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Alison Heller


Campbell Resident Scholar

Affiliation at time of award:
Assistant Research Professor
Department of Anthropology
University of Maryland — College Park

Interrogating the Superlative Sufferer: Experiencing Obstetric Fistula and Treatment Seeking in Niger

Obstetric fistula, a maternal childbirth injury that results in chronic incontinence, is presented within donor and media discourse as a profoundly stigmatizing condition, purportedly resulting in divorce by husbands, abandonment by kin, exile from communities, and high rates of depression. Donor agencies and the global media generate and circulate a narrative of a monolithic sufferer–she is young, stigmatized, and finds physical and social redemption through surgical intervention. Based on eighteen months of ethnographic research at four fistula repair centers in Niger, Dr. Heller complicates this narrative by demonstrating that most women with fistula exhibit significant personal resilience, receive continued social and familial support, and, unexpectedly, experience ambiguous surgical outcomes. In doing so, Heller interrogates the existing logics of the fistula narrative that have had the unintended effect of obscuring global structural inequalities; diverting attention away from systemic health access reforms; and resulting in sometimes harmful fistula prevention, treatment, and reintegration interventions.

Heller’s work resulting in large-measure from her time at SAR was published in 2018 by Rutgers University Press: Fistula Politics: Birthing Injuries and the Quest for Continence in Niger (Medical Anthropology)



Bad Births, Bad Bodies: Obstetric Fistula and Treatment Seeking in Niger

Dobkin Boardroom, SAR Administration Building
Wednesday, November 9, 2016, 12:00–1:00 pm, Free

In the West African country of Niger, 1 in 23 women will die from maternal causes and 5-13 more will survive with chronic disabilities. One particular injury, obstetric fistula — caused by prolonged obstructed labor and resulting in chronic incontinence — is all too common. How are women who suffer from fistula represented in the Global North? Does it matter? What is the lived experience of chronic incontinence? Can surgery make a difference? How do local networks of care expand or contract in times of illness? Based on 18 months of research in Niger, this talk will explore these questions.

Videography by John Sadd.