Ethiopia’s trail of tears

BAHIR DAR, Ethiopia

It is a smelly, offensive and debilitating condition in which women injured in childbirth uncontrollably leak a trail of urine or feces.

The condition, known as fistula, all but disappeared in the Western world in the late 19th century, when Caesarean section births became widely available.

But in sub-Saharan Africa, the condition remains widespread, sentencing as many as 3 million women to a life of abandonment and enforced solitude.

“I thought it was something the doctors did to me, or maybe God,” says Bireeh, a young woman racked by incontinence and infection after a three-day labor ended with a stillborn son.

Abandoned by her husband, she turned up at the Hamlin Fistula Hospital in the northern Ethiopian village of Bahir Dar.

A 30-minute surgery followed by two weeks of convalescence should be enough to repair the damage of childbirth, and doctors say Bireeh probably will be able to bear children.

Several Western physicians, inspired by their Christian faith, have worked in Ethiopia for more than 40 years to repair the lives of fistula sufferers.

Their efforts lately have drawn benefactors in the United States, spanning the political spectrum from conservatives to liberals.

In Congress, they range from Rep. Christopher H. Smith, New Jersey Republican, to Rep. Carolyn B. Maloney, New York Democrat, who are both attempting to win U.S. funding to treat the condition.

“No woman should have to live with this degrading condition,” says Mr. Smith, who proposes channeling $5 million through the U.S. Agency for International Development next year and $7 million the following year. His bill has passed the House and awaits approval in the Senate.

A rival measure, sponsored by Mrs. Maloney, would steer $34 million through the U.N. Population Fund (UNFPA), with the money earmarked exclusively for fistula care.

Basic surgery

“Obstructed labor exists in every part of the world, but it’s usually handled with a C-section in a hospital,” says Dr. Andrew Browning, an Australian gynecologist who performed more than 200 fistula repairs in the past year at the Bahir Dar facility.

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