The women at the Hamlin Fistula Hospital spend much of their recovery time outside, chatting and braiding each other’s hair. Photograph by Yanina Manolova.
Limited or no access to sanitation and adequate health-care, however, represents only one of the many issues affecting the still overwhelming maternal and infant mortality rates in today’s developing world: half of the deaths of expectant or new mothers in developing regions are due to hemorrhages and hypertension, together the leading causes of maternal mortality. Other less direct factors also have a significant influence in increasing maternal mortality rates: malaria, HIV/AIDS, heart diseases, obstructed labor, complications while performing anesthesia or cesarean sections, and ectopic pregnancies.
“Existence of Dismissal” by Bulgarian visual journalist and documentary photographer Yanina Manolova dives straight into one of the predominant causes of death among Ethiopia’s female population and in much of sub-Saharan Africa: obstetric fistula. Obstetric fistula is a medical condition caused by unrelieved, prolonged or obstructed labor, and it consists of an abnormal connection or passageway between the female genitalia and adjoining organs, with very noticeable consequences.
“I never thought these condition existed… The women were leaking down everywhere,” recalled Manolova in a phone interview, talking about the first time she entered an Ethiopian hospital in the obstetric ward.
Since the beginning of her career as a photojournalist, Manolova’s interest always lied in pursuing projects exploring women’s issues, ranging from domestic violence to health. Childbirth in particular interested her as a moment of fundamental change for all women ‑ and definitely in a tragic way for some. In 2006, after learning about the problem of obstetric fistula on National Public Radio while looking for an idea for a foreign reporting documentary project, she spent two weeks traveling around between Addis Ababa and the rural Ethiopian countryside photographing it.
“It struck me — all the embarrassment these women were going through and the social stigma, but also how their lives were being changed by those who helped them.”
Manolova was particularly moved by their vulnerability, both due to their precarious and embarrassing condition and the fact that they were constantly undergoing surgery, and by the desperation of the situation. She remembers the women felt they didn’t deserve to live because no one liked them.