As we prepare to launch Jewish and Islamic Supplements to Fistula Stories, we are too excited to keep it to ourselves!  Let our Jewish Contributer, Rabbi Bonnie Margulis, pique your interest, and keep an eye out for the Supplements coming soon!

Why is Fistula a Jewish Issue?

Why should Jews be concerned about the issue of obstetric fistula?  It is not a condition that affects Western Jewish women. It does not have an impact on the state of Israel.  It does not have any connection to anti-Semitism.  So what makes this a Jewish issue?

Actually, the answer is really quite simple and straightforward.  Every issue of social justice is a Jewish issue. It is a core value of Judaism that all humanity, made in the image of God, is a partner with God in the ongoing work of creation.  We are always striving toward perfecting of God’s world.  Working to bring healing, wholeness, and health to women around the world is basic to that mission.

Whenever confronted with the question, “What does Judaism say about X?” the place to start is always with text, specifically the text of the Torah, the Five Books of Moses.  Thus, when writing the Jewish version of the fistula curriculum, I began with the foundational Jewish social justice texts.   The Torah teaches us we are all made in the image of God, and therefore must act as God acts.  As God is just, we should be just; as God is compassionate, we should be compassionate; as God cares for all the creatures of the earth, so, too, should we care for all the creatures of the earth.  Further, as we are all descendants of Adam and Eve, we are all brothers and sisters.  As such, we are all responsible, one to the other.  Leviticus 19:16 underlines the urgency of this fact, in enjoining us “do not stand idly by while your neighbor bleeds.”  The meaning is clear – we cannot be apathetic or uninvolved when another human being is in trouble and in need of help.  Isaiah 58 makes this even more explicit in its classic social justice manifesto.  Ritual, prayer, holiday observance, is all very well and good, but it is ultimately meaningless if it is not accompanied by acts of social justice, looking out for the weakest and neediest among us.

The emphasis Fistula Stories puts on raising up women’s own voices and bringing to light women’s experiences spoke to me as a Jewish feminist.  When we look to Jewish text for inspiration, lessons, and role models for our own lives, we realize the many ways in which women’s voices and experiences have been de-emphasized and even hidden in the stories of our people.  The task for Jewish feminist scholars has been to uncover those stories and bring women’s histories back into focus.  What we find when we read our sacred traditions through this lens, is that there are many role models to be found among the women of our past.  Strong women like Rebekah and Hannah faced difficulties in their lives, but they faced them bravely and head-on.  Neither was afraid to address God directly and ask for what they needed.  These and other strong, courageous Biblical women inspire us and show us that we, too, can have the strength to face diversity and find our own solutions to life’s problems.  I hope the Jewish texts and prayers in Fistula Stories will likewise inspire the Jewish community to get involved in the effort to end obstetric fistula.

Rabbi Bonnie Margulis, Contributer to Fistula Stories Multi-Faith Supplements,  holds a Masters Degree in Judaic Studies from New York University, and was ordained at Hebrew Union College (HUC), Cincinnati, Ohio, in 1992.  She currently works as a Jewish educator in Madison, WI.  Read more about her and check out the Jewish Fistula Stories Supplement.

Recently, my friend Seth, accompanied by his buddy Pete, began a pilgrimage on the Camino de Santiago de Compostela, a venture they describe as “Two dudes taking a very long walk in the staggering summer heat of northern Spain to tell the world about the plight of women with obstetric fistula.”

Seth and Pete figured out that it will take each of them about 1 million steps to walk the Camino–that’s one step for each woman in the world suffering from fistula.  Their goal is to raise 1 cent for each step–symbolically raising money and awareness.  Seth’s organization, Operation OF, is an excellent beneficiary that combines treatment with micro-lending to strengthen advocates who return to their communities and spread the word about maternal health.

This is not the first of Seth’s forays into “adventure fundraising”–in the past he has scaled mountains–and he wants to continue doing this kind of outreach that he feels particularly speaks to young men:  “Everyone has a mother.  Lots of us have sisters and many of us have girlfriends or wives.  How is the health of women not of fundamental importance to every man?”

Check out more and follow Seth and Pete along their 2 million steps at www.millionsteps.org!

Violence against women, especially rape as a weapon of war, is intimately linked to fistula and maternal health.  Traumatic fistula is a type of fistula caused by violent rape.  And women who are the most poor or vulnerable, and more likely to be raped, abused, or married off early, are also the least likely to receive the maternal health care they need.  By helping to pass IVAWA, you can help prevent fistula from occurring.

Want to get involved?  Here are WomenThrive’s action steps:

• Donate (your status). Post this as your Facebook status: Elephants, Polar Bears and Ivory have more preservation rights than women. http://bit.ly/cnkzV2
• Create (a video) explaining why you believe in IVAWA. Check out the 31 Days video and post your video as a response.
  

• Change (key Representative’s minds). A phone call makes a larger impact than an email. Here are tips on making an effective call.

• Advocate (with friends). Last week, you helped to get Congressman Reichert’s (WA) sponsorship for the bill. This week, let’s focus on Senator Richard Lugar (R-IN) and Representative Ileana Ros-Lehtinen (R-FL). Post a note on their Facebook wall.

• Share (what you know). Post the 31 Days flyer around town when you visit your local coffee shop, place of worship, library, or university. 
  

Read the full article online here: http://www.un.org/en/development/desa/newsletter/2010/july/feature.shtml#fea1

And check out the latest report on the Millennium Development Goals here: http://www.un.org/en/development/desa/area-of-work/mdg.shtml

The Magburaka Maternal and Child Health Clinic, photo courtesy of The Sierra Leone Ministry of Health and Sanitation

Healthcare in Sierra Leone, West Africa, a country of almost 5 million people, has always been dreadful as far as I can remember growing up in Freetown, the capital city.  The Time magazine, June 14, 2010, story of Mamma Sessay titled The Perils of Pregnancy: One Woman’s Tale of Dying to Give Birth by Alice Park reminds me of some of the painful cases of maternal mortality, which has growingly worsened in this African nation.  A co-worker, Meagan Manas of Women’s Ministries at the National Council of Churches (NCC) approached me to respond to Mamma’s story, which shows graphic images of this fourteen-year old, who hemorrhaged to death while giving birth.  In watching the photo gallery, I was angry, yet, relieved to know that maternal mortality and the issues of cultural beliefs and family pressure, teen pregnancies, survival, patient care, access to resources, fistula, and sometimes death are common and critical concerns for support and discussions, especially in communities of faith.

Sierra Leone is not only historically known for the Trans-Atlantic Slave Trade during the 17^th and 18^th centuries and the horrible Civil War (from 1989 – 2001) that claimed the lives of hundreds of thousands and left tens-of-thousands mutilated and shelter-less, but also ranks as one of the world’s poorest nations.  This ranking has lasted for over forty years and is far from ending, which also reflects on the country’s healthcare system.  Such is the story of Mamma, a common occurrence then and now.

From the photos we learned Mamma’s family forced her to marry at age fourteen.  This custom of forcing young girls to marry early and to bear children is deeply embedded in most African cultures and needs eradicating.  Education regarding abstinence and prevention will greatly help keep young people safe from sexually transmitted diseases, and, at worst, death.  Nonetheless, by age fifteen, Mamma had her first child and three years later, she was pregnant with twins.  According to Park, Mamma was accompanied to the Magburaka Government Hospital by her older sister.  They traveled by a canoe and an ambulance to see the only district doctor, who took almost a half hour to see her.  Mamma was even luckier than many women in labor who sometimes have to bribe officials or are abandoned at the hospital because they cannot afford the fees.  Park further states that Mamma’s twins were 24 hours apart because contractions had ceased by the time the second twin came.  Mamma’s vital signs and situation worsened.  In most cases, there is usually no blood transfusion or the proper technology.  As a result, Mamma painfully bled to death as she repeatedly screamed “I’m going to die.”  Mamma’s mother, Marie Yatteh who herself is a young woman was breastfeeding her child when a nurse broke the sad news.  She unbearably collapsed to the ground as other family members shockingly looked on.  She now has to care for the twins.  As Park writes, “In Sierra Leone, 1,033 women die for every 100,000 live births, one of the world’s highest rates of maternal mortality” a phenomenon that is “almost always preventable.” Mamma’s experience brought a few cases to mind.

Upon arrival in New York City in my teen years, I could recall from letters and phone calls the stories of four closest teenage friends.  We grew up on the same street along with several other schoolmates.  They all died while giving birth.  The sweet memories of playing, cooking, sharing lunch, braiding hair and so forth are still fresh in my mind.  Yet, the bitter pain of knowing that African women are progressively dying from childbirths and suffering from fistula,  resulting from poor economic and sanitary conditions, lack of education and information, inaccessibility to doctors and nurses as well as sub-standard medical care still frustrates me.  I asked myself, where is God in the midst of these events in life?

In 1996, I was in Freetown doing doctoral research on the African tradition known as the Naming Ceremony. After only one month of tracking women who were about to deliver at the main maternity hospital (at the time, one of two) in Freetown, I stopped visiting the hospital.  Frequently only the mother or the baby survived, or both died.  I was horrified–not to mention the filthiness around the only open grayish surgical ward that was neglected and ill-equipped.  In most cases, delivering mothers had to provide their own beds, linens, medications, and at most times, their own food.  But, most importantly, some of these women carried along with them their Bibles, Korans, and other objects which they clutched onto and even kept under their pillows for reassurance and hope from God.  I watched women with very strong faith face such hardship, and despite all their prayers some of these women still died.  The end result was that I rerouted my visit from the hospital only to find new mothers in their homes.

Traditionally, women gave birth in their homes or in huts outside their homes and were usually attended by midwives or elder female relatives.  During these times, families and their communities evoked the spirits of gods and likewise used forms of cultural herbs to protect both the mother and the unborn child from conception, through birth to the end of life.  Today, it seems as though birthing at home and all the religious beliefs as well as ritual practices around it are becoming the trend in Sierra Leone as maternal mortality increases in both hospitals and small makeshift clinics.  This alarming death rate not only happens in Sierra Leone but also across Africa and elsewhere is raising some serious concerns in the global community.  From the Time article, it is clear that the situation of maternal health and survival, including the condition of fistula, is one that is reversible as some pregnant women and the mothers of newborns receive treatments within weeks or months through organizations including Doctors Without Borders (DWB), the United Nations Population Fund (UNFPA), and Mercy Ships, just to name a few.

In conclusion, the need for health education pertaining to pregnancy, childbirth, mortality as well as prevention, treatment, advocacy, and empowerment in the lives of Africans–in particular Sierra Leoneans–especially in this post-war era is of utmost need.  Sierra Leoneans in the diaspora, specifically in New York City, are slowly addressing this issue in their groups such as the Sierra Leonean Nurses’ Associations (SLNA) and the Sierra Leone United Women’s Association (SLUWA).  Likewise, there are various international organizations, NGOs and individuals who are lending their voices and providing services.  It is my belief that change can only come to Sierra Leone and the world when like-minded people come together for this dying cause.  People of faith can actively engage in prayers, education, dissemination of information, fundraising, and partnering with local Sierra Leonean NGOs at home and in the diaspora to end the sorrows and embrace the joys of life.

Elizabeth Claudia During, PhD
Socio-Cultural Anthropologist

Traditional Birthing Attendants in Liberia pose with the “Operation Healing Hope” quilt that has traveled nearly 50,000 miles promoting a campaign to end obstetric fistula, a birth disorder affecting millions of women, primarily in poor countries. (credit: Rev. Jill Wiley, UMC)

Not so prominently featured on the same page, is this photo-essay about the perils of childbirth in Afghanistan.  These hidden stories must continue to be told!

This report from Women’s e-News gives a run-down of this week’s Women Deliver conference which focused on Maternal Health.  Energy is building towards the G-8 summit in Canada later this month where gender equality will be front and center.  Stay tuned!

CONTACT:
Jon Houston, Maloney, 202 225-7944
Kate Dickens, Castle, 202 225-4165

Reps. Maloney, Castle introduce bill to prevent and treat obstetric fistula

-Legislation could save lives of millions of women and babies globally-

WASHINGTON, DC – Rep. Carolyn Maloney (D-NY) last week introduced legislation, “The Obstetric Fistula Prevention, Treatment, Hope and Dignity Restoration Act of 2010,” H.R. 5441, which would authorize funding to prevent and treat women suffering from obstetric fistula, a horrific and debilitating condition that occurs in women after prolonged labor, predominantly in sub-Saharan Africa, Southeast Asia, and the Arab States.

“Women around the world are needlessly suffering from the horrors of obstetric fistula. The World Health Organization estimates that between 50,000-100,000 new cases of obstetric fistula develop each year, adding to the estimated 2 million current cases– yet this condition is almost entirely preventable, and treatable in 90% of cases when it does occur,” Rep. Maloney said. “My bill will help ease the suffering of women suffering with obstetric fistula and demonstrate the United States’ commitment to the health of women and children around the world.”

“I am pleased to be working with Rep. Maloney on this maternal health initiative, which will help address the avoidable agony caused by obstetric fistula,” Rep. Castle said. “By focusing on a coordinated and locally relevant approach to prevention and treatment, we can improve the health of women and children around the globe and give them a chance at living full and productive lives.”

The bill supports a comprehensive approach to end obstetric fistula – prevention to eliminate occurrences, treatment to repair those women who already suffer, and rehabilitation to help those recovering fully heal and reenter society.  It focuses on efforts to build local capacity and improve national systems to prevent and treat obstetric fistula.

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Complete text of the legislation may be found here.