Marietta Kiden, Sudan
Marietta Kiden grew up in a desolate refugee camp in Uganda for people displaced by Sudan's civil war. The camp had no school and no clinic, but she managed to survive without either. She returned to her village in southern Sudan as a young adult and married a boy she loved.
Three years later, after a traditional fertility ceremony, Marietta and her husband conceived the child they had yearned for. But Marietta received no antenatal care, and only an unskilled traditional birth attendant was at her side when she went into labor. The baby’s head was too big for Marietta’s fragile body, and three days of agony tore her apart before she was taken to a distant hospital.
The baby died. The hospital saved Marietta's life, but the ordeal left her with an obstetric fistula, a devastating opening between her birth canal and her bladder. For the next 25 years, she suffered uncontrollable urine leakage, odor and repeated infections.
An estimated two million women, virtually all in developing countries, live with obstetric fistula, many in hiding and shame. Fistula was once also a devastating problem worldwide – the Waldorf-Astoria Hotel in New York City, for example, sits on the former site of an obstetric fistula hospital – but investments in prenatal care and emergency obstetric surgical facilities and health care personnel have brought caesarean section to save the lives and children of millions of other women who would otherwise have shared Marietta’s fate. One early surgical repair attempt did help Marietta for awhile, but later she was assaulted while collecting firewood outside her village and her fistula reopened. Her husband, unlike many men whose wives suffer fistula, remained loyal to her and cared for her during this period.
In 2006, Marietta's sister told her about fistula repair surgery newly available at the Juba Teaching Hospital where the sister worked as a midwife. Supported by UNFPA, the UN Population Fund, the hospital hosted a surgeon who successfully repaired Marietta's fistula. Her brother slaughtered a goat for the jubilant family’s celebration. Fully recovered, Marietta has become a public advocate, traveling through southern Sudan as part of a campaign to raise awareness among other women afflicted with fistula that they can regain normal lives as she did. She is also living evidence of the need for investment in antenatal and emergency care that could have averted her needless suffering, and in the surgical training and facilities that finally restored her creativity and energy.