How We Got a Film About a Serious Childbirth Injury (Obstetric Fistula) That No One in America Ever Heard of Into Movie Theaters

Women in developing countries are either dying while giving birth or dying a symbolic death when they develop a fistula and are left to live the rest of their lives alone.
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Yes, few people have heard about obstetric fistula (if you are one of these people an explanation is on the way), our company hadn't heard about fistula before we made our film, A Walk to Beautiful. Which is exactly why we felt compelled to bring viewers face to face with the stories of women in Ethiopia whose lives are ruined by this condition but who are unwilling to give up. These are inspiring stories of hope, courage and survival, and I believe that's why the film is now playing in cinemas in NY and LA. As we started our film festival circuit last year, we were amazed by the reaction of audience members. People were stunned and shocked that they'd been completely ignorant of this treatable problem that afflicts millions of women. Not only visibly emotional and upset but also in awe of the dramatic transformation that takes place once a woman is cured. As the film unfolds, the viewers comprehend that the title, A Walk to Beautiful, is not only about a fistula sufferer walking to a physical place to be healed, but her journey is a cure of the soul where her dignity and life are reclaimed.

When we first read the riveting New York Times column about obstetric fistula I never would have imagined that five years later we would be opening our film, A Walk to Beautiful, on Sunset Blvd in Los Angeles. Yet, here we are, opening our film Friday, February 29th at the Sunset 5 while going into our fourth successful week at the Quad Cinemas in New York City.

Almost five years ago, Steve Engel, head of our company, Engel Entertainment, brought in the column his friend sent him that changed the course of our company and certainly our lives. The column was written by Nick Kristof about a hospital in Addis Ababa -- where -- the capitol of Ethiopia that cures women with fistula -- what -- a childbirth injury that afflicts millions of women in developing countries. The story resonated with all of us; I volunteered to work on the film immediately. Two years later, under the direction of Mary Olive Smith, we were on a plane to Ethiopia in hopes of finding women with fistula whose stories we could capture in our documentary film.

But before we even left, we had to convince others how important it was to tell this story and raise funding to do so. I think it took me almost a year to successfully "pitch" the issue of fistula. It can seem daunting to explain and can make some people squeamish but it's actually pretty straightforward. A woman is giving birth but a complication arises, obstructed labor from mal-positioning of the baby in her womb. So what's the problem? In the United States a woman would get help immediately, perhaps a C-section if necessary. In developing countries, with no access to medical care, there is nothing a woman can do but continue pushing until she finally pushes out a dead baby sometimes up to a week later. After surviving the ordeal she wakes up to uncontrollable leaking of urine and in some cases feces. She has a fistula, a hole between the birth canal and bladder (or in some cases rectum) that leaves her permanently incontinent. Thankfully, for most victims, there is a simple cure and for women in Ethiopia, a special hospital that was founded in the 1960's by Dr. Reginal and Dr. Catherine Hamlin that treats women for free. The Hamlins were Australian missionaries called to Ethiopia for a three-year assignment in the public hospital but when they came face to face with fistula victims they dedicated their lives to help repair these forgotten women. They built the Addis Ababa Fistula Hospital that today treats 1,200 women per year.

New Yorkers also dealt with obstetric fistula in the 19th century. In fact, a fistula hospital existed in midtown Manhattan on the same site where the Waldorf Astoria Hotel stands now. For Americans and most of the Western world, fistula is a thing of the past, which is why it is so far removed from our consciousness. But for women in developing countries, where emergency obstetric services are rare and often obsolete, obstetric fistula is all too common. Fistula occurs in over 44 countries and there is an estimated 2 million cases but that number is considered by many a gross underestimate because it was done by the World Health Organization in the early eighties. The UNFPA (United Nations Populations Fund) started a campaign to end fistula whose goals are to assess the problem (because since the '80s no one has bothered to keep count, and cases continue to go underreported), and to help prevent and treat the problem.

Quite possibly there is fear about what we will find, that while women in developed nations have adequate access to maternal health care, hundreds of thousands of women in developing countries are either dying while giving birth or die a symbolic death when they develop a fistula are left to live the rest of their lives alone. It is an innocent imprisonment caused by poverty and lack of medical care.

The stories we encountered in Ethiopia alone were heartbreaking and in A Walk to Beautiful, we meet women who have suffered tremendously but survived because of their strength, hope and determination to be cured. I believe the film has won audience awards at many festivals and won the International Documentary Association Award for Best Feature Documentary and is now playing in NY and LA in part because the women and girls in our film speak to audiences' hearts. The film gives them a voice and an outlet to be heard. They speak openly and unashamedly about their condition and their cure offers audiences a glimpse at a true transformation and quiet call to action.

Americans, of course, are more outspoken so everyone at Engel Entertainment has been pushing A Walk to Beautiful and its message of hope with everything we've got. We're based in New York so we're often at the theater meeting, greeting and selling A Walk to Beautiful to audience members at the Quad whether they were coming to see our movie or a different film. We love this film, not only because after five years in the making it's so close to our core but because it has the potential to bring about great change by opening people's eyes about an issue that needs to be eradicated. Because of the buzz in New York City, we've been approached by theater owners in other cities in the US and hope to broaden our theatrical release. We're also organizing screenings in Washington, D.C., including a congressional screening to galvanize change with support from policy makers.

We need every American to pay attention to this issue. As one of the experts in the field, Dr. Steve Arrowsmith (VP of the Worldwide Fistula Fund and President of the Mercy Ships) explained, that without change, the backlog of fistula patients is so huge, that even if no new cases occurred it would still take 1,500 years to cure every woman with fistula today. But the more people know about the issue, the more people will contribute towards its extinction and save many women's lives in the process. Our poster displays one of our five characters, Wubete, a young 17-year-old, who developed a fistula on her first pregnancy after four forced marriages. Take a look into her eyes; she implores an answer for her mistreatments and a cure for her misery. Does she get it? You'll have to watch the movie to see the story for yourself.

The web site for A Walk to Beautiful is and for Engel Entertainment

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