The Fistula Girls

I recently re-read a book. The story is heartbreaking... but its also a story of hope.

This post is inspired by that story.

In Ethiopia, much of the population live in remote areas – often hundreds of kilometres from the nearest road. Water supplies are unreliable, hygiene is poor and money is difficult to come by.

Ethiopian culture sees girls married when they are about 12 years old. Due to malnutrition, their bodies are not yet able to bear children. By the age of 15, most of the girls will be pregnant with their first child. Being so far from a hospital, they will have no care during their pregnancy and will deliver their baby in their small hut. Sometimes, the birth goes well and the community welcomes a new child. More often, the labour does not go well.

It is not unusual for these girls to be in labour for 5 days – even longer. The unborn baby is unable to live with the constant pressure of a constricting uterus. After two days of pressure, most of the babies die inside their mother. The young mother remains in labour for a few more days. She has to wait for her unborn child to shrink in size before her small body can deliver it.

This difficult labour causes a tear, or a hole to form between her bladder and uterus. This tear is called an obstetric fistula. Through the fistula, urine dribbles constantly and uncontrollably down the girl’s legs. In the worst cases, urine and faeces will drip down her legs, 24 hours a day.

The young girl now has to deal with the death of her first child. She is exhausted and in pain. She is now living with a new condition, which repulses everyone around her, regardless of how hard she tries to keep herself clean. Very often, her husband will not be able to tolerate her smell and will divorce her. He will leave her to a life of abandonment and shame. She will be forced to live separately from the community.

Some women live with this condition their whole life. Others would have died from infections resulting from their fistula. The lucky ones find their way to a Fistula Hospital.

In 1959, two doctors travelled from Australia to work in an Ethiopian hospital. Their first fistula girl broke their hearts and they dedicated their lives to these girls.

Now, in 2010, Doctor Catherine Hamlin is still living in Ethiopia, still treating fistula patients. (She buried her husband in an Ethiopian graveyard.)

The book “Hospital By The River” was written by Dr C. Hamlin. In it, she shares the stories of many of her patients. Many of the girls walked kilometres to reach the hospital. Others were carried for days by a father or husband. Some of the older women had to wait for over a decade in order to save enough money to afford a bus ticket to the hospital.

Since the doctors arrived in Ethiopia, more than 30 000 women have been cured of their fistula. The operation is relatively simple. Women with extensive damage or scarring may need more than one operation. The hospital has maintained a 93% success rate for decades.

The fistula doctors have taught many other doctors to perform this operation. These doctors are now repairing fistulas in other countries. Ethiopia now has 3 fistula hospitals and another two hospitals are currently being built. Some doctors are living in remote areas, monitoring pregnancies, assisting with deliveries and repairing fistulas where needed.

Many of the hospital’s nursing staff were once fistula girls. They arrived at the hospital downcast and shame-faced. These girls now wear a smile on their beautiful faces. They welcome new patients to the hospitals. What’s the cost of this smile?

US$300. For three hundred American dollars, a girl will have her fistula repaired. She will receive her surgery, all medications, three weeks in hospital and a new dress to wear home. No patient has ever paid for her treatment.

The hospitals are registered charities. The administrators work voluntarily. They promise that every cent from every dollar goes to the hospitals and to the patients. Visit the website to see the smiling faces of girls who no longer have to live with an obstetric fistula. Read the books. The fistula girls are worth it.

htttp://www.hamlinfistula.org