We were introduced to Malika while working with UNFPA/UNICEF on a collaborative film project focused on ending the practice of FGM (Female Genital Mutilation). Malika, featured in our film True Story. Malika had experienced one of the worst forms of FGM – infibulation. Infibulation involves the removal of the clitoris, the labia minor, and parts of the labia majora, which are then pulled together with thorns and thread, leaving a small vaginal opening that must serve to pass urine and menstrual fluid.
We met Malika in her debora (a style of housing in Afar, Ethiopia). The interior of her dwelling was in total darkness due to the coverage of straw matting. We asked Malika for her permission to remove some of the straw matting so that we might see her and her baby and to bring some light into the home.
As the light filtered through the straw matting, we saw Malika lying prostrate on a mat, while her mother, using her own breast as a dummy, comforted Malika’s baby daughter.
Malika's mother comforts her granddaughter
Due to Malika being infibulated, the injuries she suffered on her wedding night were extreme. When she became pregnant, she had little or no antenatal care. Had Malika received antenatal care she would have learned that due to her being infibulated she had a high risk of facing an obstructed labor and birth and would have been recommended to give birth with a midwife at a health centre.
Malika delivered in her hut with a traditional birth attendant. Her prolonged and obstructed labour led to an anal and vaginal obstetric fistula, leaving her constantly leaking feces and urine. She was fortunate that her daughter survived.
Malika with her baby daughter
More than 75% of women and young girls with obstetric fistula have endured labor that lasted three days or more. Often, women with fistula injuries are rejected by their husbands and community, due to their foul smell and incontinence. Unfortunately, this is precisely what happened in Malika’s case.
Confined to her small house, unable to move properly due to her condition, she lay on her mat day after day, until her muscles atrophied. She now has trouble walking, and uses straps placed in her home to lift herself up to attend to her daughter.
Malika told us that she considers herself a “dead woman” and that she would never contemplate circumcising her daughter after what she experienced.
Upon hearing Malika’s story, we asked our translator and local health worker if there was anything that could be done to help Malika’s situation. The health worker said she might be able to speak with the local clan leader, Ware Musa.
The same day, our health worker was able to speak to Ware Musa, who said he had heard of Malika and knew it was a very serious case. The health worker explained that although her injuries were severe, she could be taken to a Hamlin Fistula Hospital in Addis Ababa for assessment and surgery that would change her life.
The next morning, we were working at the local health centre, and were overjoyed to see Ware Musa there, who had brought in Malika, her baby and her mother to be assessed and hopefully begin the long journey to Addis Ababa. It was heart warming to see patients and staff at this rural health centre passing a tin donation cup around and hearing the clink of coins in aid of helping Malika with the cost of her journey ahead.
We would like to visit Malika the next time we are in the Afar region, but until then, we trust that Malika made it to Addis Ababa and received the life changing surgery that would give her back her dignity.