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The Other F Word: Fistula

The Other F Word: Fistula

Do you know what a fistula is? If you do, then you're likely fidgeting uncomfortably. If you don't, I'll take a moment to explain.

A fistula is a childbirth complication that occurs during obstructed labor, resulting in a stillborn child. The tissues that separate a woman's vagina from her bladder or rectum are destroyed by prolonged pressure from the fetal head trapped in the birth canal. The destruction of these tissues leads to continuous incontinence. It is surgically reparable, but cannot heal on its own.

Now that you know what fistula is, you're definitely fidgeting uncomfortably.

As many as 3 million women are living with this condition. More accurately, many of these "women" are really teenage girls, their bodies not developed enough to carry a healthy pregnancy and delivery, or worse yet, who suffer from obstetric complications because of genital mutilation.

And yet, we will likely never come across any of these women, because, for the most part, they live in sub-Saharan Africa. To make matters worse, these women - who already hold a lesser status among their male counterparts - have become invisible in their own villages and communities. They are shunned because of the terrible smell their condition exudes; oftentimes, their spouses abandon them, and their villages leave them to die. Even if they can get to a hospital and pay for the necessary surgery, they are often moved to the end of the priority list and, ultimately, never get the procedure.

Living with fistula is unacceptable and would never be tolerated in the Western world. Indeed, because of access to a good education, excellent hospital care and an increase in cesarean sections, women suffering from fistula injuries are entirely unheard of in our own circles.

A recent article in Christianity Today describes the importance of addressing fistula and outlines the efforts by Nick Kristoff, Dr. Lewis Wall and Michael Horowitz to draw attention to the topic. The article refers to a meeting the Religious Action Center co-convened this past November with the World Evangelical Alliance (WEA) and the NAACP, held at the RAC. Approximately 30 participants representing a dozen groups came to the table, discussing eradicating the future of fistula in Sub-Saharan Africa. To summarize, the goals of this proposal are to build fistula repair centers in Niger, encourage American doctors to spend an extended period of time working at these repair centers, and training African doctors to do the same. In addition to the actual repair centers, we propose implementing fistula prevention programs and intensive educational and outreach efforts on and the issue.

The article also referred to existing efforts for fistula repair/prevention. It cites the Central Peninsula Church in Foster City, Calif., which took on fistula because its members were looking for an opportunity to address both physical and spiritual needs. Indeed, in our own Jewish tradition, when we recite the prayer to heal those who are ill, we ask for "refu'at hanefesh u'refu'at ha-guf" - the healing of the soul and the healing of the body. Repairing a fistula would certainly heal a woman's body and soul. What's more, by simply offering the opportunity to heal these women, we increase their stature in their society, and culture. We strengthen these women, who in turn have the opportunity to strengthen their own mothers, sisters and daughters. We can strengthen the family unit, which can only serve to strengthen the larger community. What could be more healing than that?

People of goodwill have the opportunity to help the otherwise helpless and voiceless women of Sub-Saharan Africa. Mark Pelavin, associate director of the RAC, was quoted in the Christianity Today article saying, "The combination of the magnitude of the problem and the ability to solve it make it exactly the kind of issue or cause that a lot of organizations will be interested in." Dr. Lewis Wall is quoted in the same article as saying that fistula has been "lost from the collective memory." Let's take our combined interest and energy and run with it so that one day, that collective memory loss can extend itself all around the world, making fistula a thing of the past.

Published: 1/28/2010

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