what I want you to know: the fistula epidemic

What I Want You to Know is a series of reader submissions.  It is an attempt to allow people to tell their personal stories, in the hopes of bringing greater compassion to the unique issues each of us face. If you would like to submit a story to this series, click here.  Today’s post is by Hope, who blogs about her life in Niger here.


The idea here is that when we share our personal stories, we bring greater compassion and awareness to the unique issues that we individually face. Reading these posts made me think long and hard about my story. What one thing would I want to tell other women? What is it in my life that needs to be told?

I want you to know about an epidemic called fistula. Not because it’s something that I am facing myself; I only became aware of it this year. But once you know, if you are like me, you will carry this story of heart break and tell it with passion.

I encounter this epidemic in the faces of the women who live around me here in Niger. I am sitting at my desk in front of my iMac, but there is another woman not very far from here (a mile or two maybe- I live in the capitol city) who is suffering from the horrible problem called fistula.

A fistula by strict definition is an abnormal hole in an organ or vessel. The problem here in Niger is Obstetric Fistula.

Girls and women in Niger work hard. Many of them haul water every day, traveling miles between huts and wells with jugs on their heads. This is expected of girls and women young and old. When they have reached puberty, girls are often married. Men in this country frequently take four or more wives. A young girl makes a “good” third or fourth wife because she can help with the many chores in a very large family. These girls are often small in stature because of a lack of good nutrition. Sometimes they become pregnant at 12, 13, or 14 years of age. Pregnancy is harder than you and I can imagine. No electricity. No running water.

One day labor starts and does not stop. The small girl labors all day and into the night. Sometimes for days.  Her small body does not help her deliver the baby the way an older or larger body would. By the time the family realizes that she is in danger, it is too late. The nearest clinic is very far by donkey cart. She is too tired to make the journey.

Eventually the baby arrives. Many times he or she is already dead.

She survives, but in the days following her delivery, she finds that her body will not heal. The fluids keep leaking out of her. The delivery has torn a hole in her that will not heal. It is a fistula.

Weeks. Months. Years go by.

Her husband has left her. She cannot bear him any more children. Because she still constantly leaks bodily fluids, she stinks and no one wants her around.

Her husband has sent her back to her parents. They see her as a disgrace. A failure. They cannot stand to let her live in their home because of the smell and the shame. They build her a hut behind their house. She lives there for years.

This story belongs to THOUSANDS of girls and women in Niger and in other parts of Africa and Asia. In places where women work hard and medical care is not adequate to meet their needs, they suffer in silence and shame.

They do not have an iMac to help them tell their story. And so I will.

There is help for women with fistula. The surgery to repair the damage to their bodies is often a fairly simple one. With a little education and encouragement, women at risk for fistula can travel to clinics in the days or weeks before delivery to ensure they receive the care they need.  Organizations have formed to try to make a difference for these women.  And in Niger a new hospital is being built.

Why do I want you to know about the fistula epidemic?  It is not my story.

I am a 32 year old American woman.  I am a mother of 3 children all born in a very beautiful hospital in Richmond, Virginia.  I want you to know about my gratitude and my obligation.  My gratitude is to God.  I thank him that I happened to be born in America, one of the richest countries in the world (see the human development index of countries here.)  I thank him for the amazing life I lead- full of adventure, travel, and opportunity.  My obligation is to help those who were not.  That is why I live in Niger.

I want you to know that the need, the poverty, that exists in the world outside of America is beyond what we can really comprehend.  Even me, as I sit here typing on my iMac.  I will never really know or be able to imagine what her story really feels like daily.  I am learning that my middle class American life- that I thought was not that flashy or extravagant- really was.  I made $32,000 a year teaching in a public school.  I thought I was kind of low on the socioeconomic totem poll.  Maybe.  In America.  But when I left the comfortable confines of my homeland, I found that the majority of the world operates on a totally different game board with totally different pieces.  I want to encourage you to take a break from the game you’re in and dare to sacrifice for a woman- or a child- or someone somewhere else in the world who could really use your help.  I want to encourage you to travel- not on vacation, but to a place less beautiful than that.  Take the time to educate yourself experientially.  Even if it means giving up something that you feel like you “need” to succeed at the game of Life.  I want you to pray.  Pray for that woman whose name you do not know, but whose story you have heard.  I want you to know that your life can make a difference to more than just you or your kids or your neighbor.  That is what I want you to know.

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