Sierra Leone surely qualifies as one of the many little hells on this earth. Apart from diamonds, the country has little else to bring a glimmer of hope to its economy. What it does have is political instability, a landscape and a people ravaged by a decade of civil war, and the recrimination that is the natural result of post-civil war reconstruction.

But for the women in Sierra Leone, childbirth may also be a life-sentence of ostracism and humiliation. If it were not horrific enough that approximately two in every 100 women die during childbirth, due to inadequate medical care, an inordinately large number of child-bearing women are afflicted with fistula, or vesico-vaginal fistula, whereby, due to complications during pregnancy, a woman is condemned to a lifetime of incontinence.

Fatmata Kargbo is one of the approximately 5,000 women — in a country of five million — to be afflicted annually with the easily curable condition of fistula. She is regarded as unclean and jinxed, lives in solitary humiliation, and earns a living by chipping rocks for builders.

Fatima states: “Everyone deserted me – my husband deserted me, my friends deserted me. I know I will never have a husband, I will never have a boyfriend, I will never have a baby. So I just live by myself.”

The condition is cheaply curable, at 180 U.S. dollars, but there are so many women with the condition that it would take 50 years to treat the backlog of women in Sierra Leone, according to Elizabeth Hunter, the head midwife at Mercy Ships, a Christian medical charity ship that was recently moored outside of Sierra Leone’s capital.
  
Such tragic afflictions should remind us of the pressing need to specifically examine women’s issues within the broader context of regional political and economic studies. While most of Sierra Leone lives in absolute poverty, these women, stripped of social and family networks of support, are cast into their own private little hells.  

Mimi Hanaoka