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Rough Cut
Sierra Leone: Yeabu's Homecoming
Overcoming the stigma of a childbirth injury


Jenny Chu

Jenny Chu recently earned her master's degree from U.C. Berkeley's Graduate School of Journalism. After spending years as a still photographer, she recently shifted her focus to documentary film. For her photographic work, she has traveled extensively, documenting the ethnic minority groups of China, the massive changes overtaking Shanghai, and the struggles of those in war-torn and poverty-stricken African countries.

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Length: 13:39

Throughout the developing world, more than 3 million women suffer from a little known yet devastating medical condition called obstetric fistula. It is essentially a hole worn away in a woman's bladder or rectum due to prolonged labor and inadequate medical care. Eradicated in the U.S. and Europe over a century ago, at least 100,000 new cases develop annually in Africa and Asia, of which less than 7,000 get treated. Women with obstetric fistula live in constant shame and humiliation because they drip urine or feces constantly. Many are shunned by their husbands, families and communities, and they often struggle to eke out a living for themselves.

Yeabu Thronka is one such woman. For four years, she lived with obstetric fistula. She had few friends and raised her three daughters alone, with little support from her community. Before developing the condition, she had been happily married, but it was her 7th pregnancy that ended with her obstetric injury. Living at least a day's trip from the nearest hospital and with no money to get there, Yeabu struggled for three days to give birth in her village hut. Not only did she end up with a stillborn child, but she also discovered that she was incontinent, due to the internal damage caused by the baby's head bearing down against her pelvis for so long.

Yeabu is a farmer in a remote area of Sierra Leone, West Africa. From 1999 to 2002, a brutal civil war destroyed much of the country's infrastructure, leaving virtually no maternal healthcare available to its rural population. Despite the country's abundance of diamonds and lucrative minerals, Sierra Leone ranks the lowest on the United Nations 2008 Human Development Index and has only168 doctors to serve a population of over 6 million.

I first visited Sierra Leone in 2002 when I worked as a still photographer for an American NGO called International Medical Corps (IMC), documenting their medical activities in a number of African countries. At that time, IMC was treating women who had been abducted by rebel soldiers during the war and trapped behind rebel lines. IMC found that many of these women were dripping urine as a result of obstructed or prolonged labor and lack of access to medical care. IMC brought in Dr. Gadelkareem Ahmad, an Egyptian obstetric fistula surgeon, to treat these women and to train local doctors to perform the somewhat complicated surgery. The procedure costs about $300 - more than half of the annual per capita income.


Throughout the developing world, more than 3 million women suffer from a little known yet devastating medical condition called obstetric fistula.

Dr. Alyona Lewis was one of his students. Fresh out of medical school, she happened upon IMC's program as she was doing her residency at the dilapidated Princess Christian Maternity Hospital in the capital city of Freetown. There, she began what would become a career as an obstetric fistula surgeon. Today, she is the only Sierra Leonean physician performing these types of operations.

This year, for my master's thesis from the U.C. Berkeley Graduate School of Journalism, I returned to Sierra Leone to report on this story that I had learned about 7 years earlier. I wanted to tell the story of Dr. Lewis and her work at the Aberdeen West African Fistula Centre, a specialty clinic operated by the NGO Mercy Ships, which treats as many as 350 women each year. It was there that I met Yeabu.

I found that little had changed since my first trip there. It was obvious that any profits the country yielded from its resources did not make it back to the people, who continue to struggle to earn a decent living. The infrastructure has improved at a snail's pace, though the healthcare system is still glaringly inadequate.

Mercy Ships is known for its ocean vessel hospitals that dock at ports around the world, but in 2005, following Dr. Lewis' recommendation, they built a land-based fistula clinic in Freetown. Not only do they treat women who find their way to the clinic, but they also send outreach teams into the countryside to identify and bring back new patients. These women, typically poor and uneducated, usually have no idea what they suffer from or that a cure exists. Such excursions into the country's remote areas can be hazardous because of the lack of accessible roads to the remote villages. But it is those women, who live far from towns and hospitals, that are most at risk.

Yeabu Thronka would have continued to live an isolated life in despair had it not been for the work of organizations like Mercy Ships. And it's people like Dr. Alyona Lewis, who choose not to abandon their country for a better standard of living abroad, working instead to uplift and bring pride to this devastated country.

-- Jenny Chu

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I was moved by the faith of this women.This problem is also there in East Africa. Basically what is needed is functioning rural clinics.