Tuesday, March 23, 2010

It is called Fistula

If my sister-in-law who gave birth last week had lived in Africa, chances are that she would now have developed a whole new set of problems in her life.

It would be called Fistula. 
What's that?  Fair warning:  If you are male (or female for that matter) you might not want to read this. 

Today I am feeling real and I wanting to really say it.  I took a class in the UN about this topic, and it is time you learn about it for yourself.  I have thought about it for two weeks, and I am tired of thinking
about it all alone.

Fistula holds no respect for money, fame, status or education.

And I quote: (remember, this is just one country's example)
Rural Ethiopian girls traditionally receive their first water jar at age two. By age eight they are carrying loads of water, wood and grain that are much too heavy for their physical size. Despite females being assigned the beast-of-burden role, if food is short, it must go to the boys before the girls. This favoritism exacerbates the stunting of girls’ bones, particularly in the pelvic region.


In Ethiopia rural, poor and often illiterate girls are betrothed between ages of 9 and 13. Married two years later, they usually begin having babies usually by 15 years of age while their bones are still undeveloped. Rape victims may be as young as seven. Whether married or raped, most Ethiopian women have at-home deliveries under dirty conditions with no clean water.


The fistula damage begins early in the labor process when babies become lodged in narrow birth canals, blocked by underdeveloped pelvic bones. This obstructed labor lasts for an average of 3 to 4 days, sometimes as much as a week. During that time, repeated, futile contractions cut off blood to vaginal tissue compressed between the fetal head and the bony pelvis. This tissue becomes necrotic, sloughs off and a fistula (opening) develops between the bladder and the vagina, the rectum or both. The uterus squeezes the unborn babies to death in 95% of fistula cases. The girls are left mourning, traumatized inside and out.


These meant-to-be mothers soon realize that, rather than gaining the status of having produced a child, they are incontinent due to their fistulas. Urine and feces continually trickle down their legs causing sores and soaking their clothes. Due to the resulting stench, husbands, families and communities ostracize these victims, forbidding them from using the village well, which in most cases is their only water source. Because delivery is often on the ground, dirt often enters the uterus and thus many women die from septicemia and other gynecologic injuries. Fistulae can lead to kidney disease and even death. Many of these women drink as little as possible to avoid leakage and thus become dehydrated. Some victims of fistula choose suicide as the only escape from living as a pariah.

Did you know that the US answer to fistula is called a Caesarian Section--C-section.  Chances are if you had a C-section here in the states, you would not/could not have had one in Africa and the risks of fistula happening to you are very real.  There are an estimated 2 million women and girls living with this every single day.  Those are the ones who survive.  A woman dies every single minute in pregnancy or childbirth, almost all occurring in Asia or Africa.

There are two countries that this is rampent.  Afghanistan and Nigeria.  Not passing judgement on culture or religion.  Just stating the facts.

My sister-in-law holds a Master of Education and is the director of an environmental education center in California.  My foster sister, who gave birth last month, is a foreign diplomat to Tanzania, holding a Masters degree from Columbia University.  Both had C-sections.  What would their story be if they were in Ethiopia or Nigeria?

The experts say that the number one cause of fistula is children having babies.  Their bodies cannot handle it.  Their bodies weren't designed to do it.  The number one cause of children having babies is child marriage.

That, my friends, is a subject for another day.  Another day very soon.

If you want to know more, go to http://www.endfistula.org/