I watched Nova last night with BJay. It was titled “A Walk to Beautiful”. The story was about Ethiopian women who sought treatment for obstetrical fistula which happens in childbirth. Because women in rural villages are malnourished and are doing hard physical labor from the age of 2, they don’t grow to be very tall, and their pelvic bones aren’t very wide. Plus they are married young and get pregnant very young. A combination of all these and the lack of obstetrical care leads to problems with delivery. The babies just can’t fit through the birth canal and are often stuck there way too long. The pressure of the baby’s head cuts off blood supply to parts of the woman’s bladder and/or rectum and so the tissue dies and falls off. So the women are left with the horrifying problem of leaking urine or feces or both. Most often the baby dies in childbirth and then the husband leaves. The women are sent home and shunned by their communities. I was absolutely heartbroken watching this. I usually turn away from stories like this that make me sad. But I was just so hooked from the start by the women’s plight. Ayehu, one of the women in the documentary had lived with her fistula for 6 years. When she came home to her parent’s house after her husband left her, her mother made her sleep outside. She had to build a makeshift hut on the back of the house where she expected to die. She said that even her brothers and sisters despised her for living. Then one day a woman named Fikre who had also lost a baby and lived with a Fistula for 10 years came and told Ayehu about the Addis Ababa Fistula Hospital where Fikre had been cured. They followed Ayehu on a 6 hour walk to the city and 17 hour bus ride to the hospital. Ayehu had surgery and was cured. Another woman Wubete had sustained so much damage to her bladder that it could not be repaired. She had to have a device that acted as a plug that she would remove when her bladder was full. She refused to go back to her village and was set up with employment at an orphanage where she cares for 4 children there.

This left me thinking about a lot of things. First of all, how grateful I am that I live in the United States. For so many reasons. But I think that being a woman here is a thousand times easier than being a woman almost anywhere else. I can’t imagine what it must be like to have to take a 17 hour bus ride with serious incontinence. But then I can’t imagine how the 17 hour bus ride is the end of a 6 year struggle with humiliation, alienation, and despair. I am in awe of people like Dr.Catherine Hamlin who dedicate their lives to serving the poor. It was in my master plan to join the peace corp out of college. I don’t know what our lives would have been like had we done that. But I like to think we would have learned to love the people we served. I can only hope that I would have been as understanding and compassionate as the Hamlins. When I watched the documentary I was so angry for the women. How could their husbands and families be so cruel? How can you treat someone who has suffered so much with contempt? Catherine and her husband went to Ethiopia in 1974 and never left. Her husband died and Catherine stayed on. She understands the culture, the actual journey of these women. From her interview with directors Mary Olive Smith and Amy Butcher:

“So she’s married to a farmer boy and looking forward to having a baby…

She starts labor and she expects to perhaps deliver by the evening or early morning. But the day goes by and she doesn’t have the baby. The village women encourage her. The second day goes by and even a third and fourth—up to 10 days I had a woman in labor. By that time the girl is exhausted and dehydrated, and she finally pushes out a dead baby. There’s her dead baby lying on the sheepskin rug on the mud bench beside her.

Q: And this is only the beginning of her pain.

Hamlin: Yes. She slips into a sleep of exhaustion because of her long labor. She’s worn out, she’s exhausted—and she wakes up to a worse horror…Her life is shattered, ruined. She can’t control any of her body waste.

Her husband comes back from the fields in the evening and says, “Why is the house smelling? Why can’t you get up and cook my meal for me?” He probably loves her; most of them do love their wives. He just can’t understand what has happened, and he can’t really accept this girl. Afterward, he may stay with her two or three days or two or three weeks even, but finally he thinks, “Well, she’s no use to me now as a wife.” And he will say to her—or, often, she will say to him, “Look, I’m no use to you. I’ll go back to my mother and father.”

Q: How should we feel about the husbands who abandon these girls?

Hamlin: We shouldn’t condemn them. These men are farmer boys; they might be only 18 or 20. They’ve never seen a medical condition like this, and they have no idea what’s the cause of it. They think that perhaps they have been cursed by God or the devil. They’ve got superstitious ideas that this has happened to them for some punishment. They don’t associate it with the days of labor.

They’re not cruel. Many of them love their wives. I’ve had one or two come back and say, “Please cure my wife, I want her. I want her to get better.” So we can’t condemn these young boys. I condemn the older men who have had two or three wives, an older man who is married to a young teenage girl. He should know better.

Q: So then she goes home to her parents.

Hamlin: She will go home to her own village—maybe it’s next door, maybe some distance away. They run out to welcome her, thinking she’s coming home with a baby, and they find her in this state. They love her, they put their arms around her, they hug her, they bring her into the house. But not for long, because of the other children in the house, the neighbors coming and going. They can’t manage with somebody who is leaking urine and possibly bowel contents.

So the mother will say to the father, “What can we do?” And he’ll say, “Well, we’ll build a little shed outside and put her [there].” They will build her a little hut somewhere in the village, somewhere on a farm plot they’ve got, and there she will stay till death. This is the fistula’s sufferer’s tragedy, her tragic life. Psychologically she’s terribly disturbed. She’s lost all her femininity, all her dignity, all her hope of having another child, all her hope of mixing with her society.”

And that is how it happens. When you think of it, this happens in the developed world all the time on many levels. Initially we have compassion and time to serve those who are suffering, but when the suffering becomes prolonged and there is no end in sight, we don’t have the capacity to go the distance. There are many levels of humanity.