In her most famous song, "Torn," Natalie Imbruglia sings of loneliness and shame.
They are feelings the Australian pop star is hoping to spare hundreds of thousands of women suffering with fistula. She brought her campaign to the United Nations on Monday, urging international support for women who have a hole in their birth canals as a result of childbirth without assistance or with complications.
"There's a lot of shame," said Imbruglia, who has been a spokeswoman since 2005 for an obstetric fistula program supported the U.N. Population Fund and the charitable arm of the Virgin Group.
"It's a double trauma. Some of them are ostracized from their community. They feel dirty. They feel ashamed," Imbruglia said in an interview with The Associated Press. "Some of them might feel they've been cursed because they don't really understand what is happening to their body. And if that is what everyone is saying to them in their communities, a lot of them are left just suffering on their own."
Once common worldwide, fistula was eradicated by medical care in Europe and North America a century ago but still affects more than 2 million people in developing nations, according to UNFPA. Women with fistula experience incontinence and often give birth to a stillborn baby. Untreated, fistula can also lead to chronic medical problems, including ulcerations, kidney disease and nerve damage in the legs.
It costs only about €235 ($325) to provide one woman with the necessary surgery, postoperative care and follow-up support.
Imbruglia, 34, was a teenage television star in Australia and broke through internationally as a singer with her album "Left of the Middle" in 1997. She said she was completely ignorant about fistula until learning more about the condition from Virgin founder Richard Branson.
She then traveled to Ethiopia and Nigeria to see firsthand how women with fistula struggled to get the surgical response they needed, and rediscover the dignity many of them lost. Her campaign has since raised over €875,000 ($1.2 million) and has supported a community program of awareness, treatment and reintegration in Nigeria.
"Lifting the taboo and getting the facts to the community is important, because emotionally it is really difficult for these women," Imbruglia said. "Most of them have lost a baby. They've had no kind of counseling to deal with that."
Imbruglia said her campaign encourages women who have had the operation to help educate others in their communities. Once the taboo is lifted, men support women with fistula where they once might have left them. Some women suffering for over two decades have come forward for surgery on the urging of other women, she said.
"That's 100 percent the goal," Imbruglia said. "It's about helping these people help themselves."
She told a session of the U.N. Economic and Social Council that countries needed to better support poor women susceptible to fistula.
"We can make childbirth safe and motherhood joyful," said Imbruglia, speaking only a few hours after U.N. Secretary-General Ban Ki-moon called for greater development aid and U.N. health chief Margaret Chan spoke about helping poor countries prepare against swine flu.
"The topic needs a voice, and I'm happy to lend my voice and give my time to end fistula."
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