Low Hanging Fruit of the Womb

I was talking about my summer plans wit a pair of female friends yesterday, Meredith and Sayward, trying to explain:

1) where I was going (pretty sure about that, thanks to the magic that is GoogleEarth),
2) what fistulas even are (somewhat sure, if only in a textbook sense), and
3) what I'd be doing with the NGO (mostly unknown, truth be told).

Meredith wondered if it might be tough, seeing women with a devastating and completely unnecessary debilitation each day and not having any friends or family nearby to talk it over with. And I realized that strangely, I'm not worried about that at all. In a certain sense, I've chosen this group and this project because I don't think it'll drag me down emotionally. I actually have this idea that it'll boost me up, make me feel like progress is being made and that a lifetime in global health wouldn't be an uphill battle. Obstetric fistula has always appealed to me as such a low-hanging fruit of a problem: if we the healthcare professionals can get to the women (or they can get to us), chances are quite good that we can get them back to full health and functioning status. That's pretty rare with most of the things we worry about in global health. Further, it's less complicated to prevent it happening again - a woman is only at risk during labor, a rather recognizable state, so surgeons can legitimately ask women with repaired fistulas to try to give birth in a hospital the next time around. (Granted that costs get in the way, but compared to something like HIV, when you're at risk everytime you have sex/take care of an HIV-positive relative, or guinea worm, when you're at risk everytime you want a drink of water, the chances of avoiding fistulas by education and behavior change look pretty good.)

My spin on this is admittedly probably naive. But I'm not going to be working on HIV, or unwanted pregnancy, or gender-based violence, or any of those seemingly intractable problems in women's health where the public health workers seem to be constantly swimming hard against an overwhelming tide. Compared to those battles, the outlook for fistula patients is downright sunny. A good surgeon can completely turn a life around; the pull of instant gratification is very strong here.

So I know that I won't be tackling the hardest of the hard problems facing the international community. But I've always been a fan of tackling low hanging problems first anyway (see also: putting things on my to-do list that I've already done, just so I can cross them off); in fact, you might be able to help more people at an earlier point in time than if you tackle the hard problems first. And maybe this way I can get a little taste for what a successful health intervention campaign feels like - maybe the knowledge of that taste will keep me going if I move on to the more complex things.