Updated 25 July 2016

Health24 exclusive: Meryl Streep talks to us about obstetric fistula

Oscar-winning actress Meryl Streep has announced that she will participate in a documentary film, Shout Gladi Gladi, that highlights the debilitating effects of obstetric fistula in African women.


Giving a celebrity voice behind the debilitating disease that is obstetric fistula in Africa is one of the most powerful acts we've seen happening on the continent in quite a while.

Health24 contacted Hollywood A-lister Meryl Streep's agents to find out what moved the actress to put her weight behind the awareness campaign and was delighted to receive a direct response from the multiple Oscar winner herself.

Meryl Streep will be narrating a documentary titled Shout Gladi Gladi that highlights the plight of millions of African women who, through lack of medical care and stigma, suffer through the indignity and health dangers brought on when they develop obstetric fistula during a traumatic childbirth. 

What is obstetric fistula?

An obstetric fistula is a hole that develops either between the rectum and the vagina (rectovaginal fistula), or between the bladder and the vagina (vesicovaginal fistula) and is caused by prolonged, obstructed labour during which the mother does not receive adequate treatment or care.

The World Health Organisation (WHO) estimates that approximately 2 million African women suffer from this condition, with 50 000 to 100 000 new cases developing every year.

The physical problems associated with this condition is a constant leakage of urine or faeces, or both, condemning the women to a lifetime of incontinence. The constant urinary incontinence often leads to skin infections, kidney disorders and even death if left untreated.

The sufferers are often ostracised by their families and communities because they smell and are constantly soaked in urine and/or faeces.

Read: What is faecal incontinence 

Compounding the problem is the fact that, in various Sub-Saharan countries such as Malawi, Mozambique, Nigeria, Uganda, and Zambia, obstetric fistula is not considered a medical condition but rather a “punishment” for women being disloyal to their families, or as a divine punishment for carrying a venereal disease. 

These perceptions, along with the physical symptoms, mean many of the women live in isolation, poverty and shame.

What is Streep's take on it?

Streep told Health24 that Shout Gladi Gladi focuses on the long term efforts of a Scottish nurse turned entrepreneur, Ann Gloag.

“She has worked hard to combat fistula and health care deficits for rural women in Malawi, and I was happy to help bring attention to her work. “

When asked if she is aware of any other similar programs in Africa, Streep told Health24 “I am not in a position to speak more specifically about other programs in Africa, but I was glad to be able to amplify her [Gloag's] good work and inspire others to do the same.”

Praising the continuous efforts of health care workers in Africa, Streep said: “I continually am amazed by the resilience of underserved people, and the dedication of health care providers like yourself on their behalf.”

More about Shout Gladi Gladi

The film is made in collaboration with Gloag’s Freedom From Fistula Foundation, an organisation that helps women by providing free surgeries to heal their fistulas (a simple procedure that takes about an hour to perform), free maternity care to prevent fistulas and ensure safe childbirth, and training local healthcare workers.

The United Nations Population Fund says obstetric fistula is preventable and can be avoided by delaying the age of first pregnancy (by, for instance, ending the practice of child marriage); family planning to space births and providing emergency obstetric care to pregnant mothers.

The film also features appearances by Melinda Gates and Nobel Peace Laureate Wole Soyinka and was shot just before the Ebola outbreak in 2014. The release date will be announced shortly. Like Freedom from Fistula on Facebook and follow them on Twitter for updates. 

Watch: Shout Gladi Gladi trailer

Read more:

About incontinence in women
UN passes resolution on genital mutilation
Global ban on female circumcision


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Incontinence Expert

Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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