A real feminist issue.

I got a pap smear today. I hate getting pap smears.

On the other side of the world, women wait in a hospital, some living in cardboard slums outside for months, waiting for an operation that will give them back their status as human beings.

Status they'd never have lost as even the poorest, most oppressed western woman. These women suffer from fistulas , caused by inadequate or absent medical care during childbirth. Basically, a fistula happens when a woman ought to have medical/surgical intervention and doesn't. A tear forms in the tissue between the bladder and vagina, or between the bladder and rectum, or both. The woman leaks, basically, until the defect is corrected. Most times,to her family and her husband, it's as if she died in childbirth. She is an outcast.

Surgical repairs are mostly crude or absent, and efforts are underfunded. Occasionally, flesh from the labia majora is used to patch a hole in the vagina, and it continues to grow hair. Multiple operations are common. In some cases, full continence is never regained even after multiple surgeries. This problem is alleviated, a community at a a time, when routine obstetric care becomes both accessible and affordable.

We don't hear much about this. We hear much more about female genital mutilation. We hear about burkas. We hear about child marriage among the roma. We hear about the trafficking of young macedonian optimists to saudi arabian brothels. We hear about those things because they conform to our idea of the exotic other. They're sexier as social problems. They conform to our idea of the exotic, musky, smokey land beyond our mundane 9-5 lives. The first popular romance novel in this country was The White Sheik (later it was Fellini's first film- I've heard it's moderately worth watching). Social problems that seem to be, at least partly, romanticizable (totally not a word) are completely more digestable. Nobody really thinks it's hot to be made into an object, made into nothing but a collection of parts and values. It's enraging, nauseating, horrifying, to think that women are being cloistered within their own bodies; infibulated to ensure chastity; raped and broken for profit. But it's about sex. And we like that.

Fistulas aren't about sex. They're about women's health. And they're about childbirth (something we, and I know I love to divorce from anything sexual). They're about piss and shit and fear of contamination. They're about political, economic, and pragmatic prioritization that neglects preventitive and urgent care, leaving some women with a chronic, sometimes debilitating condition that leaves them as lepers.

I hate getting a pap smear. I never want to have children. The latter is a choice; the former I can't prevent. I live in a country where gynecological care is nearly mandatory. I'm not trusted NOT to have children without a yearly check from a gynecologist. What absurd luxury. What ridiculous excess. What a world. A ceasarian section costs nine month's pay in Nigeria (Outreach programmes for obstetric fistulae. Kelly, J.. Journal of Obstetrics & Gynaecology, Mar2004, Vol. 24 Issue 2, p117, 2p-118) and my unneccesary yearly exam (that I bitch and bitch and bitch about) was free.