On the Subject of Health Care

It is believed that 2 million women are living with fistula in the world today. Sarah Omega Kidangasi was one of them. She was a 19-year-old Kenyan schoolgirl when she became pregnant as the result of rape. Like many fistula victims, she lived in a small village, far away from a hospital with the equipment and personnel to deal with a complicated pregnancy. "Due to the distance, I was late to reaching the health facility," said Sarah, now 31. "I'd been laboring for 18 hours. It was unfortunate, in that village, they were lacking some of the equipment. I was transferred to another facility, a mission hospital, and I gave birth to a stillborn baby boy who weighed 4.8 kilograms [10.6 pounds]. Three days later, I was leaking urine, and I realized that I had developed fistula. I stayed in the hospital for two months, and I was discharged in the same condition."

Sarah's ordeal began in earnest when she returned to her village, where the leaking made her an outcast. This triple punishment of losing a child, living with a hole between her vagina and bladder and being isolated from her community is common, according to Kate Ramsey, global coordinator of the U.N.'s campaign to end fistula, which is now active in 45 countries. "In some countries, there's a misperception that women did something wrong, that she was adulterous," said Ramsey.

Pretty Lady brings this up, not merely to encourage a bit of consciousness and fund-raising on the part of her friends, but to illustrate a general point, which she has been noticing in recent Healthcare Discussions. To wit: that it is a general human tendency to blame others for their problems--nominally in order to disclaim responsibility for helping them, but subconsciously to avoid facing the fear that one day, It Could Be Them.

Now, when we look at a barbaric society in a far-away place, and note honored traditions such as raping young village girls, butchering them in substandard medical facilities, and ostracizing them for the results, we may clearly and comfortably declare, 'The horror!'

But she is here to tell you that we do this in our OWN society. In our OWN culture, we turn away from the ill, the disabled, the odiferous and the unfortunate, and look for reasons to blame them for their conditions. We cannot look suffering in the face, accept it, and accept the sufferer, even though this acceptance is far less difficult and painful than enduring the suffering itself.

We do this because most of us fail to understand one salient point: We don't have to fix it. Accepting the humanity and essential blamelessness of a suffering person does not entail anything other than that. It does not mean we must swoop in, pay their medical bills, build them a house, and wait on them hand and foot; it does not mean that if they continue to suffer, we have failed.

It may be that if we get into the habit of this acceptance, we may see more clearly how certain pervasive systems contribute to the problem, and how, with diligence, clarity and efficiency, they can be made to serve a better purpose. But this comes after the fact. First, we must bear witness.