By Ellen Ratner
Having just returned from Sudan (see last week's column), I made the usual rounds of telling people the story of what I had seen. My traveling partners and friends, Diane Gooch and Tony Sayeg, arranged for us to meet with House of Representatives Chairman Chris Smith. Chairman Smith, R-N.J., heads up the subcommittee on Africa.
Under normal circumstances, we would most likely not agree on what day it is. He is about as conservative as you can be, and I am about as liberal. However, rarely have I seen someone so devoted to a cause in Congress. He is a champion of human rights and women's rights. He has attempted to get all kinds of legislation through Congress on Africa and human trafficking. He has pushed though a lot, but politics has intervened in too much of it.
Chairman Smith told me about the legislation he sponsored on treatment of obstetric fistula. Obstetric fistula "occurs during childbirth when prolonged pressure of the baby's head against the mother's pelvis can lead to the child's death as well as cut off the blood supply of the tissues surrounding the woman's vagina, bladder or rectum, causing those tissues to deteriorate, and thus leaving an open hole or fistula.
The reporting on this has been scant at best with 2 million reported cases worldwide. Many think this is underreported with as many as 1 million cases in Nigeria alone. It's not just a small medical problem, as many of these women are abandoned by their husbands and families.
'We don't agree on politics. If we were on radio or TV, we would fight like cats and dogs. But Chairman Smith is a great American, and I am proud that he is willing to stick his neck out there when few are willing.'-- Ratner
Treatment of this costs as little as $150 per woman. It can also be prevented by proper nutrition during pregnancy and good obstetric care, which is often unavailable. In the area we work in, a population of about 1 million people, there are three doctors for a hospital of 70 beds. The entire county has five physicians for a million people.
Get on the Internet and you will find that Chris Smith's bill never passed. In fact one site listed it as "dead." However, Chairman Smith was undeterred. He went at it administratively, engaging the U.S. Agency For International Development. In its March 2011 report, USAID reports 30 centers for fistula repair in 11 countries. Most are in Africa, but four are in Bangladesh and one is in Pakistan. They have also trained well over 100 surgeons.
It is not just "repair and goodbye." USAID uses the opportunity for intervention by encouraging women to work with others toward social integration, teaching women working skills and helping women recover by telling their stories.
The program is also working with women to prevent early pregnancy, as well as increasing education for nutrition. There is a long way to go. USAID has repaired 18,000 women. That is a far cry from the millions that need help. It is making a difference, and as they say in development parlance it is "giving women a hand up, not a hand out."
To be blunt about why these programs are in the interests in the United States, as well as to provide direct help, it is important to understand that as these women become productive, they and the areas they live are not vulnerable to unsettling forces such as terrorism or extremism. Productive, healthy people do not need to join forces with the "bad guys." People around the world who are direct recipients of a "hand up" do not need to respond to forces that are contrary democratic institutions.
Chairman Smith has gone where few members of Congress refuse to go; he has had hearings on the slavery issue. He has taken on causes where there is not big constituency, such as women and fistulas. He understands that what we do in the world is important not only for "the least of these" but also for America.
We don't agree on politics. If we were on radio or TV, we would fight like cats and dogs. But Chairman Smith is a great American, and I am proud that he is willing to stick his neck out there when few are willing.
