My Painful Musings on the Suffering of the African Woman from Obstetric Fistula

Constantly in pain, incontinent of urine and feces, bearing a heavy burden of sadness in discovering their child stillborn, ashamed of a rank personal offensiveness, abandoned therefore by their husbands, outcasts of society, they live, they exist, without friends and without hope.
– Reginald Hamlin & Catherine Nicholson, 1966

Nearly half a century later, that scenario of obstetric fistula continues to haunt the humanity and has been aptly termed ‘the scandal of the century’.

Between 2 and 3 million women, mostly in Africa, are in need of surgical repair with about 130,000 new patients being added annually.

This colossal embarrassment of our male dominated society will not be solved unless we address the root causes of lack of empowerment. In these societies, a woman’s low socioeconomic status and illiteracy often lead to child marriage followed by early pregnancy. The lack of obstetric care causes obstructed labor and ultimately complex injuries to vagina, bladder and rectum. In the worst case maternal death – which needlessly claims one woman a minute.

Unfortunately our developed world with its economic clout is not willing to come up with any significant help to emancipate the young women of the developing world with education and empowerment, nor with help in providing effective systems of maternal health care. Thus safe motherhood has largely become an orphan initiative.

Historically however we owe it to the African women for our knowledge and surgical technical developments in repairing these injuries. These surgeries were mostly initiated in the US through painful and degrading experiments on the enslaved women in the antebellum south in the 19th century. Those slaves from Africa sacrificed their dignity in muted agony without consent to the extremely painful experiments enforced upon them without anesthesia by racist white physicians and slave owners.

And now after centuries, our complacency in extending any helping hand to the African women is unacceptable and disgraceful.

Watch a webcast of my presentation Vesico-vaginal Fistula Management: A Tribute to Anarcha, Betsy, Lucy and the Hamlins at the 4th International Congress on the History of Urology.

– Sakti Das, 2009.

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A Walk to Beautiful” – Emmy Award winning feature-length documentary tells the stories of five Ethiopian women who suffer from devastating childbirth injuries and embark on a journey to reclaim their lost dignity. Rejected by their husbands and ostracized by their communities, these women are left to spend the rest of their lives in loneliness and shame. They make the choice to take the long and arduous journey to the Addis Ababa Fistula Hospital in search of a cure and a new life. [PBS/Nova]