I've read about women suffering from fistulas before and been horrified -- a nightmare that could potentially affect any woman unlucky enough to have been born outside of a developed country.
Usually I just feel powerless reading about stuff like this. But this column offers a link (
http://www.wfmic.org/) where you can donate, using Paypal. So I contributed $100. It took less than five minutes. I am seriously underemployed and can't afford to donate the whole $300 for an operation (at least not all at once), but if anyone else wants to pitch in, maybe we could make one person's life more livable.
http://www.nytimes.com/2009/11/01/opinion/01kristof.html?_r=1&partner=rssnyt&emc=rssNovember 1, 2009
Op-Ed Columnist
New Life for the Pariahs
By NICHOLAS D. KRISTOFPerhaps the most wretched people on this planet are those suffering obstetric fistulas.
This is a childbirth injury, often suffered by a teenager in Africa or Asia whose pelvis is not fully grown. She suffers obstructed labor, has no access to a C-section, and endures internal injuries that leave her incontinent — steadily trickling urine and sometimes feces through her vagina.
She stinks. She becomes a pariah. She is typically abandoned by her husband and forced to live by herself on the edge of her village. She is scorned, bewildered, humiliated and desolate, often feeling cursed by God.
I’ve met many of these women — or, often, girls of 13, 14, 15 — in half a dozen countries, for there are three million or four million of them around the world. They are the lepers of the 21st century.
Just about the happiest thing that can happen to such a woman is an encounter with Dr. Lewis Wall, an ob-gyn at Washington University in St. Louis. A quiet, self-effacing but relentless man of 59, Dr. Wall has devoted his life to helping these most voiceless of the voiceless, promoting the $300 surgeries that repair fistulas and typically return the patients to full health.
“There’s no more rewarding experience for a surgeon than a successful fistula repair,” Dr. Wall reflected. “There are a lot of operations you do that solve a problem — I can take out a uterus that has a tumor in it. But this is life-transforming for everybody who gets it done. It’s astonishing. You take a human being who has been in the abyss of despair and — boom! — you have a transformed woman. She has her life back.”
“In Liberia, I saw a woman who had developed a fistula 35 years earlier. It turned out to be a tiny injury; it took 20 minutes to repair it. For want of a 20-minute operation, this woman had lived in a pool of urine for 35 years.”
Dr. Wall started out as an anthropologist working in West Africa, and he speaks Hausa, an African language. But he concluded that the world needed doctors more than it needed anthropologists, so at age 27 he went to medical school.
He has had a dazzling career as an academic, writing several books and scores of journal articles, but his passion has been ending the scourge of fistulas. In 1995, he founded the Worldwide Fistula Fund, and he has been campaigning tirelessly year after year to build a fistula hospital in West Africa. That has been his life, his dream.
Now it is a reality.
The West African country of Niger recently approved Dr. Wall’s plan for a fistula hospital, affiliated with an existing leprosy hospital run by SIM, a Christian missionary organization. Eventually, when $850,000 in fund-raising is complete, a new 40-bed fistula hospital, modeled on the extremely successful Addis Ababa Fistula Hospital of Ethiopia, will rise on vacant ground next to the leprosy hospital. (For information on how to help, please visit my blog, nytimes.com/ontheground.)
For the time being, an existing operating theater in the leprosy hospital has been renovated for fistula repairs. Dr. Wall has already shipped a container of medical supplies to Niger, and he expects to go with a team to conduct the first fistula repairs there in December.
The day the final approval came through, Dr. Wall sent me an elated e-mail message with the news. “There are tears in my eyes,” he wrote.
Aside from repairing fistulas, the hospital will also organize outreach efforts to promote maternal health and reduce deaths in childbirth. It will also undertake education and microfinance efforts to empower women more broadly.
It could be just the beginning. The new hospital is part of a grand vision to eradicate fistulas worldwide by building 40 such hospitals in the world’s poorest countries. The plan, drawn up by Dr. Wall, would cost $1.5 billion over 12 years and operate as an American foreign aid program.
I can’t imagine a better use of foreign assistance dollars — or better symbolism than having the most powerful nation on earth reach out to help the most stigmatized, suffering people on the planet. The proposal for the global plan is circulating in Congress, the State Department and the White House, as well as among religious and aid organizations that are lining up to back it. President Obama hasn’t signaled a position yet, but I hope he will seize upon it.
The new fistula hospital in Niger is a tribute to the heroic doggedness of Dr. Wall, and with luck it will be replicated in many other countries. Anybody who has seen a fistula patient after surgery — a teenager’s shy, radiant smile at something so simple as being able to control her wastes — can’t conceive of a better investment.
