Fistula: An American Rarity, an African Reality

06/05/2010 11:48 am ET | Updated May 25, 2011

Imagine a life living alone and being ashamed. Imagine a life where you have no control over the leaking urine and feces dripping down your legs. Imagine a life where your partner, your family and your friends cannot bear to be around you. Imagine a life, where you wonder whether dying during the birth of your baby would have been more welcome than living with the consequences of a harmful pregnancy. And when maternal mortality is a preferred choice over maternal morbidity for women in developing nations -- as Americans, we must stand up and take action.

With headlines around the nation screaming of wars, environmental disasters and a fledgling economy, the bi-partisan introduction of "The Obstetric Fistula Prevention, Treatment, Hope and Dignity Restoration Act of 2010" by Rep. Carolyn Maloney (D-NY) and Rep. Michael Castle (R-DE) is inspiring and hopeful enough to put the microphone in the hands of the two million, voiceless women who are victims of obstetric fistula. The bill, H.R. 5441, calls for the authorization of funding to prevent obstetric fistula, to treat those already suffering from the condition, and to enable the women and girls who undergo fistula repair to return to productive lives.

Fistula typically occurs due to obstructed labor. After being in labor for agonizing hours, and in some cases, days, without access to a doctor, the baby is generally delivered stillborn and the woman is left with a hole between her bladder, vagina and sometimes rectum. This results in uncontrollable leakage that is discovered early in the post-partum period. In some cases, the woman is also left crippled from nerve damage.

For Americans, it is a difficult concept to visualize. Perhaps this is because we cannot conceive the trauma of obstetric fistula, which has virtually been eliminated from Europe and North America. Or, perhaps, it is because it is an uncomfortable issue to think or talk about. Or, maybe it is due to the fact that we are barely exposed to it. After all, we haven't suffered from fistula since the late 1800s, when the last known fistula hospital stood on the site of today's Waldorf-Astoria Hotel in Manhattan.

A disease that is nearly a century old to us is being fought daily in the countries around the world. That is why when life saving legislation, like H.R. 5441, is introduced we must work together to restore hope, health and dignity to the women who suffer from this debilitating disease through no fault of their own. The passing of this bill will also free up funds to provide access to quality maternal healthcare services, family planning, skilled birth attendance, and emergency obstetric care - all of which will go a long way to reducing maternal mortality and morbidity in developing nations.

The lifetime risk of an American woman dying due to pregnancy or childbirth is just 1 in 4,800. However, for a woman living in Sub-Saharan Africa, that risk is 1 in 22. Worldwide, for every woman who dies of maternal related causes, at least 20 women experience a maternal morbidity, of which obstetric fistula is one of the most severe forms. These are the facts, and they are horrific.

But there is good news. Thanks to initiatives like the Global Campaign to End Fistula, led by UNFPA, obstetric fistula is being addressed in 47 countries around the world. With the support of many partner organizations the Campaign promotes a comprehensive strategy to ending fistula based on a three pronged approach: prevention, treatment and rehabilitation.

With success rates as high as 90 percent for less complex cases, the average cost of surgery is a mere $300 - less than the average cost of a smart phone in America. Treated women who once led a life of isolation and shame are able to reintegrate into their societies, support themselves, their families and their communities.

Sarah Omega, an advocate for ending fistula is a native of Kenya who delivered a stillborn child through a c-section after eighteen gruesome hours of labor. Three days after her delivery she realized she had developed obstetric fistula. And she lived with it for 12 years, before finally having her fistula repaired. You can listen to Sarah speak first hand about her experience of living with fistula here.

This week, 3,500 advocates from 140 different nations will convene in Washington, DC from June 7-9 at Women Deliver, the largest ever conference on maternal and child health. The head's of five UN agencies plus the Secretary-General, will attend the conference -- an extraordinary lineup for a non-UN conference. With the spotlight shining bright on the issues of women's health, I hope you will join us at Americans for UNFPA to step up to the plate and tell Congress to support "The Obstetric Fistula Prevention, Treatment, Hope and Dignity Restoration Act of 2010."

To reach out to your Member of Congress visit:


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