‘To be in labour is to have one foot in the grave’

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My research trip to Tanzania is fast approaching and I have been doing a lot of reading around the whole subject of OF. Fistula itself is considered a debilitating and devastating condition which is directly caused by prolonged,  obstructed labour. Where the babies head, or presenting part,  is  too large to pass through the mother’s pelvis it is impacted against the soft tissues of that region. If this situation is left unattended blood supply to the soft tissues is compromised and widespread vascular injury occurs, eventually resulting in the formation of a fistula, or ‘hole’ between the bladder and/or the rectum and the vagina. This leaves the woman with uncontrollable incontinence, sometime doubly so, and they become, as according to one quote I found, ‘urological cripples’. To add to their suffering, in the vast majority of cases the baby is still-born.

With this is mind, the above quote, taken from a personal account of a women with obstetric fistula,  stood out for me as particularly harrowing given the complete emotional reversal it implies, in terms of the way birth is celebrated in the West. In Western culture, the high standards of medical care ensure that being in labour is most often a joyful  –  if painful! – experience, but for women living in countries where cultural norms are very different, and medical provision is far less advanced, widespread incidence of maternal birth trauma such as fistula is a very real factor. As such, the birth experience for many women in Africa is a very different story to the one we would wish to hear told.

The Drawing Out Obstetric Fistula project nevertheless aims to listen to just those stories.

Using a similar methodology to to that of  Drawing Women’s Cancer , working with women suffering gynaecological cancer in the UK, as an artist, I will listen and talk with women in Tanzania who have lived with OF and who are now receiving treatment, and create artwork based on my experience of their experience as they communicate it. This project of course differs in that it crosses international, cultural and – perhaps most importantly – linguistic boundaries. Visual art will here become very much into its own as the driving force for the process of communication as a whole and I am excited and optimistic about the its potential to traverse  international, cultural and linguistic borders. What I am most interested in is how to address the total experience of having OF,  experience that entails not just the physical pain and trauma that comes with the multifaceted nature of such an injury, but also the devastating assault on self-perception and the emotional and psychological issues that are caused by social and cultural stigmatisation.

On the other hand, I also want to celebrate the resilience and fortitude of women suffering OF, the strategies that they develop for living with such a condition and the strength with which they endure treatment and rehabilitation. There are always two sides to any story.