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.
Nigeria is a hard place to be a mom. As a midwife there, I should know. Many women who are in need of medical care there don't get it for a variety of reasons. Either they can't afford it, they live too far from a health facility, or their husbands haven't allowed them to go. Some women literally die waiting for this permission.