The 2007 documentary, A Walk To Beautiful, follows three women's journey to a Fistula Hospital in Addis Ababa, Ethiopia, and their transformation from being considered social pariahs to them being included in the community. Obstetric Fistula is a preventable, yet severe, medical condition where tearing occurs between the rectum and the vagina, the bladder and the vagina, or both.
Fistulas' often develop during a prolonged and severe obstructed labor where blood flow is limited or cut off from surrounding tissue, which results in the tearing and holes.[1] Based on women seeking treatment, it is estimated that 2 million women live with fistula, however the exact number is unknown due to lack of access to treatment centers.(UNFPA, 2011)[2] Ethiopia has one of the highest rates of maternal mortality in the world and it is estimated that about 500,000 women and girls experience complications in child birth.[3] Of these 500,000 women, there are approximately 9,000 new cases of fistula reported in Ethiopia each year.[4]
"I, her mother, made her live out back," explains Ayehu's mother in A Walk to Beautiful. Six years ago, Ayehu, 25, first noticed something was wrong once she delivered her stillborn baby after one week of labor. She felt ashamed to walk in the village and ride buses because of her incontinence. Soon after her husband left her she was ostracized by her community, and her brothers and sisters turned their backs on her. With little left to lose and at the behest of a friend, she heads to Addis Ababa. Ayehu, like so many women and girls in Ethiopia, travels over 17 hours by foot and bus to reach the nearest clinic. Once at the clinic she is introduced to other women who suffer from fistulas and receive treatment. Often thinking she was the only one with this condition, she is relieved to see others who can relate to her and her own condition at the hospital. The joy on her face is overwhelming. From joking during a maternal health class, to fixing each others hair, the girls form an encouraging bond, probably some of the first they have had since being shunned from their homes, a bond that invites them to relax and be themselves. The women at the hospital are quick to form a supporting community for each other.
The transformation, both psychologically and physically, of all the women in the clinic, including Ayehu is apparent throughout the documentary. Dr. Ambaye Woldemichael, a fistula surgeon at the Fistula Hospital, mentions that women are not only shunned by their community, but feel like less of a woman because they can not have a normal life with a family. When patients enter the hospital they feel like the world is against them. Despite this they are able to start trusting the other patients, nurses and doctors. Even women who were unable to be successfully treated after the first operation return to the hospital to continue treatment, while others seek positions at the hospital after treatment. Upon successful treatment and recovery time, the women are given new clothes before being released from the hospital. The pure elation on the women's' faces' and the gratitude towards their doctors when they walk for the first time without urinating is heartwarming. Additionally, the symbolic action of being presented new clothes is something that is incredibly moving because it represents a return to the life they knew only a long time ago.
Throughout the documentary both Dr. Ambaye Woldemichael and Dr. Catherine Hamlin, Co-Founder of the Fistula Hospital, emphasize that there are ways to prevent fistulas from occurring before conception and during childbirth. Dr. Ambaye Woldemichael notes that many girls in the countryside are "too small for their age" resulting from malnutrition and strenuous work. The result, for a pregnant girl, is that the baby is too large for the mother to naturally deliver. This is also seen in the case of child brides whose bodies are not fully developed. Further, in rural Ethiopia women do not have access to a mid-wife or doctor and it is customary for women to deliver their child at home with the presence of a female elder.[5] During complicated and severe labors, it is essential for women to have access to a trained professional who can assist in helping the labor and preventing serious and long-term medical conditions, such as fistula, as well as maternal death. This is but one example of the great importance of access to health care and trained medical personnel.
A Walk to Beautiful provides a touching journey into the life of women living with fistula. You can feel the emotion of the individuals that you are introduced to, whether it is hopelessness, joy, or envy, and you connect with them as if they were your friends. It does this, all the while bringing the issue of fistula to the table. This is an excellent documentary to watch if you want to see how fistula effects everyday life of women, the treatment process, and the reintegration back into society.
A Walk to Beautiful is a documentary film released in 2007. Directed by Mary Olive Smith and Amy Bucher.
By Emily Elizabeth-Anne Meyer
Emily is the Program Manager for Communications and Media, and Program Manager for HIV/AIDS & Reproductive Health at Make Every Woman Count.
___________________________________________________________________
1. UNFPA. "UNFPA's Leadership of and Contribution to the Campaign to End Fistula. " The Maternal Health Thematic Fund: Annual Report 2010. Pg 69.
2. Ibid.
3. USAID. "Ethiopia" Maternal and Neonatal Program Effort Index. P 1.
4. German Foundation for World Population (DSW). "Fast Facts: Fights Fistula." April 2011. P 1.
5. Fistula Foundation. 2011. Fistula Foundation. 27 Dec. 2011. http://www.fistulafoundation.org/wherewehelp/ethiopia/