Zadie Smith is one of those contemporary writers who, despite being celebrated for her very British-ness, always seems to have her finger on the pulse of human behavior the world over. So much of her writing tackles issues of identity, race, classism and general “otherness” that her observations on human nature resonate with people from north-west London to the shores of Timor-Leste.

In “The Embassy of Cambodia,” her short story from this week’s New Yorker magazine, Smith once again transcends the supposedly narrow POV of her narrator – here, a 20-ish immigrant from Côte d’Ivoire making her way in present-day London – with a comment on the interest we take in people whose lives are far from our own, physically and intellectually:

"The fact is if we followed the history of every little country in this world -- in its dramatic as well as its quiet times -- we would have no space left in which to live our own lives or to apply ourselves to our necessary tasks, never mind indulge in occasional pleasures, like swimming. Surely there is something to be said for drawing a circle around our attention and remaining within that circle. But how large should this circle be?"

Out of context, these may seem like rather heavy-handed musings from a naïve protagonist, intended to force us all to address our own versions of these mentally constructed circles. But not only is this something we as individuals face on a daily basis when we skim the news headlines or ponder where to spend our next holiday, but it’s something we at Operation Fistula think about in professional terms. How many world issues can we become truly educated in? How do we choose who to care about? To put it bluntly, why fistula?

Though we may not like to admit it, imperfect knowledge is a handicap we all strive to overcome. We can never know everything about everything, but we work to belong somewhere, alongside some people, and to understand some piece of knowledge, however tiny, as best we can. We are drawing our circle around fistula, this sliver of maternal health, because we want to make it extinct. Though our knowledge of the cultures it inhabits may always be incomplete and our understanding of the exact circumstances and obstacles will only be as good as we are told and can observe ourselves, we have to try.

One of the most energizing parts of our job is the idea that we are reaching a neglected community. Women who suffer from fistula are some of the most marginalized, silent, and invisible people on the planet. We’re trying to find them, and to give them the opportunity they deserve to become functioning members of society again. And this is something we can cure! And even prevent! There is so much hope present in this scenario that we are genuinely excited to spread the word about the potential of eradication.

But the sobering part of the equation is the number of women currently relegated to second-class citizens. The estimate that 2 million women in Asia and Africa suffer from obstetric fistula is rough at best. The truth is that so many of these women are too ashamed to come forward. So where do we start? Where do we draw our circles? Who do we help?

We are fortunate to work alongside many other organizations devoted to improving maternal health in low- and middle-income countries, and many of them have established large-scale operations in some of the most densely populated areas in Africa and Asia. But because it’s so easy for small pockets of the population to fall through the cracks, OpFistula made the conscious decision to attend first to areas of neglect and under-reporting -- Malawi, Madagascar, the tiny countries in the west of the continent so many people can’t even locate on a map.

The numbers can be overwhelming, and the prospect of deciding who to care about is unpleasant. But in the desire to feel some integrity about the professional circles we’re forced to draw, we hope that our presence reassures the people of these neglected lands that they are not forgotten while we live our everyday lives so many miles away.