top of page

A Walk to Beautiful: The Power of Women's Stories - Women's Media Center

Updated: Apr 30, 2018

By Peggy Simpson

It's hard enough to get U.S. audiences to watch international news, let alone news about women, let alone news about a medical tragedy that has made two million women in Africa and South Asia pariahs in their own families.

That’s why it is somewhat amazing that PBS/NOVA is showing “A Walk to Beautiful” Tuesday May 13, a documentary about all of that.

The film addresses the epidemic of obstetric fistula, a totally preventable medical condition that disappeared in the developed world more than a century ago. It has spread in Africa and South Asia for lack of medical care as well as complex interactions of culture and religion that sanction child marriages—and worse. 

Girls as young as 10 and 11 can be kidnapped, raped and then forced into “marriages” with their abductors. They get pregnant; they give birth. Their bodies are too fragile to accommodate the stresses of childbirth, however, and far too often they suffer devastating injuries that leave them incontinent—and socially isolated. There are rarely doctors available to repair the damage. Girls plagued with obstetric fistula often find themselves outcasts.

New York Times columnist Nicholas Kristof wrote about this scandalous and oft-ignored situation several years ago, on site in Africa. That got much notice here, not that much action there.

The columns eventually had a significant ripple effect, however.  Paula Apsell of Boston public TV station WGBH, who also is a senior executive producer at PBS/NOVA, took note.

Steven Engel, president of Engel Entertainment of New York, got his own wakeup call from a friend who said he had donated to the Fistula Foundation after reading the Kristof column but said that wouldn’t help that much. He urged Engel to tackle the subject in a film.

“The entire senior leadership of our company is women. I work for them. We’d been looking for a serious film-it had to be about women but it had to be transformative,” he said. “I read the Kristof column and said ‘Here’s the film. We’re going to do this.’”

He sent researchers and producers to Ethiopia to develop a network of contacts. It took months, then years. Ultimately, they got magnificent footage, evocative stories.

“A Walk to Beautiful,” directed by Mary Olive Smith, focuses on three women in Ethiopia who leave their families and walk across the desert in search of a hospital and of doctors who can do the difficult repair operations on them, after living for years with the tragic consequences of obstetric fistula.

The film beat out Michael Moore’s “Sicko” in a number of independent film festivals including in Los Angeles and San Francisco.

The government of Ethiopia initially appeared hostile to the unfavorable publicity posed by the exposé in the film. By the time of a congressional preview of the film two weeks ago, however, the Ethiopian ambassador to the United States, Dr. Samuel Assefa, praised the film as being “not about tragedy but about triumph” and said he demands that fundamental changes be made to prevent more cases from happening.

“The disease is not an act of God but an act of man. And I mean man, not woman,” he said, referring to customs that tolerate marrying off girls as young as 10, sometimes after being abducted and raped. “Their bodies are not sufficiently developed at ten, twelve, thirteen for child-bearing. So of course medical intervention is very important…to give new opportunities to make a life for these young women.

“But we also need to recognize that it is wrong in the first place for these young girls to be pregnant at so young an age. This is gender injustice, this abduction, rape. And we need to talk about it,” to get religious leaders to work against it, to persuade mothers not to sanction this.

In the short term, girls pregnant at so young an age can get a caesarian—if they can find a doctor. There are 80 million people in Ethiopia, only a few thousand doctors. It costs $300 to repair a fistula condition; $900 to prevent it with a C-section.

Ethiopian doctors, let alone midwives, are poorly paid, which fuels their departure soon after they get medical training. The authoritarian government can get in the way of international efforts to help.

The World Health Organization is active on this issue. So is the UNFPA, the UN Population Fund, which began a global Campaign to End Fistula in 2003 and now supports activities more than 40 countries—to prevent the condition, treat it and help the women return to their communities.

The governments of Italy, Germany and Australia have built fistula hospitals in Ethiopia.

An Ethiopian American psychologist from New York, Abaynesh Asrat, took on the challenge of rallying support from the U.S. community of a half-million Ethiopian immigrants. She raised $270,000 from them to build a sixth fistula hospital-and with the head of the Fistula Foundation, flew over for its dedication in early May.

Representative Carolyn Maloney, D-NY, one of nine congressional sponsors of the “Walk to Beautiful” preview at the Capitol, is attempting to better secure U.S. funding for the UNFPA, support that has been on shaky ground during the Bush presidency.

She also planned to get constituents together for the PBS/NOVA showing. “The last case of obstetric fistula in this country was in my district,” she said, more than 120 years ago.

Director Mary Olive Smith said the Ethiopian women were not uneasy having a camera crew track their trek across the desert. “They’d never seen a camera before…but we got on intimate terms quickly. They were so amazed that anyone wanted to hear their stories.”


bottom of page