Millions of women suffer from obstetric fistula, a catastrophic childbirth complication that exists today mainly in the world's poorest countries. Fistulas are created by the prolonged pressure of the fetal head in the birth canal during obstructed labor, which grievously injures a woman's bladder, leaving her incontinent. With a fistula, a woman's life revolves around futile attempts to control her condition and the stigma associated with it. Abandoned by their loved ones, ostracized from their communities, and cut off from modern surgical care, which can repair fistulas and return patients to full health, these women suffer wretchedly.
Based on over 20 years of personal experience with fistula patients in multiple African countries, Dr. L. Lewis Wall's Tears for My Sisters describes the ancient history of obstetric fistula, tracing it as far back as ancient Egypt. An expert in repairing obstetric fistula, Dr. Wall explains how these injuries occur and how Western medicine developed the technical capacity to overcome obstructed labor and repair fistulas. Arguing that obstetric fistula results from a general disregard for women's human rights and reproductive health around the globe, he lays bare the obstacles that poor women face in getting emergency obstetric care. Finally, he presents a solution to this problem based on the inspiring story of Drs. Reginald and Catherine Hamlin, who created a hospital system in Ethiopia to care for fistula patients, improve health care, and eradicate these injuries.
Providing these women with a much-needed voice, this compassionate book is the first to tell the comprehensive story of this tragic but preventable condition. It is compelling reading for everyone interested in women's health, reproductive rights, the history of medicine, and social justice.
L. Lewis Wall, MD, DPhil, is the Selina Okin Kim Conner Professor in Arts and Sciences, a professor of anthropology, and a professor of obstetrics and gynecology at Washington University in St. Louis. He is the author of Hausa Medicine: Illness and Well-Being in a West African Culture and the coauthor of Practical Urogynecology.
PrefacePrologue1. The Tragedy of Queen Henhenit2. The Human Obstetrical Dilemma and Its Consequences3. The Conquest of Obstructed Labor4. Dr. Sims Finds a Cure5. Structural Violence and Obstetric Fistula among the Hausa6. Deadly Delays in Deciding to Seek Care7. Deadly Delays in Getting to a Place of Care8. Deadly Delays in Receiving Care9. Compassion, Respect, and Justice10. The Vision of Hamlin FistulaEpilogueAcknowledgmentsAppendixGlossaryEssay on SourcesIndex