New Life for the Pariahs

Perhaps the most wretched people on this planet are those suffering obstetric fistulas.

Fred R. Conrad/The New York Times

Nicholas D. Kristof

On the Ground

Nicholas Kristof addresses reader feedback and posts short takes from his travels.

Go to Blog »Go to Columnist Page »

This is a childbirth injury, often suffered by a teenager in Africa or Asia whose pelvis is not fully grown. She suffers obstructed labor, has no access to a C-section, and endures internal injuries that leave her incontinent — steadily trickling urine and sometimes feces through her vagina.
She stinks. She becomes a pariah. She is typically abandoned by her husband and forced to live by herself on the edge of her village. She is scorned, bewildered, humiliated and desolate, often feeling cursed by God.
I’ve met many of these women — or, often, girls of 13, 14, 15 — in half a dozen countries, for there are three million or four million of them around the world. They are the lepers of the 21st century.
Just about the happiest thing that can happen to such a woman is an encounter with Dr. Lewis Wall, an ob-gyn at Washington University in St. Louis. A quiet, self-effacing but relentless man of 59, Dr. Wall has devoted his life to helping these most voiceless of the voiceless, promoting the $300 surgeries that repair fistulas and typically return the patients to full health.