An Ancient Problem

Before medical systems existed, fistula was a problem everywhere. A papyrus scroll from 1550 BC found between the knees of a mummy at Thebes is the first recorded reference to fistula. No treatment existed until the 1840s when Dr. James Marion Sims developed a surgical repair technique that is still more than 90% effective. Women from around the world came to New York City to get this revolutionary treatment. As emergency obstetric care improved, fistula all but disappeared from the USA and in Europe.

So obstetric fistula was a problem in the USA?

James Marion SimsYou bet it was. Back in the days before we had broad-based access to emergency obstetric care, women died in childbirth at rates likely just as high as the worst anywhere in the world today. Obstetric fistula presented such a problem that many surgeons attempted to find a solution.

An American surgeon named James Marion Sims developed the surgical technique to treat fistula that he reported in 1852. Sims is a controversial figure in history as most of his early test subjects were women with fistula who were living as slaves.

However, his treatment proved very much in demand.  Women from all over the country needed this technique and Sims found himself helping to set up the world’s first fistula hospital on the current-day grounds of the Waldorf Astoria.

Widespread access to emergency obstetric services made obstetric fistula a thing of the past in the USA. Access to quality medical care would end obstetric fistula in Sub-Saharan Africa and South Asia, where maternal death and disability is a huge problem. But developing these types of health systems takes generations and there are people who desperately need help today.