Without a Mother’s Love
Fistula is considered a highly stigmatizing condition – creating social pariahs of young, vulnerable girls victimized by their husbands, their families, their cultures, and a system which fails them. Indeed, this portrait of a girl, a girl forced into marriage too young, pregnant too soon, too small to deliver normally, too remote and too poor to visit a health center in times of emergency, and too powerless to resist the social stigma accompanied by chronic incontinence – it is powerful. It is an image that moves people. An idea that opens their hearts (and ultimately their wallets) to the cause. The problem with this portrait is that it is a simplification, it is an imaginary, and for the majority of women, it isn’t their reality. Indeed, most women with fistula do not experience fistula in this way.
During interviews I’ve been trying to parse out why women with fistula have such diverse experiences – why for some the consequences of fistula are profound, affecting every aspect of women’s lives, deteriorating their social bonds and community status, exacerbating poverty, causing profound emotional distress, and diminishing their chances of finding a romantic partner – while for others, the illness is merely physical, causing anguish in the way any illness does, shame in the way me might imagine chronic incontinence would, but largely leaving their social lives untouched and their support systems in tact.
Before conducting this research I hypothesized that factors such as severity and duration of their illness, number of living children, age at the contraction of the fistula, and seniority among co-wives would largely determine the degree to which women are exposed to fistula-related social stigma.
But there is one factor that I hadn’t initially considered – the complex role of the family.
At first glance, families appeared to be the most important line of defense against negative social consequences for women. Tucked away in the heart of the household, women with fistula often take refuge among their extended families. While most women have very little experience being openly ridiculed or mistreated, this might be because the majority of women practice strict self-regulation, frequently avoiding leaving their homes, and carefully managing who knows about their condition – often keeping it a secret from everyone in the community except their closest family members. But, as we all know – families can be tricky, particularly here in Niger…
What if, like the majority of Nigerien women, you are married to your first cousin, and your aunt is your mother-in-law? (Bear with me for this thought experiment.) Then things get complicated. The teams become blurred and allegiances messy. As your aunt, she probably would have taken your side, cared for you, acted as your second mother, and kept your secret. But as your mother-in-law, her primary concern is her son and his interests – and more often than not, that means that she gossips about you, belittles you, and pressures her son to leave you for a woman who can more easily bear her grandchildren. Yet, she is still your aunt, and still privy to the information and access of any other close family member, making your family feel a little less safe.
And what about fathers? Unfortunately, that relationship isn’t straightforward either. Most men here are married to between two and four women. Husbands often spend very little time at home and relationships between co-wives can be messy, riddled with jealousy and resentment (In Hausa the word for co-wife and the word for jealousy are the same, telling indeed). Co-wives are often engaged in a silent but strategic war, which can battle on for decades over scarce resources, status, and a husband’s preference. So, let’s say that your mother is gone, and you are left living with your father and your mother’s co-wife. Then your family might not be such a sanctuary.
Indeed, I’ve found that women who live beyond the watch of their mothers have a very different relationship to their families. Those who live only with their fathers and his co-wives recount stories of mistreatment and the lack of financial support. One woman whose mother died when she was young told me “Even as a child my mother’s co-wife hated me. She’d tell me that every bite of food I took was a bite taken from her own children’s mouths. When I got fistula, things were much worse. She was very happy that I became ill. When she prepared food, she’d never give me any. I was always hungry. She ridiculed me. She told everyone in the village about my illness. She wanted me gone.”
From a preliminary (and not yet statistical) consideration, it appears that women who’ve lost their mothers (due to death, migration, divorce, or abandonment) have experienced the greatest degree of social stigma – most like the classic portrait of the girl suffering from fistula. Indeed, out of the 50 interviews I’ve conducted, the women who recalled the worst social treatment and the highest degree of stigma had one thing in common – they were without mothers. I cautiously posit that the power of this one social fact to predict social stigma far exceeds any other predictor. Conversely, women with fistula who live with their mothers tend to experience shame but little to no mistreatment, or ‘stigma’. (Additionally, those who are accompanied to clinics by their moms tend to receive operations more quickly than women who come alone.)
Yep, turns out that even in rural Niger, mom’s protection, support, and love insulate women from the dog-eat-dog world. Indeed, moms (and not necessarily families) prove to be a woman’s strongest defender and advocate.
It’s times like these that I’m particularly grateful for a mom who will always fight in my corner.
