hide captionObstetric fistula is a terrible childbirth injury in which a hole is formed between the birth canal and the bladder or rectum during prolonged or obstructed labor. It leads to incontinence and, often, rejection by society. But advocates are helping these Ethiopian women with fistula get medical care and giving them the means to make their own livelihood.
![Obstetric fistula is a terrible childbirth injury in which a hole is formed between the birth canal and the bladder or rectum during prolonged or obstructed labor. It leads to incontinence and, often, rejection by society. But advocates are helping these Ethiopian women with fistula get medical care and giving them the means to make their own livelihood.]( "Obstetric fistula is a terrible childbirth injury in which a hole is formed between the birth canal and the bladder or rectum during prolonged or obstructed labor. It leads to incontinence and, often, rejection by society. But advocates are helping these Ethiopian women with fistula get medical care and giving them the means to make their own livelihood.")
Obstetric fistula is a terrible childbirth injury in which a hole is formed between the birth canal and the bladder or rectum during prolonged or obstructed labor. It leads to incontinence and, often, rejection by society. But advocates are helping these Ethiopian women with fistula get medical care and giving them the means to make their own livelihood.
Kristie McLean In 2010, well-traveled freelance photographer Kristie McLean arrived in Ethiopia, her first trip to the country. She was there to photograph women with an injury that can happen when a baby gets stuck during childbirth: obstetric fistula. It's a condition common in rural Africa and Asia, where women give birth far from hospitals and C-sections aren't readily available.
The injury is caused by prolonged, obstructed labor. (Fistula can also happen in cases of rape.) Often the baby dies. A hole — called a fistula — forms between the woman's birth canal and her bladder or rectum, leaving her incontinent, leaking urine or feces or both.
"Typically their husbands and their families reject them," McLean says. "They're completely shunned from society."
'I'm In The Wrong Place'
Fistula can often be fixed with a simple surgery, but women who are shunned by their families have little means of raising the money for treatment. They can be weakened physically and mentally.
So when McLean and another photographer on the trip were introduced to a new patient in Ethiopia's Hamlin Hospital, they were cautioned not to extend their visit past 30 minutes.
Those 30 minutes came and went, but McLean's partner kept shooting.
"The fistula patient was cowering, and was clearly not comfortable," McLean says. "And I said as much to my partner, and her response was: 'Don't tell me what to do. I paid thousands of dollars of my own money to be here and I'm going to get the shot.' I went outside and was just wondering, what the hell am I doing here? If this is what it's like to be a professional photographer, I'm in the wrong place!"
McLean stumbled out into the hospital parking lot. There, she met a young man covered with dust.
Tsega was an engineer who built grain mills in far-off villages. In his travels, he heard stories about fistula patients and was inspired to do something to help them. So once a month, he volunteered with a church group to transport Muslim women with fistula, three at a time, from their remote villages to this hospital in the capital, Addis Ababa.
The journey was two days each way. Tsega pointed to his dusty clothes and car.
"Very bad roads," he said. "Very slow driving."
Then Tsega told McLean a story.
Saved
The story he told, as McLean recounts it years later, was that he always traveled with three women, but on this particular day there were only two women available. There even was some question whether to make the trip or to wait for a third, because petrol is expensive. But they decided to go anyway, because the women were extremely ill.
hide captionWhen Ajayibe was 22, she tried to kill herself after being shunned by her family. Surgery could not repair the hole in her birth canal, but her story helped inspire an American photographer to start a project to benefit women with fistula. Proceeds from the project have enabled Ajayibe to have livestock of her own.
![When Ajayibe was 22, she tried to kill herself after being shunned by her family. Surgery could not repair the hole in her birth canal, but her story helped inspire an American photographer to start a project to benefit women with fistula. Proceeds from the project have enabled Ajayibe to have livestock of her own.]( "When Ajayibe was 22, she tried to kill herself after being shunned by her family. Surgery could not repair the hole in her birth canal, but her story helped inspire an American photographer to start a project to benefit women with fistula. Proceeds from the project have enabled Ajayibe to have livestock of her own.")
When Ajayibe was 22, she tried to kill herself after being shunned by her family. Surgery could not repair the hole in her birth canal, but her story helped inspire an American photographer to start a project to benefit women with fistula. Proceeds from the project have enabled Ajayibe to have livestock of her own.
Kristie McLean On the drive they encountered a crowd blocking the road.
"And Tsega got out of the car and asked someone on the side of the road, what's going on, what's happening?" Kristie recounts. "And someone said, 'There's a woman who's hanging from a tree. And she's trying to kill herself.'"
The woman had fistula. She'd been chased from her home by her husband and family, and she had nowhere to go.
"And [Tsega] was able to say, 'Come down from the tree, and come with us, and we have room for you in the car. We're going to the fistula hospital,'" McLean says.
The woman was 22. Her name was Ajayibe. In the Oromo language, that means "amazing."
The name Tsega means "grace."
Even today, McLean cannot tell the story without choking up.
"I don't know what it was specifically about that story because I had interviewed other really interesting, really lovely women," she says. "But I heard that story of Ajayibe and it changed something in me."
The Story She Needed To Hear?
Back home in Seattle, McLean told the story to anybody who would listen: strangers on airplanes or next to her in the supermarket's frozen food section.
Obstetric fistula affects up to 2 million women and girls around the world. And there are a number of fistula organizations already. But McLean collected enough money on her own to set up a new project in Western Ethiopia, in the region where Hijaibe lives, to help women support themselves after surgery. http://wholeheartedstory.tumblr.com/post/67457985865/red-roads-wide-skies-and-new-beginnings
hide captionTsega (left) is an engineer volunteering to help women with fistula in Ethiopia. A chance encounter photographer Kristie McLean (right) had with him led her to raise money for a grain mill that benefits the women.
![Tsega (left) is an engineer volunteering to help women with fistula in Ethiopia. A chance encounter photographer Kristie McLean (right) had with him led her to raise money for a grain mill that benefits the women.]( "Tsega (left) is an engineer volunteering to help women with fistula in Ethiopia. A chance encounter photographer Kristie McLean (right) had with him led her to raise money for a grain mill that benefits the women.")
Tsega (left) is an engineer volunteering to help women with fistula in Ethiopia. A chance encounter photographer Kristie McLean (right) had with him led her to raise money for a grain mill that benefits the women.
Courtesy Kristie McLean On her fourth trip back to the country, McLean took along a tape recorder. Three years had passed since she'd heard the story in the parking lot, and she'd come to celebrate. She'd raised enough funds to help Tsega build a special grain mill that would benefit women with fistula. The proceeds from the mill allowed women to own livestock.
She interviewed Ajayibe, who was ecstatic about her six sheep. Ajayibe was still living with the symptoms of her injury. There was too much scar tissue to fix the hole in her birth canal.
For the first time, Ajayibe told McLean the story of her attempted suicide, how she felt "completely out of options, out of hope," McLean says. "She found some rope and had strung it through the tree."
Except McLean now learned that the person who rescued her wasn't Tsega, the man named "Grace." It was one of Ajayibe's neighbors. Tsega didn't enter the story until two months later, when he heard about Ajayibe from villagers.
On the phone from Addis Ababa, Tsega confirmed Ajayibe's story.
"They were talking about Ajayibe, and I tell them, please bring this woman to me, I will take her to hospital," he said.
McLean wondered how she could have misheard such an important detail. Perhaps it was "pure interpretation," she says. "We were talking about a woman on the tree and then they're telling me that they brought this woman and that they had one spot left, so I'm not even realizing that there's a two-month gap."
Or maybe she heard the story she needed to hear.
Moved To Act
That day in the hospital parking lot, McLean was in a profound state of doubt about her life and career. The story she thought she heard suggested that the unlikeliest rescue can come exactly at our lowest moment of despair.
"There's times in our lives where we're that person hanging from the tree," she says.
hide captionWith proceeds from the grain mill, women have been able to buy their own livestock for income.
You could say this story rescued McLean, gave her a purpose. Intellectually, she knows that the true version is not that different.
"The pain is the same, and I think the sense of hope is the same," she says.
Just that miraculous cinematic timing — potentially a valuable fundraising tool — is gone.
"Emotion is what moves people to action," she admits. "That's the tender spot."
Now that she's met Ajayibe and the other women and seen their lives up close, McLean no longer needs a supernatural coincidence to be moved to compassion.
But if back then in the parking lot, she'd heard the real story, she might have just shaken Tsega's hand and walked away, never becoming any more than a stranger.