Wobete Falaga, who is from a village in the northern Gojam province in
Ethiopia’s Amhara region, was only 13 when she became pregnant.
Married at 11, just before her first menstrual period, her small
underdeveloped body was not ready for the stress of childbirth. After five
days of grueling labor at home, her child was finally born, but it was dead.
As a result of the long, strenuous labor, Wobete suffered crippling injuries.
There was a hole, or fistula, between her bladder and vagina and another
between her vagina and rectum. The damage left her body unable to control
its normal excretory functions, and urine and feces were constantly
dripping down her legs. Her husband quickly rejected her, sending her
home to her family. Wobete’s mother took her to the government health
clinic in the province’s main town, Bahir Dar, but the nurses there said
they were unable to treat the girl. They advised Wobete’s mother to take
the girl to the capital Addis Ababa as soon as possible and said if her
condition remained untreated, she would face death from infection and
kidney failure. The family sold a cow to pay for the three-day bus journey
and arrived penniless at the gates of the Addis Ababa Fistula Hospital with
As incredibly touching as this story might sound, Wobete’s experience is
not at all atypical. 3 In fact, her ordeal is replicated in the lives of millions of
women in regions of the world where stifling poverty makes early marriage
appealing and restricts access to obstetric care. 4 Whilst fistula has been
“unknown in the West for nearly a century,” the condition remains pervasive
in several other countries, mostly in resource-scarce settings. 5 The World
Health Organization (WHO) reports that the poorest regions of the world,
namely, sub-Saharan Africa and Southeast Asia, are sheltering the largest
just to infuse a fresh lease of life to impoverished women in distant parts of the globe, and to
Ada Obi Nnamuchi, my able assistant, I remain eternally grateful. The usual caveats apply.
**LL. B., LL.M., PhD (Nigeria), Associate Professor of Law, University of Nigeria.
***LL. B. (Enugu), LL.M. (Dalhousie), PhD (Osgoode), Assistant Professor of Law, University
1. Sonny Inbaraj, Married as Children, Women with Obstetric Fistulas Have No Future,
POPULATION REFERENCE BUREAU (Mar. 2004), http://www.prb.org/Publications/Articles/
3. Consider, for instance, this description of a patient by Dutch fistula surgeon Dr. Kees
Waaldijk in 2005: “She managed to push out only her baby’s head before collapsing from
exhaustion in her hut, he said. Her brother carried her, balanced on a donkey, to a road, where
a bus driver demanded 10 times the usual fare to take her to a hospital. She half-stood, half-sat for the trip, her dead baby’s head between her legs, her urethra ripped open.” See Sharon
LaFraniere, Nightmare for African Women: Birthing Injury and Little Help, N. Y. Times, (Sept
28, 2005), http://www.nytimes.com/2005/09/28/world/africa/nightmare-for-african-women-
4. See When Childbirth Harms: Obstetric Fistula, UNITED NATIONS POPULATION FUND 3,
available at http://www.unfpa.org/sites/default/files/resource-pdf/EN-SRH%20fact%20sheet
-Fistula.pdf (last updated Dec. 2012).