What is a fistula?
- A fistula is technically a hole between one organ and another where there should be no hole. In most of our cases, it is a devastating injury to the mother during a prolonged childbirth. Women regularly give birth without medical care in this country, and when a birth lasts 3 or 4 days, the pressure of the baby’s head against the pelvic bones cuts off circulation to the tissues caught between. This results in the death of the tissue, and a hole opens up between the bladder and the vagina, or sometimes also the rectum and the vagina. The baby most often dies, and the mother is left with a continuous, uncontrolled flow of urine or/and feces. The result is a bad smell and stigma that often results in a divorce and rejection by others, besides sorrow over the loss of the baby.
So what do you do at the Fistula Center?
- We welcome women with fistulas and give them a home in our “village” where they are surrounded with other women like themselves. We build up their health if necessary to prepare them for surgery, and we perform the delicate surgery of reconstruction. Then we encourage them to remain at the “village” for at least 3 months to promote complete healing. During that time we train them in embroidery and knitting, reading and writing, and other skills. We also share the story of Jesus with them and seek to address the emotional pain they have suffered through counseling and special sessions on trauma healing.
Do you only treat obstetric fistulas?
- We also treat fistulas caused by traditional practices such as female genital cutting. We treat other women with urinary incontinence issues that can be treated with surgery.
Are all your surgeries successful?
- If it is a first-time surgery, we have a high success rate just above 90%. Some of the women we see come from other hospitals where they have had several previous unsuccessful surgeries. In these cases we see about a 50% success rate. Unfortunately, with each unsuccessful attempt, the chances of a future successful surgery diminish. The overall success rate is about 75%. Physical therapy can strengthen muscles that have become weak or tight by providing stretching and exercises to achieve good bladder control, achieving a better overall result than surgery alone.
How do the women pay for their care
and their long-term living expenses?
- Donations from partner organizations and individuals pay for the surgery and care for the fistula patients. Their donations allow us to offer it to them for free. Women who have other surgeries for incontinence are asked to pay reasonable fees.
What are your seasons like?
- Hot and hotter! In July-September and sometimes a little on each side of these months we have rainy season, where it rains once or twice a week if the rains are good. Temperatures range from 78-95 degrees F or 25-35 degrees C. We have a hot spike in October, and then temperatures moderate and humidity drops in November-February. This is most Westerners’ favorite time of year, “Cold Season”, where lows and highs are about 58-85 F/ 14-30 C. We also get heavy dust during this time. “Hot Season” is from March till the rains start in May or June, where daily highs exceed 115 F /46 C and lows may not drop below 90F /32 C.
What do you eat?
- We eat generally the same sorts of things we do in our home countries, but we eat a lot less cheese, less meat and fish, less variety in fruits and vegetables, and a lot more rice and pasta. We find that it is easier to cook foods in a quasi-Asian style, like curries and stir fries. We avoid long cooking times (heats up the house) and grilling meat (it’s too tough).
What does poverty look like?
- This is a very complicated question. Malnutrition, a very poor educational system, low literacy rates, poor quality items for sale, a lack of medical facilities outside of large population centers, and isolation from helpful knowledge are all symptoms of poverty. When people have almost no money, they will put off medical treatment as long as possible, hoping the person will get well on their own. They will also seek cheaper traditional cures. For this double reason, many of the patients we see are far sicker than they would have been if they had come in earlier, and for some, sadly, it is too late.