Out of Africa: ‘A Walk to Beautiful’ Humanizes a Devastating Disease - IDA

Updated: Apr 23, 2018

By Cathleen Rountree



Last December, A Walk to Beautiful won the IDA Award for Best Feature Documentary. Directed by Mary Olive Smith and co-directed by Amy Bucher, Walk chronicles the stories of five Ethiopian women who suffer from devastating childbirth injuries, and their subsequent healing journeys at the obstetric Fistula Hospital in Addis Ababa, where remarkable doctors devote their lives to repairing these women's bodies and hearts.


Obstetric fistula is a rupture that develops between the vagina and the bladder, and sometimes between the vagina and the rectum during obstructed labor. According to UN figures, three million girls and women in developing countries suffer from this chronic condition. In addition to the embarrassment and shame of incontinence, these women are often rejected by their families and driven from their villages because they cannot hold jobs, take public transportation or, due to the fetid odor, even walk in public.


This noteworthy, lovingly rendered film has won audience awards at the San Francisco, Denver and St. Louis International Film Festivals. A Walk to Beautiful opens February 8 in New York City and February 29 in Los Angeles and will air on PBS' NOVA in May. IDA met up with directors Smith and Bucher in April 2007 during the San Francisco International Film Festival.


IDA: What provoked the idea for A Walk to Beautiful?


Mary Olive Smith: We read a column in The New York Times by Nicholas Kristof about obstetric fistula. He was the inspiration for this film. It was the first time he'd written about the Addis Ababa Fistula Hospital; he writes a lot about women's health issues now. We knew it would be a difficult film to make, but we started talking with the Fistula Foundation, which was very small at that time and recently founded.


IDA: Where is the foundation located?


MOS: In New York City. The hospital had been supported for 30 or 40 years by foundations in Australia, New Zealand and the UK, but there had never been a foundation in the US. So it was new and they were supportive of the idea. Then Steve Engel [a producer] asked me to direct it because I'd had previous interest in human rights in Africa.


IDA: When did you first travel to Africa?


MOS: I went to Ethiopia about three years ago on a scouting trip and visited the hospital and met with Dr. Hamlin and Ruth Kennedy. I wooed them and told them how much we loved their hospital and how much we wanted to do this project. And they said OK! I think that was our biggest success, just getting their approval, because they're very protective of the women...


Amy Bucher: They'd had some not so good experiences.


MOS: In fact, when we first arrived, Amy started shooting in the hospital, while I went out to the countryside to find women--we weren't sure we'd find women who would agree to being filmed--so we thought we'd better shoot in the hospital to be safe. But right before we arrived, another film crew had been thrown out.


IDA: What had happened in that situation? 


AB: I think they weren't as sensitive to the women. They may have filmed before asking permission. I think there was an assumption that they could just go where they wanted to go. And that certainly wasn't the way we handled it. I don't think I had known they had been given the boot until we'd been there a couple of days. And then Ruth Kennedy said, "Oh, you guys are such a delight to work with." Then she told me what had happened before we arrived.


IDA: Who is Ruth Kennedy and how did she get connected with the hospital?



AB: Dr. Catherine Hamlin and her husband went to Ethiopia from Australia about 47 years ago-not necessarily to do fistula repair, but to do gynecological obstetric care.


MOS: They were working at a hospital when Haile Sellassie was in power, and they came across fistula patients and, as she says in the film, they were so moved by these women, who were often pushed to the end of the line waiting to get into the hospital because people complained that they "smelled...those wretched women, get them away." So both doctors began specializing in operating on fistulas, and eventually decided to found their own hospital. They've survived through the monarchy, the communist era and now the attempt at democracy. The hospital is still being supported by the government- or tolerated, at least.


AB: And it's growing like crazy. They recently added on a new wing. And Dr. Hamlin appeared on the Oprah Winfrey Show about two years ago, and within days, several million dollars had been raised and they were able to expand. Now their goal is to open five more hospitals in the outlying areas of Ethiopia. Two have already opened. So, that's a big change just since from when we were there.


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