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Award-Winning Film Captures the Agony and Endurance of Fistula Survivors - UNFPA

Updated: Apr 23, 2018

By Anusha Alikhan

NEW YORK – Four years after a film producer first read about obstetric fistula, a documentary portraying the lives of its survivors is drawing wide audiences and winning major awards.

 The film, “A Walk to Beautiful”, follows the journeys of Ayehu, Zewdie, Almaz, Yenenesh and Wubete to the Addis Ababa Fistula Hospital to seek treatment for the devastating child-birth injury that has left each of them incontinent. From their remote villages, over miles of dusty steppes and sprawling lowlands, the women travel to the capital city to reclaim their dignity after years of social ostracism.

The film was conceived in 2004, after Steve Engel, executive producer and owner of Engel Entertainment, read a New York Times column by Nicholas Kristof. The column, entitled “Alone and Ashamed”, described the lives of fistula survivors in rural Ethiopia. “I didn’t even finish the second paragraph, before thinking—first, I’ve never heard of this condition, and, second, we have to make a movie about it.”

Taking a leap of faith

Relying on a dedicated team, Steve was able to gather support and initial funding for the movie. Partners, including UNFPA, the United Nations Population Fund, contributed seed money to the film, and Steve and his wife put up a substantial portion of their personal resources to begin shooting. “Without taking that leap of faith, the film would never have been made,” said Steve.

In February 2005, the Engel Entertainment crew boarded a plane bound for Addis Ababa. They received full cooperation from the Addis Ababa Fistula Hospital, a key partner in the global Campaign to End Fistula, and they were able to quickly hire local staff to assist with logistics and filming.

Finding women in hiding

Their most difficult job was however assembling their cast – the socially isolated survivors of fistula proved hard to find. “There are thousands of fistula cases in Ethiopia alone, and yet it’s scary to think they so are buried,” said co-producer, Allison Shigo. “People in the community don’t want to talk about them, either to protect their privacy, or because they don’t even know they exist.”

To look for fistula survivors, Allison and director Mary Olive Smith travelled to a small town in the Ethiopian province of Gojam. After several long drives and strenuous hikes through the countryside, they got their first real lead. Allison met a young school boy in a locale village market who led them to 38-year old Zewdie, a mother of five who had been abandoned by her husband due to her injury.

Once the cast was assembled, the shooting began, with each of the women personally recounting her own struggle. “I wanted to take a cinéma-vérité approach, where we could dispense with a narrator, and use footage and sound bites to capture the reality of these women’s experiences as much as possible,” explained Mary Olive.

Bearing the unbearable

Twenty-five-year-old Ayehu is relegated to her mother’s backyard because of her incontinence. She crouches in a rickety shelter made of dry leaves and sticks to discuss the agonizing labour that left her with a stillborn baby and unbearable disgrace. “Even death would be better than this, this is not life,” she said. Ayehu is one of five Ethiopian women whose struggle with obstetric fistula is revealed in the documentary. A similarly despondent Almaz explains from her hospital bed that she was abducted and raped by her own husband. She now endures a double fistula that causes her to leak both urine and faeces.

It was a challenge to accurately depict the isolation and shame the women faced, said Mary Olive. But it was not difficult to convince the women themselves to share their stories. “They were desperate to be heard, after virtually no interaction with their communities for years,” she said.

The women’s stories, told through “A Walk to Beautiful,” have had a tremendous impact on audiences across America. The film recently won the International Documentary Association’s 2007 Feature Documentary Award, and a host of other accolades. It is being screened in major theatres across the United States, and is being shown at the United Nations headquarters in New York on 7 April 2008.

The production team is thrilled with its success. But according to Mary Olive, the true “life achievement” is the exposure the film has given to fistula and its victims. Engel Entertainment is continuing its outreach by partnering with several organizations, including UNFPA, to publicize the issue. “Most people in this country, including those who watched the film, had never even heard of fistula,” said Allison. “So we wanted to go beyond our normal roots of distribution.”

The company is putting together an outreach effort for screening the film at schools, universities, churches and other faith-based organizations. In addition, it is scheduled for airing on the PBS NOVA series on 13 May 2008.

After the filmmakers recover their expenses, all of the profits will go to benefit fistula survivors. Engel Entertainment is also producing a short ‘question and answer’ segment to accompany the film, featuring UNFPA staff and other experts, in order to build awareness for fistula in other parts of the world.

To find out where the film is playing, or how you can contribute to it, go to the A Walk to Beautiful website.


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