Views: Bringing dignity

May 23, 2012 | 8 a.m.

"Half the Sky" discusses the demeaning condition of an obstetric fistula

Views | Abby Ingalls

Views: Bringing dignity

Nicholas Kristof's book "Half the Sky" discusses women with obstetric fistulas, but awareness is only the first step before making a difference. | Images courtesy of

Pulitzer Prize winner and New York Times columnist, Nicholas Kristof once said, “Just about the worst thing that can happen to a teenage girl in this world is to develop an obstetric fistula that leaves her trickling bodily wastes and shunned by everyone around her.”
After many days of labor a woman’s body can no longer sustain itself, it is broken by trying to give birth to her child. During contractions, the baby’s head is continually pushing against the woman’s pelvic bone which causes tissue to die due to lack of blood flow to this area. This creates a hole, or a “fistula”, between the birth passage and internal organs. Women with fistulas can no longer hold their urine, sometimes bowel content, and can sometimes even lose the ability in their legs. Now her child is unlikely to survive and her husband will most likely reject her because of her smell and inability to have more children.

Nicholas Kristof wrote in his book, Half the Sky, about one woman who suffered severely from an obstetric fistula. Mahabouba Mohammed was raped at the age of 13. After days of excruciating labor trying to give birth alone, the baby died a stillborn and she had a fistula so bad it damaged the nerves in her legs which disabled her to walk or use her legs. Immobile, suffering, and smelling foul from the stench of her fistula, the people in the village put her in a small hut on the outskirts of the village and removed the door to leave her to the hyenas overnight.

Mahabouba, though hurting and almost defeated, had a fighting spirit and defended the hyenas off with a stick until morning. In the morning she crawled using only her arms for more than 30 miles to an American missionary’s house. The missionary found her half dead on her doorstep, and took her to the Addis Fistula Hospital where she recovered.

The World Health Organization estimates that there are as many as 50,000 to 100,000 new cases of fistula each year. In Ethiopia alone, there are an estimated 100,000 women suffering with untreated fistula, and another 9,000 women who develop fistula each year. There are thousands of women and girls just like Mahabouba in poverty-stricken areas who suffer like her.

The main causes of fistula are poverty and the low status of women and girls. According to the United Nations Population Fund (UNFPA), there are three delays that add to the development of fistulas: delay in seeking medical attention, delay in reaching a hospital or medical facility, and delay in receiving medical attention and care once arriving at a facility.

There is a way to help women like Mahabouba. For such an overwhelming topic, with such staggering numbers, it is easy to turn away or point your finger at yourself and say, “What can one person do?” and then leave it at that.

But there are small steps that one can take if they feel the need to help women suffering with obstetric fistulas. No lone person can tackle the world’s problems, but together you can make a difference in many women’s lives around the world. Even if you take one of these small steps, or many, it will make a difference in some way. To make it simple, I will list ways you can help women with obstetric fistulas.

  1. Go to and check out the website. They have everything from FAQs to individual women’s stories, information on the 16 different countries they help, and all about what fistulas are and how you can help.

  2. On their website you can donate money. Don’t want to do it monthly? Don’t worry; it can be a one-time donation, or a monthly donation. As little as $10 a month can help a woman with an obstetric fistula.

  3. Join the Love-A-Sister program to help cover the cost for one woman’s free and safe fistula surgery. You can fully sponsor one woman’s surgery with a one-time donation of $450 or a monthly donation of $37.50. A fistula surgery is highly needed for a woman with a fistula.

  4. Don’t have the money but still want others to hear about women whose lives are shattered by fistula? Be a voice for the voiceless women. The Circle of Friends program is a volunteer program where you raise awareness and donations. Full information on how to join is on the Fistula Foundation website.

  5. And lastly, if nothing else, at least always stay informed and updated on obstetric fistulas and how it is taking the lives of women around the globe. Let others know Mahabouba’s story and several other personal stories you can find about women on the Fistula Foundation’s website.

All of these steps, in some way, bring dignity back into a woman’s life that was once ripped completely from her.


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