Tuesday, June 14, 2005

Niger and fistulas and hope

I don't ordinarily read the Wall Street Journal. It's one of the periodicals that isn't available for free online, and I've never felt such a deep need to read it that it seemed worth the price to me.

But I'm reconsidering, mainly because of an article by Roger Thurow that appeared in yesterday's WSJ. I came across it only through a fluke--on rare occasions, in an attempt to entice me into buying it, a free copy of the WSJ simply appears on my doorstep, and that's what happened yesterday.

Perhaps they know exactly what they're doing, because this particular article was enough to make me think I should be reading the paper regularly. The title, "Married at 11, a teen in Niger returns to school," gives little hint of the depth within.

I assume that most readers here are not subscribers, so I am going to summarize the article for you. It deals with another sad fact of sexual and reproductive life for Moslem women in the area of the southern Sahara--the first, of course, being what is sometimes euphemistically referred to as female circumcision, but is more correctly known as female genital mutilation. The second is the prevalence of early marriage, pregnancy, and fistulas, common in an area stretching from Eritrea to Mali.

Yes, these topics are sickening and sad, but so are the realities of these women's lives. But the story is not without hope, as you will see.

What's a fistula, and why are they so common in these countries? This article highlights Niger, where girls are typically married even before the arrival of puberty, although they don't ordinarily live with their husbands until after reaching puberty (the girls, that is--not the husbands, who are typically older). At that time sexual relations commence, often leading to very early pregnancies. In addition, the girls drop out of school on marriage, which means they leave primary school, never to return.

Many teens' bodies haven't yet matured enough to deliver vaginally, but in all of Niger, only 10 medical centers are capable of performing Caesarean sections. A fistula is caused by unrelieved, protracted labor. The pressure of the baby pushing for days causes a hole to tear in the wall between the bladder and vagina. This results in uncontrollable leaking of urine.

These restrained words convey an almost unimaginable but unforunately commonplace horror--girls barely emerged from childhood themselves, enduring painful and lengthy labors, and ending up with a defect that causes them to become outcasts.

More than one million young women with the condition are scattered throughout the so-called fistula belt...Because of their severe incontinence and smell, many have been ostracized by their families and villages and live by themselves or with fellow fistula sufferers.

Horrible, tragic.

But, strangely enough, this ends up being a story of incredible courage and heroism on the part many people--and, especially, of familial love.

The author follows the story of a young girl in Niger named Anafghat Ayoub. Hers is the usual tale of extremely early marriage, dropping out of school in the third grade, and very early pregnancy. Her husband had left for work in Libya, her mother was dead, and her father was a poor goat herder with several daughters younger than she. Here is what happened when Anafghat was ready to deliver:

After three days in labor, Mr. Mahomed [Anafghat's father] knew he needed help. He scraped together money from friends and relatives to hire a car to take them to the nearest town with medicine and maternity nurses. For about 60 miles they bounced over rutted dirt roads [imagine this journey, after three days of exhausting and unproductive labor!]. Once there, the nurses said they weren't equipped to handle her delivery. Mr. Mahomed hired another car, for $40--a fortune for a goat herder. It took them to Niamey, the nation's capital, more than 100 miles away down a paved road pocked with potholes.

So the same father who had married her off at such a tender age (for the brideprice of a precious camel--a camel that ended up either lost or stolen, by the way) is the father who now was willing to go through fire to save her.

At the hospital, doctors performed a forceps delivery of her stillborn child. Anafghat lived, but she now had a fistula "the size of a baseball," and an infection, which the doctors staved off. But they could do nothing about the fistula.

Anafghat stayed at the hospital for four months, awaiting the arrival of a team of American doctors, who have been to Niger six times already to help women like Anafghat. When they finally arrived there, she endured a three-hour repair surgery, performed by a volunteer surgeon from Johns Hopkins. She has since recovered nicely.

During her recuperation, Anafghat noticed a woman from Niger who was a medical student making the rounds with the American doctors. Anafghat, the goatherder's daughter from the rural village, was extremely taken with her, saying: I want to live in Niamey, be a doctor and be an important woman. And she extracted a promise from her chastened father that she would be allowed to return to school, unheard of for a woman (or, rather, girl) in her situation.

And so she has returned to school, and she's doing very, very well. According to the school's director: The others call her "the college student" because she is so smart and older...

Anafghat is back living in the small round hut with her family. She and her father say she has no plans to return to her husband and she will stay with her family until she advances to the higher school. And she wants to make sure her younger sisters follow her. Mr. Mahomed sat on one of the beds stirring a bowl of rice, surrounded by all of his daughters.

He says he will keep his promises to Anafghat. "Even if one of my daughters asks to get married while they are still in school," he says, "I will refuse."

I have to say that this story--which is much longer and more detailed than I've excerpted here--moved me to tears; first of rage, and then of inspiration. People like this will be the ones to build the foundation of a better future for the women of the area, if allowed. There is great hope that this movement will grow. Hear what Sabou Ibrahim, director of the National Hospital, has to say:

A fistula woman who is repaired and goes back to her village brings many changes...All the women get together and they talk about the risk of having a child so young."

Before, I suppose these "fistula women" stayed away, shunned by all. Now they can go back and spread the word, and have a good chance of preventing this from happening to others.

The more people see it is in their own interest to decline to follow a traditional cultural dictate which has led in the past to so many blasted lives, the more people will feel comfortable doing so. Then the practice (and the fistulas) will disappear from these societies--and not a moment too soon.

ADDENDUM: I wanted to include a link to the agency sponsoring the American doctors, the International Organization for Women and Development, Inc., founded by Barbara and Ira Margolies of Rockville Center, NY, and also to give them a donation. But I couldn't find a webite for the group. This was the closest I could come, a feature on one of the doctors. If anyone can get any better information on this organization than I was able to find, please post it in the comments section. Thanks.

ADDENDUM TO ADDENDUM: Reader Marianne has found the website, which is here. And this is the donations page. Thanks so much, Marianne!


At 11:57 AM, June 14, 2005, Blogger Dymphna said...


Many thanks for your email about this story. Very moving. I'll get something up tonight about it.

You know Ayaan Hirsi Ali was forcibly held down by her grandmother when she was five...these clitorectomies are done without anesthesia.

This young woman, like Hirsi Ali, is unbelievably resilient. It is awe-inspiring. And like Mukhtar Mai, she's fighting the system.

BTW, all three have strong fathers who gave them spine. We can argue with this young woman's being sold off, but that's usual and customary. His fight for his daughter's life is not. Same with Mai. Her father and her imam were the ones who gave her the strength to not only refuse suicide (the usual response in Pakistan to village-condoned gang rape...I guess so!) but to fight her rapists legally. As a result, she's garnered support world-wide and is changing the face of the world she lives in: schools, electricity, etc. Of course, right now they won't let her leave the country because they're afraid if she came on a speaking tour to America she would bring "shame to our country." Amnesty Intl is sponsoring her trip. Or trying to.

Here's a link to some information I have on Pakistani abuse of women. It's estimated that 70-80% of Paki women are abused. Hard to credit, I know, but looking at the common-place nature of the stories when they make the Paki press you know it's only the tip of the iceberg.

The Pain is Etched in Her Face

Warning, though -- I put up a graphic picture. I sometimes do that when it seems the words don't convey the reality (for someone who suffers from PTSD, believe me it's not easy to look at).


At 12:33 PM, June 14, 2005, Anonymous Anonymous said...

The "genital mutilation" of men, better known as circumcision, is a wide spread practice in the West.

In some cases, this practice does lead to mutilation. We know that it causes a significant loss of sexual sensation.

So, a practice that is close to universal in the West doesn't seem to grab your attention, but a similar practice in Africa does. Why?

I'm going to ask this blogger again. When are you going to begin to question the sledge-hammer indoctrination in feminism that you received alongside your leftist indoctrination in the Vietnam War?

At 12:49 PM, June 14, 2005, Blogger goesh said...

Well, it's clear that I am going to have to compose a Shouting Thomas ballad to compliment my Burkah Blues song which is just about finished. Tom, I just flat out don't know what to tell you, but I will try. Have you considered assisting Howie Dean with some of his rants?? I do see a future for you there. I guess I will be the first man to fess up here and tell the whole world that I had my foreskin removed as a baby. I was cut!! OMG! Should I demand my tonsils back too, and my wisdom teeth while I'm at it - whataya' think, Tom? Surely you are a prankster! Sledehammer indoctrination? HA! HA! That's good, in fact that is the best I have read in a long, long time. I doubt you will believe me when I tell you I have had no problems with sexual sensation due to being cut, or am I just so deprived and oppressed that I don't know any better? We have gone from clitorectomy to viet nam. What a journey you are taking us on, Tom. I need to close and start on my ballad for you now.

At 12:49 PM, June 14, 2005, Blogger Alex said...

ST, enough already! The physical analogue of female genital mutilation is not circumcision, but, as any doctor could tell you, cutting off the penis! That does not happen in the west. You've made a extremely false analogy, though one I've certainly heard before...

At 12:55 PM, June 14, 2005, Blogger Dymphna said...


Are you really comparing clitorectomies with circumcision? Are you kidding? Surely you are.

A clitorectomy removes the hood, the clitoris and often the labia minora. If often damages the urethra.

Circumcision is removal of the foreskin. If you want to make them comparable, you'd also have to remove at least the glans, or head of the penis.

Granted some circumcisions are botched. And it may be that this procedure makes for some insensitivity. However, with a clitorectomy, ALL, and I do mean ALL sexual sensation is totally removed.

I guess women will stop their sledgehammer tactics when more men stop seeing women as nails to be hammered. Right now, the statistics aren't so good.

Perhaps you could find a site devoted to ending circumcision of little boys. It would be a good place to put your energy.

Good Lord, fellow, get a grip.

At 12:58 PM, June 14, 2005, Anonymous Anonymous said...

Remember Baghdad Bob? I wonder if Tom isn't him? Baghdad Bob has been given a reprieve by the Iraqi government and has been secretly hired by someone to do his thing? I bet this is sort of a test to see how it will fly.

At 1:02 PM, June 14, 2005, Anonymous Anonymous said...

I bet some of Neo's friends in good natured humor will start calling her Sledge now........ This is unreal!!

At 1:03 PM, June 14, 2005, Anonymous Anonymous said...

Western feminism men are a constant source of amusement.

Once again, I'll tell you. These attempts to ass kiss feminist women grew out of the college boy tradition of playing at sensitivity in order to get laid.

Until you being to reconsider the brain death that has been imposed on you by feminist dogma, you will remain utterly incapable of thought.

I suggest a reading of Warren Farrell's work.

I will retire for the day, boys and girls, so that you can bombard yourselves with feminist boiler plate. You are all quite well indoctrinated.

One day, you might just consider ceasing being manipulated by feminist women.

I suggest that you consider dumping your feminist woman. Try meeting and dating non-feminist women. You'll discover that most of them are educated achievers. It's also a lie that its necessary to be feminist to be educated or to achiever.

I've done my work for the day. Five decades of being bombarded with feminist dogma in grade school, high school, college, post-graduate school and on the job can't be undone in one day.

At 1:10 PM, June 14, 2005, Blogger goesh said...

What a hoot! I'm sorry, Sledge, ah, I mean Neo, but it is catchy you know now that Anonymous mentions it. You are able to, ah, 'hammer' home some good points you know. Wasn't there some kind of TV sleuth or cop named Sledge? I hope I haven't offended you.

At 1:14 PM, June 14, 2005, Anonymous Anonymous said...

Shouting Thomas,

Between the two of us... eh-hem... I'm a little shy... but I had that, you know, procedure when I was a little one... let's just say my business is working just fine.

At 1:26 PM, June 14, 2005, Anonymous Anonymous said...

Terrific post. Thanks for summarizing that article.

I found the Web site for the International Organization for Women and Development, Inc.; here's the link:

At 1:31 PM, June 14, 2005, Anonymous Anonymous said...

I've read some of Farrell's work.
He's good, but you don't want to consider him the Unified Field Theory of Cosmic Organization.

Sure, men have it rough. In a discussion of how women have it rough, we'll discuss how women have it rough.

At 1:33 PM, June 14, 2005, Anonymous Anonymous said...

I have exited this conversation. I've e-mailed my challenge to the writer of this blog.

bob, you are the most pathetic example of the absolute destruction of the western feminist man, bragging that you don't care what happens to you in favor of weeping over the fate of women.

I've lived in leftist communities throughout my life so I know you quite well. Underneath the purported self abnegation is a vicious predator turned perverse, a predator willing to do any level of harm to his fellow man to curry favor with worthless women. (And by this I do not mean feminist women. I mean worthless women, a subject to long and deep to ponder in this blog.) You are very dangerous.

At 1:35 PM, June 14, 2005, Anonymous Anonymous said...

Anonymous is right.
Feminist interest in such issues is inversely proportional to the possibility George Bush--and the US--might get credit for fixing them.

At 1:42 PM, June 14, 2005, Blogger Alex said...

RE: Shouting Thomas

This post is not addressed to Shouting Thomas, but to everyone else on these threads. I've already made a good-faith effort to talk to him here but his response, directly below mine, addressed absolutely none of my points. Which was unsurprising.

The question is, how does one deal with a troll? Most of the trolls on this blog come from the left, but ST here has proven this need not be so. (Does ST come from the right? From Mars? It's unclear.) And indeed trolldom has little to do with one's views, but much more with how one behaves. I like to enumerate lists, so here goes one. What makes a troll:

1. lack of evidence/hand waving -- ST only talks in generalities. He's afraid to let himself get pinned down with specific statements about specific people and events.

2. moving the goalposts -- when he makes a mistake by making a verifiable declarative statement (like his equation of clitorectomy and circumcision), and when people "hammer" him on how wrong that statement is, he quickly moves on. Back to unrelated generalities! Never address your critics!

3. repetition -- ST writes: Feminism is a religion. I'll repeat that as many times as you wish. I think I speak for everyone when I say that several hundred more times wouldn't be enough to convince us of whatever it is you're arguing for...

4. unclear goals -- Does ST have a clear agenda? Would he like to take away the vote from women in the US? More clitorectomies? He just seems to like to rage against anything connected to improving the state of women.

5. stooping low -- Leftist women really have you by the balls, boys. And a tinfoil hat has really got you by the head!

Why bother listing this crap? Because trolls are all like this, in one way or another. And they always come round, whether peddling anti-feminism or conspiracy theories about Jews in the towers or what have you. On one hand they're kind of fun -- they get the blood pumping and make good sport. On the other hand, they distract from productive conversation. (Anyone figure out how to donate to that foundation yet?)

The blogosphere has so far figured out no good way to deal with trolls, other than by banning, which tends to offend my liberal sensibilities (probably inculcated through countless hours of feminist brainwashing) and furthermore often doesn't work. So what to do? I recommend ignoring. So very tempting to engage, but man, it does nothing.

ps. if neo-neocon needs a nickname it should be Sister Sledge...

pps. I see ST has graced us with his exit. Long may it last.

At 2:11 PM, June 14, 2005, Anonymous Anonymous said...


You said, "I've lived in leftist communities throughout my life so I know you quite well. Underneath the purported self abnegation is a vicious predator turned perverse, a predator willing to do any level of harm to his fellow man to curry favor with worthless women."

You got all that out of me saying my "business" works fine? Who said I was weeping over anything? I was just using a little thing called humor. You should check it out some time. It's a great anger management tool. Oops, shouldn't a mentioned anger management. That will open up a whole new can of "worms." Worms, that's humor too. I hope you liked that one.

At 2:13 PM, June 14, 2005, Blogger Asher Abrams said...

Neo -

Thanks for posting this important piece. I will link it ASAP.

At 2:17 PM, June 14, 2005, Anonymous Anonymous said...

Well, Alex, since you challenged me:

This is a blog run by a psychotherapist. What do you call agonizing about a problem beyond your control and jurisdiction, like genital mutilation in Africa? What is the psychological term for ignoring a real problem in your midst (like male genital mutilation) while focusing on that problem beyond your control and jurisdiction?

It reminds me of the old joke about husbands: They're in charge of foreign policy, while the wives are in charge of everything else.

Feminism is a religion, as your post proves.

I'm not a troll. You are. I challenged the author of this blog directly because she's focusing on a problem that is outside her control and purview, while she's ignoring a problem well within her control and purview.

Leftist feminist women do have you by the balls. This is not the statement of a troll. It's the statement of a man who's had the guts to challenge the orthodoxy of feminist women. The fact that you aren't bright enough to understand what I say doesn't mean much, except that you're not very bright.

This conversation has not focused on me for no reason. I actually have something to say. You don't. I've exposed you to one or two ideas you've never heard before. You have nothing to contribute except for the usual platitudes.

Perhaps, you should retire until you actual have something interesting to say. So far, it's the usual BS.

At 2:50 PM, June 14, 2005, Blogger Dymphna said...

ST, I'm intrigued.

1. What is your definition of a feminist?
2. What is your definition of a masculinist?
3. Are these complementary terms or are they opposed?
4. Did you notice that in my first post I praised the resilience of three badly damaged women and gave their father credit for this capacity? Here's what I said:

...all three have strong fathers who gave them spine...

Mean and women need one another. Children need men and women intimately involved in their lives.

I'm concerned about the treatment of women and children in Islamic countries because the torture is so extreme and wide-spread. Men are more randomly abused in that system; they are not deliberately targeted. With women and children it is rampant and egregious.

If we are going to have any semblance of order here, we have to begin where it is worst and, in some ways, most threatening.

In a post-9/11 world, which is the focus of this blog, such issues are germane.

Sooo...how do you define the terms and what is their context?

At 6:14 PM, June 14, 2005, Anonymous Anonymous said...

What a shame that such a thoughtful and important post is being drowned out by the nonsense of a raving troll. Rants from trolls are best ignored, just as you'd ignore the tantrums of a two-year-old. And Neo, thanks for your post and its message of hope.

At 7:09 PM, June 14, 2005, Anonymous Anonymous said...

Shouting Thomas--Perhaps it's time to change your name. Shouting, and insults, are not going to get you anywhere. If you, or anyone, has a point to make, it's best to make it with at least some semblance of politeness. Do you really think you enhance the strength of your arguments by random potshots at people here?

I actually am very conversant with the literature on the pros and cons of male circumcision. In my opinion, some of the criticisms seem valid, some not. I could get into a lengthy discussion of it if it were an issue I choose to discuss, but at the moment it's not. Most men who are circumcized seem to have a minimum of problems with the process. Whether it should be routinely done for non-religious reasons is in fact an issue that can rightly be debated, and there are definitely arguments to be made on behalf of those who say, "No." But to equate it with female genital mutilation is incorrect, in my opinion.

This post of mine, by the way, is not about female genital mutilation at all. I mentioned that in passing as something that exists in the same geographic area in which the problem I am writing about, fistulas, occur with great regularity. Fistulas, however, are not connected to female genital mutilation. If you read my post, you'd see they are a result of very early pregnancies combined with very poor health care. In fact, this entire post has as its message the fact that this is something we actually can do something about, by donating to the cause of sending physicians to repair these fistulas, and enabling girls such as Anafghat to go back to school and have better lives. I don't care whether one calls this feminism, humanism, liberalism, conservatism, neoconism, or any other "ism" you care to call it. I call it good.

At 7:51 PM, June 14, 2005, Blogger Dymphna said...

Well, the comment section often ends up branching and re-branching, like a crystal...it can be intellectually stimualating when it takes on a life of its own. Even when the trolls jump out from under the bridge and want to take the ball and run away with it. Even then, it's grist for the mill of the mind.

What I got out of it was the address. I came back here to get it and link to it -- I believe Marianne listed it.

Like you, I think kvetching should be limited and solutions should be plentiful and varied. With the MSM still in charge, finding the information can be time-consuming. For example, it took me a looong time to any extra info on the couple in Colorado. Some of it I googled on news (though not google news) and some of it thru googling the guy's place of work.

Anyway, thanks for the forum and the hospitality...I'm off to put up something about the work the docs are doing to repair these women. I carry with me the story of that father...what love.

At 10:44 PM, June 14, 2005, Blogger Psycho said...

I found the fistula article very informative. I feel bad for those little girls. :(

About the other semi-non-related comments.
Anonymous said...
"Once we feminists can prove in a convincing manner that American males are at fault for all of this, we will get on board and liberate these women. Until then and until Bush is willing to tone down his blatant Christian views, the beneit of the doubt will be given to islamic culture.
Ciao! - Betty and Gloria

That's trolling (or ignorance), what's going on in Niger has nothing to do with American males. Christianity and Islamic culture? Bush professes to have christian views, but that doesn't make him one, if he was, how would that give any benefit of the doubt to Islam? (no wonder you were anon.)

Businesses have used US feminism to lower the standard of living, as more two income families emerged, pay has not increased well, making it difficult for one income families. Yes, I think women should have the right to work outside the home, but one parent should be home for the children. (nobody can love your children like you do.)

US men aren't as pampered as some women think, equal pay for equal work is TRUE here, or companies (interested in making money) would only hire women. Some nations don't have gender equality, but the US does for the most part.

It felt strange to me when I heard how the father traded his daughter for a camel. It shows that some women are treated very poorly in other nations and also how some nations indoctrinate their people to think so little of their children. I could care less about being PC, feminist, or masculinist. The only view I hold concerning those type of isms, if I had to label it, would be Equalist. I think everyone in their hearts really thinks equal is the only fair thing.

At 6:25 PM, June 15, 2005, Blogger Dymphna said...

Wow...that's quite a summing up.

What is the definition of equal?
What is the definition of fair?
Who gets to define these terms?
Who gets to decide what is which?

Reminds me of when the kids were little: one would divide the piece of cake and then the other would get to choose which part he wanted. Now *there* was some equal and fair for you. Took a looong time divvying that sucker up.

At 3:02 PM, June 16, 2005, Blogger Psycho said...

Answers to your four questions:

1 Equal: "Having the same privileges, status, or rights"

2 Fair: "Just to all parties; equitable"

*note they both have derivatives of the Latin word aequlis meaning "even" in their definition, or as the word it's self.

3 They already have definitions.

4 Everything that is equal cannot be differentiated, because it is equal. If your definition of equal is different than someone elses it is obviously not equal.

Like your cake example, here's another instance of fairnes:

If Joe puts a price on an apple of $1, and I think it's fair, I pay $1, and Joe gives me the apple. On a larger level it could be debated whether he or I got a fair deal, but it is irrelevant, as I was willing to pay the price he was looking to sell it for.

If Joe was to tell me I had to pay double because I was different than him, that would obviously be unfair. I would refuse to buy apples from him, tell all my friends, and Joe would go out of business. Things naturally tend towards equalitiy, even when you talk about laws of physics.

Was there something specific that you wanted to point out to us that is unfair to you? Show me some evidence, give me some time to look up the facts. If I can deduce an inequality, I'd be glad to help change it, even if it's only spreading the word. ;)

At 10:02 PM, June 19, 2005, Blogger David said...

This post actually made me kind of happy, because I had been under the impression that RECTAL/vaginal fistulas were what everyone was talking about in Africa. That bladder thing practically sounds delightful next to what I thought was going on.

Nabokovian Psycho: I'm pretty sure Anonimouseses's comment was a joke.

At 5:28 AM, June 23, 2005, Blogger Psycho said...

Ouch, but the article didn't mention rectal vaginal fistulas either way. It seems logical that between Eritrea and Mali there are quite a few RVF's. VF's are probably just the most common.

P.S.-I never understood sarcasm, don't care to either.


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