For many it is a condition that complicates lives, reduces wellbeing, causes social anxiety and results in many women trying to manage their shame by staying home, limiting the time they spend with friends or neighbors, concealing their condition, regularly reducing the amount they eat or drink, and practicing various other forms of strict self-management. Isn’t that enough? Why doesn’t that motivate us to act? Why do we need the superlative of suffering? Why must we highlight the extreme cases when the norm is bad enough?
So here is my question for you, but also for myself. Are we willing to give towards NGOs like the Worldwide Fistula Fund just because, hey, it would sure suck to be chronically incontinent? Or do we live in a world where only the most horrific of stories will overcome our natural selfishness? A world where no one is deserving of generosity unless their experience can make an increasingly-desensitized society weep?