Making a Difference, One by One

The women came into my Seattle home one by one, eager to learn, ask questions, and mingle. One by one, they each browsed the carefully laid-out materials, quietly listened to the information presented, asked thoughtful questions, and made donations. Camaraderie was created as people made new acquaintances and connections over their pregnancy stories.  The primary connection for all these women, though, was the desire to find out how they could help eradicate obstetric fistula in the developing world.

These women had come together in a “giving circle” to learn about this devastating health condition manifesting primarily in developing countries where health care in some places is inaccessible or non-existent. Obstetric fistula is a condition caused by prolonged obstetric labor, when the mother does not have access to emergency obstetric care in the form of a cesarean section.  In about 90% of the cases, the baby dies and if the mother survives, the tremendous pressure of the baby’s head against the pelvic bone causes tissue damage between the vagina and the bladder and/or rectum, causing a hole, or fistula.

A woman visits her daughter as she recovers from fistula surgery at Addis Ababa Fistula Hospital in Ethiopia. Copyright One by One

A major outcome of this injury is chronic incontinence.  Uncontrollable leaking of urine and sometimes feces often leads to severe health consequences and sometimes death.  Due to the intense odor caused by the leaking, women are shunned by their families and rejected from their communities. Many women are left for dead in isolated valleys or simply expelled from their villages.  This catastrophic chain of events leads many women to despair and often suicide.  The real tragedy of fistula is that it is an entirely preventable and treatable condition.

The giving circle is a concept promoted by the Seattle non-profit organization, One by One, which is dedicated to eradicating obstetric fistula through research, education and fundraising.  One by One partners with overseas agencies to study the best prevention and treatment practices. Grants and donations pay for medical treatment at fistula hospitals, which provide surgery to sew up the injury, purchase equipment for the hospitals, and provide training to midwives and doctors.

Heidi Breeze-Harris, the co-founder of One by One, was drawn to the topic of obstetric fistula while she was pregnant and on bed rest, with only the television to help her pass the long days.  One day she saw a story on Oprah about fistula.

Moved by what she had learned, she later explained, I couldn’t, for even one more moment, abide hopelessness about the world that had been mounting in me so I got up and went to the internet to learn more [about fistula] and figure out how to give whatever I could.”

When I discovered Heidi’s work and the practical ways One by One is making a difference in women’s lives, I became excited about using my training as a public health educator to design an informative and interactive giving circle in my home.  I was touched by how many people wanted to contribute and get more information. I had hoped to raise $420, which pays for a fistula repair surgery for one woman and instead, ended up with $1600!

Hosting a giving circle was extremely rewarding for me and is just one way to make a difference. Going to a fundraising event like an annual dinner is another way to continue your support of an organization.  Your participation can take as little or as much time as you want.

Here are five ways you can make a difference:

  1. Educate yourself about obstetric fistula (or an issue you are passionate about) and tell your friends about this preventable health problem. One by One and The Fistula Foundation have useful information. A Walk to Beautiful is a wonderful movie about this issue.  It tells the story of several women who travel to Addis Ababa, Ethiopia, seeking the operation that would cure them of their debilitating condition.
  2. Read Half the Sky, an amazing book by Nicholas Kristof and Sheryl WuDunn, with inspiring stories about women who were able to escape their oppressive situations.  Fistula is discussed in several chapters of the book and several very practical ways you can help are described.
  3. Hold a giving circle. It is a way to build community, educate others, and raise money for this issue.
  4. Donate to One by One.
  5. Volunteer for One by One.

A fistula doctor in the movie, “Walk to Beautiful”, says:  “The future of these women is a real problem that involves all of us.”   And indeed, it takes a village to support these women who must travel long distances to get the treatment they so desperately need.

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1 Response to Making a Difference, One by One

  1. Kristin Distelhorst says:

    This is a lovely summary of such a tragic and preventable public health problem.
    Thank you,

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