Obstetric Fistula – a Menace to Maternal Health:
Does Fidelity to Country Obligations under the
Millennium Development Goals and Human Rights
Regimes Provide an Antidote?
Dr. Obiajulu Nnamuchi,* Dr. Edwin Ezike,**
and Dr. Jude Odinkonigbo***
“At first I didn’t see myself as a human being since people didn’t want to
be around me. Now, I see healing and it’s like life has returned again.”
Aminata, Sierra Leone.
“Like maternal mortality, fistula is almost entirely preventable. Yet at least
2 million women in sub-Saharan Africa, South Asia and the Arab region
are living with fistula, and some 50,000 to 100,000 new cases develop each
year. The persistence of fistula is a signal that health systems are failing to
meet the needs of women.” The United Nations Population Fund.
“Think for a moment of poverty as a disease, thwarting growth and
development, robbing children of the healthy, happy futures they might
otherwise expect. In the exam room, we try to mitigate the pain and
suffering that are its pernicious symptoms. But our patients’ well-being
depends on more, on public health measures and prevention that lift the
darkness so all children can grow toward the light.” Perri Klass, M. D.
Even if a work of fiction, the vignette recited below would still have been
disturbingly horrific. But this story, as raw and chilling and profoundly
compelling as the misery it narrates, is indeed true. The people are real – as
are the suffering, shame, pain and hopelessness that, in most cases, must
accompany them throughout their lives and unremittingly constrain their
agency and pursuit of individual goods. It is an account of human frailty and
vulnerability of the worst kind. For the girl whose tragic story is told, it began
in March 2004: 1
* LL. B. (Awka), LL.M. (Notre Dame), LL.M. (Toronto), LL.M. (Lund), M. A. (Louisville),
S.J. D. (Loyola, Chicago), Assistant Professor of Law, University of Nigeria; President &
Chief Consultant, Centre for Health, Bioethics and Human Rights (CHBHR) Enugu, Nigeria.
To those brave hearts (Western physicians) that were willing to sacrifice the comfort and
leisure of their home countries to labor under the most excruciatingly suffocating conditions,