Mary Olive Smith's documentary focuses on five Ethiopian women whose experiences illustrate the complex web of circumstances that produce obstetric fistulas, devastating internal injuries that blight the lives of millions of women in developing nations.
Obstetric fistulas are the result of prolonged, unsuccessful labor without medical intervention, which is common among young, underdeveloped girls in many parts of rural Africa; some remain in labor for days, or even a week. Constant pressure on their internal organs cause pieces of flesh to die, leaving internal gaps that allow bodily waste to leak uncontrollably from the victims' bodies. Though a relatively simple surgery can repair most of such damage, the women most likely to suffer it are the least likely to have access to facilities like Australian-born Dr. Catherine Hamlin's bluntly named Fistula Hospital in Addis Ababa. The filmmakers' subjects put engaging faces on a distressing problem: Wubete and Yenenesh, both lively 17-year-olds, were married as very young girls and were abandoned after their unsuccessful pregnancies left them damaged goods. Zewdie, 38, had five children when her sixth labor went wrong; her husband left her for another woman — a woman not much older than her oldest child — but her extended family held out hope that someday she would be cured and her marriage repaired. Ayehu's husband stayed with her after her first pregnancy, which left her incontinent; she successfully bore him a daughter, but he then left her. At age 25, she and her little girl live in a hut behind her mother's home. Almaz, who's in her twenties, was kidnapped into marriage and suffered a devastating double fistula. All five women find more than medical care at Hamlin's hospital: They also find psychological and emotional healing in a community of women who share their experiences and their desire to have a normal wife — to work, have children and participate in community life. Hamlin and her staff voice a weary frustration at the conditions that keep them in patients; the magnitude of the problem overwhelms their resources and they all know there's no easy fix for entrenched poverty, lack of medical care, malnutrition, local customs and inadequate infrastructure.
Smith makes no pretense of keeping a dispassionate distance from her subject: Her film is an unabashed call to action that shines a spotlight on a problem whose intimate medical nature relegated it to the shadows.
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