Tuesday, October 2, 2012

Fistulas Are for Everyone

So I was reading about obstetric fistulas the other day in Half the Sky (mentioned here). For those of you who don’t know (like me) and don’t want to go to Wikipedia, obstetric fistulas are painful holes that develop between the rectum and vagina. They’re usually caused by poor medical treatment when a woman is giving birth, but unless surgically fixed, will continue to be humiliating and painful holes for the rest of a woman’s life.

What kinds of pictures do you put in a post about fistulas
and worms? Landscapes . . . 
That’s rough, you and I say, but there’s AIDS too. And poverty.

Call me callous, but I’m human and so are you: the world is full of suffering of one kind or another. We all agree these women with fistulas suffer (“the modern day leper” from one source), but so do lots of people—with muscular dystrophy, with cancer. The list of physical ailments goes on and on; fistulas are only one more problem.

Then I got worms.

You think and I wish I was joking. A week ago, all I knew about worms (the disease) was that we gave the dog pills for their prevention every month. Now I know so. So. SO much more. After I googled my symptoms and started reading, my first thought was this: I would rather re-label this apartment as my coffin and force the police to break down my door to discover the source of the worm-infested corpse stankiness than go to a doctor here in Korea for this. Ever.

. . . and happy memories. . .
Luckily it’s pretty treatable and aside from severe asscrack[1] itching, nothing but my self-esteem and all levels of comfort were destroyed. But even if no one knew—and believe me, until I figured out and took the first steps to treat it, no one did—I was ashamed. I still am. This post horrifies me just as it does you. Probably more so, because it’s disgusting and I feel disgusting and that’s the difference I had missed when I was reading about fistulas.

Shame. Fistulas are holes combining two parts of a woman’s body that women—especially women in traditional settings where fistulas normally occur—are never supposed to talk about. Undeserved shame is the real disease for these women, though that shouldn’t undermine the physical suffering of fistulas.

. . .and times when I'd never heard of a fistula.
It’s not like I hadn’t read that part: half the chapter was about a woman who was starving herself to death because she wanted to die due to her isolation. Not from the fistula, mind you, but from the shame. Still, I missed it in the same way you overlook words you don’t really know. The word is there; you see it and pass over it—until one day you learn its meaning and very suddenly it’s everywhere.

Fistulas are everywhere. Holes that aren’t supposed to be there and, anyway, “there” is not something we talk about. Maybe if we could talk about it, could give and receive our pain the way we do candy on Halloween—[2]asking for it, ready and willingly dropping into the asker’s hands—then physical fistulas, cancer, AIDS, poverty: they wouldn’t stand a chance.

[1] I apologize for the crassness, but it’s the half-hysterical giggle in my throat when I think about this word that makes me able to say it, unlike any of its socially more acceptable synonyms.
[2] Season references are always in style!


  1. Knew that book would give you things to think about! Well done. As always. Hope you're feeling better.

  2. My eldest sister has worked with patients experiencing the pains of fistulas in various places. I believe it comes often at a time in a woman's life when she also isn't appreciated as much in old age. It sounds like your experiences in Korea continue to unveil new dimensions, and areas of personal reflection and development. Hope you're doing alright!

    This post was nothing like my initial impression from your title. :)