Written by Caballero Oscuro
I have to admit, I was leery of watching this documentary because of its seemingly depressing subject matter. We all know that life can be difficult in Africa, especially for women, so a film about devastating childbirth injuries in Ethiopia had about as much initial appeal to me as preparing tax statements. What’s surprising then is just how life-affirming and positive this film is, both for its subjects and its viewers.
The documentary focuses on five Ethiopian women who suffered through prolonged obstructed childbirth without medical assistance. As a result, their children were stillborn and they were left with seemingly permanent incontinence due to obstetric fistula, a hole in the birth canal wall between the bladder, rectum, or both. This incontinence and resulting stench make them social pariahs in their community, forcing them to live shunned existences on the fringes of society. Like I said, not exactly the cheeriest subject matter. However, the film is centered on their voyages of hope, not their initial despair.
In the city of Addis Ababa, a large hospital has been caring for fistula patients for decades. The hospital’s sole mission is to examine obstetric fistula cases and either surgically correct them or train the patients to use special exercises to improve their conditions. The hospital appears to be always at full capacity, a testament to the severity and prevalence of the issue. Sadly, the doctors relate that there are far more affected people throughout the country that may never be seen due to far-flung remote communities and lack of knowledge about the hospital’s existence. Even the patients who know about the hospital still have to find a way to reach it, meaning a days-long hike for most. As an example of the travel burden for patients, one doctor tells of a patient who begged for cash for a full six years before saving up enough for a bus fare to the hospital.
As described in the film, the patients are generally susceptible to fistula due to a combination of very early childbirth, undernourishment, as well as heavy labor as children that doesn’t give the girls a chance to physically develop enough to successfully deliver a child. After hauling heavy loads around all through their childhood, then sometimes marrying and conceiving before they even enter their teens, the girls are left with stunted bodies that can’t expand far enough to give birth. This results in prolonged labor lasting up to 10 days where the outcome is death for the baby and significant odds of fistula. The biggest contributor to the problem is lack of proper medical care, but due to their remote communities hours from the nearest road, let alone medical facility, they’re left with no other option than natural childbirth.
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