They all had terrible internal injuries, such as had not been seen in Europe, America or Australia since the 19th century. Here these were endemic, owing to the malnutrition that meant the bodies of Ethiopian girls remained small. The attitude of the Ethiopian Orthodox church which encouraged child marriage—to keep girls virtuous, they insisted—only made things worse, as did the lack of obstetric care, especially in rural areas. Betrothed at eight or nine, girls would find themselves pregnant in their early teens.
他們都患有嚴重的內傷，這種情況自19世紀以來在歐洲、美國或澳大利亞從未發生過。在埃塞俄比亞，由于營養不良，女孩的身體仍然很小，在這里這是很常見的情況。埃塞俄比亞東正教鼓勵童婚的態度-他們堅持認為這可以保持女孩的貞潔-還有產科護理的缺失，都使事情變得更糟，尤其是在農村地區。女孩們在八九歲就和人訂婚，然后在十幾歲的時候就懷孕了。
When they went into labour, sometimes with no one to help but a wogesha, a village doctor offering a potion made of herbs, it went on and on. There was nothing to do but squat and push, often for five or six days. If the fetus did not survive, the only reason the mother could eventually deliver was because babies get smaller when they are dead. But then, as she discovered, the mother wakes up to an even greater horror: her bed is soaked and stinks. Her protracted labour has left her so badly injured that her vagina has ruptured, her bladder is shredded, her rectum torn. Urine and faeces leak out of her without cease. Soon, her husband leaves her.
當他們要分娩的時候，有時除了一名“沃格沙”之外沒有任何人幫忙，“沃格沙”是提供草藥制成的藥劑的鄉村醫生，就這樣循環往復。他們除了蹲坐著往外推之外，常常會持續五六天，別無他法。如果胎兒沒有存活下來，母親最終能夠分娩的唯一原因是嬰兒死后會變小。但是，當她醒來的時候，她發現了一件更可怕的事情：她的床又濕又臭。長期的分娩使她嚴重受傷，陰道破裂，膀胱破裂，直腸撕裂。尿和糞便不停地從她身上漏出來。不久，她的丈夫就會離開她。
Her family and her village community turn their backs on her. She lies on her bed, her legs drawn up to her chin to try to stem the flow; shame is her only company. The Hamlins would sit up late into the night in their little mudbuilt house in the hospital grounds, studying the history of obstetric fistula, as these injuries were known, which was first written about in 1550bc. They went over the evolution of the treatment, rereading the autobiography of Marion Sims, who, in the 1850s had treated similar injuries among American slave women.
她的家人和她所在的村莊都背棄了她。她躺在床上，兩腿抵著下巴，試圖阻止水流；陪著她的只有羞恥。哈姆林一家常常在醫院空地上的泥房里熬到深夜，研究產科瘺管病的歷史，這些損傷就是產科瘺管病，它最早記錄于公元前1550年。他們回顧了其治療方法的演變過程，重讀了馬里昂·西姆斯的自傳。在19世紀50年代，西姆斯曾治療過患類似傷病的美國奴隸婦女。
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