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waiting for fistula treatment
Women like Grace, who here is awaiting fistula treatment in Masaka, Uganda, do not conform to the stereotypical image we have of them. Photograph: Seth Cochran
Women like Grace, who here is awaiting fistula treatment in Masaka, Uganda, do not conform to the stereotypical image we have of them. Photograph: Seth Cochran

Poverty porn: is sensationalism justified if it helps those in need?

This article is more than 10 years old
Stories about fistula in the media prove we've got to do a better job of reporting the plight of the people we want to help – so that the voices that emerge are not ours, but theirs

My journalism professor was fond of a provocative anecdote, the punch line of which was made famous by the foreign correspondent Edward Behr. Simultaneously reprehensible and practical, it is a poignant comment on the profession of conflict reporting.

To set the scene: a grizzled reporter treks to the middle of a Congolese war zone. Men with machetes abound, women clutching half-clothed children are weeping. It's a familiar sight on this beat, and the reporter knows what he has to do now is get the horror-flecked story inherent to the region's conflict.

And thus his query: "Anyone here been raped and speaks English?"

Poverty porn is a well-established trope in media-studies circles. Violent deaths. Bone-chilling rapes. Diseases that leave bodies ravaged and mutilated. Hunger that is evident in the rib cages of small children. These ubiquitous images practically define today's perception of humanitarian work.

By comparison, quality-of-life issues elicit little more than a yawn. If no one's dead or dying, there are more compelling causes beckoning.

The ethics of humanitarian reporting is perpetually ripe for discussion in the age of sensationalism and "worst is best" attitudes. But reporters and aid workers may find more and more that they're after the same thing: a compelling story, whether to sell papers or raise funds. With compassion fatigue plaguing the western world, what's wrong with a little drama if it ultimately helps those in need?

The organisation I work for, Operation Obstetric Fistula (OperationOF), is a global health non-profit. We're tiny, we're young, and we're working to increase awareness and treatment capacity for the childbirth injury obstetric fistula. It primarily affects poor, uneducated, rural-dwelling women in sub-Saharan Africa.

Women with this injury leak urine, constantly. They smell horrid. They leave a telling trail of fluid in their wake and dripping down their own legs. It is embarrassing, it is stigmatising, and it is an unacceptable way of life.

It is also the perfect set-up for a closer examination of the poverty porn dilemma, because of the stereotypical image now associated with a fistula sufferer – that of a girl married too young, losing her children in stillbirth, and ostracised because of her smell. As Nigerian writer Chimamanda Ngozi Adichie has said: "the problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story."

A recent duo of articles on fistula presented both sides of the coin. The first, a CNN piece given the ominous headline – 'A fate worse than death for scores of African women' – used all the tools in fistula's arsenal of devastation. By sketching profiles of several sufferers, the reporter guided readers who had likely never heard of the condition to understand that fistula's effects are social and psychological, in addition to merely physical. The piece garnered more than half a million page views – a huge win for awareness.

Then there was the blog written in response. Ali Heller, a doctoral candidate in anthropology writing a dissertation on fistula patients in Niger, expressed frustration with mainstream media's insistence on sensationalism.

Titled, 'The Race to the Bottom and the Superlative Sufferer', Heller writes of fistula: "Imagine for a minute that you were chronically incontinent. Now imagine that you didn't have access to adult diapers or sanitary napkins. ... Imagine how the acidity of the unremitting flow of urine burned away at your thighs, cracking your skin and leaving you vulnerable to painful infections. Imagine the shame you'd feel – a grown adult incapable of avoiding the small pool of urine you'd leave behind on a friend's chair after a visit ... Why must we highlight the extreme cases when the norm is bad enough?"

The piece was thought-provoking and challenging. And it probably was read by a few dozen people.

Granted, CNN is a global media brand and even its worst piece would get better traffic than the best blogpost almost anywhere. But the integrity of what is communicated is personal for Heller, and it's personal for me. Which brings us back to the responsibility of aid organisations like OperationOF.

At Queens hospital in Malawi this spring, we interviewed doctors and patients to learn more about regional obstacles and realities – and to collect stories to boost fundraising efforts. The first three patients I spoke to were in their mid-20s and 30s. They all said their husbands were supportive. All three had developed their fistulae just recently. None of them fit the stereotype and listening to the banal responses of these capable, average women, I was bored. With each drab answer to my prying questions, I was scanning the room for other girls with better sob stories.

This is a difficult admission. That I deemed their situations not awful enough to merit attention means I had failed at a very human level: an inability to find a story in the quiet, unassuming lives of my fellow humans.

But I also failed on both an aid-worker and journalistic level. What had happened to the girl with the jagged scar on her forehead? Or the lady missing an eye? I couldn't muster the audacity to ask these women to share intimacies that might be terribly painful for them to recall, just so their sorrow might pull in a few extra dollars to help others like them.

Therein lies the challenge. I don't believe we've yet found the best way to talk about these complex issues. And that's on us. But two takeaways that strike me most are: the academic criticisms we revel in look different when applied to the realities of aid work; and we need to become better storytellers.

The truth is that we don't necessarily crave high drama in our stories. We just like them well told. It isn't an easy fix (partly because I don't think the best writers would work for non-profit wages) but if there is one thing that connects humans the world over, it is stories. We've just got to do a better job of telling them, so that the voices that emerge are not ours, but theirs.

Glendora Meikle is the project director for OperationOF. Follow her on Twitter: @gmeiks

Editor's note: for more on communicating development, read the 'best bits' from our live chat: Development with dignity – how to talk aid.

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