Until I met Mariama, ten years after her agonizing delivery, I had never heard of vesicovaginal fistula (VVF). That's because in the United States, stories like hers haven't been told in more than 100 years. Today, VVF keeps company with obsoletes like smallpox and polio in the shadows of Western medicine, where its symptoms are referenced in the past tense. But in sub-Saharan Africa and parts of Asia, more than 2 million women still suffer from the condition.
Once trained, a single midwife can provide care for 500 women every year, including safe delivery of 100 babies. An estimated that 350,000 more midwives are needed around the world to help reduce maternal and child deaths -- but training is prohibitively expensive for most women in the developing world.
Until a decade ago, fistula was literally not on the global health agenda, even though it is arguably the most devastating and disabling of all childbirth injuries. The simple reason: women who suffer from fistula live almost exclusively in rural areas of very resource constrained countries, and are therefore some of the least empowered human beings on the planet.
Even more shocking is that more babies die within the first day of life in the United States than any other country in the world. This is not only the highest rate of any industrialized country, it is also 50 percent greater than all other industrialized countries combined. In our own backyard, mothers are experiencing unhealthy pregnancies and deliveries, and babies are dying.