Dr. Lewis Wall (with shovel), the EMI architectural team, and Danja Hospital staff broke ground for the Worldwide Fistula Fund's Fistula Center this past May.

Architectural rendering of the WFF Fistula Center

Day laborers from nearby Danja village, hired by the hospital to construct the WFF Center, dig the foundations.

Blank stares generally greet Lewis Wall when he discusses obstetric fistulas, which result from obstructed labor. But hundreds of thousands of women throughout the developing world who do not have access to Cesarean sections suffer from them.

Dr. Wall, who has dual appointments in Arts & Sciences’ Department of Anthropology and the School of Medicine’s Department of Obstetrics, has spent nearly 15 years trying to solve this problem pandemic throughout much of Africa. Now, through the nonprofit Worldwide Fistula Fund (WFF) that he helped found, Dr. Wall is building a hospital in Niger.

“This has been a persistent dog barking in the night, and we’ve finally attracted enough attention to build this special fistula hospital,” Dr. Wall says.

Obstetric fistulas are abnormal connections between the bladder and vagina that can lead to a lifetime of pain and misery. While largely absent from the developed world for more than a century because Cesarean sections prevent labor from continuing for days when a baby’s head cannot fit through the pelvis, obstetric fistulas persist in developing nations with bitter poverty and poor medical infrastructure.

“We’re trying to build a model facility in terms of its philosophy and architecture, a facility that can be exported to other parts of the world where this is a problem.”

“Because fistulas are not fatal, there are hundreds of thousands — if not millions — of women living with this, mostly under the age of 20,” Dr. Wall reports. “When it happens, in effect their lives are over because they get pushed out by their families and pushed into a cycle of worsening physical conditions that sometimes ends in suicide or death.

“The injuries don’t heal by themselves,” he continues. “But, in most cases, they can be healed using low-technology surgery. The total cost of care is only a couple hundred dollars. If you can repair them, you can transform these women into healthy women with hope.”

WFF broke ground on its new center in May 2008 and hopes to open within a year. Dr. Wall and others will make regular trips to help provide care at the hospital. In the future, the hospital may also be a site for ongoing medical anthropology field research.

In the long run, Dr. Wall hopes that the groundwork laid in Niger will help address the problem of fistulas wherever it occurs: “We’re trying to build a model facility in terms of its philosophy and architecture, a facility that can be exported to other parts of the world where this is a problem.”

For more information, visit http://www.worldwidefistulafund.org.