“Maria’s” first
pregnancy ended in 2 days of labor, an eventual delivery by vacuum extraction,
a dead baby, and an obstetric fistula. Over the next 10 years she had four
unsuccessful fistula repair surgeries at two different locations, multiple still-births,
and the ongoing burden of constantly leaking urine. When she came to Danja
Fistula Center, the medical team soon discovered that she had an infection
requiring immediate attention. As she recovered on the ward, she shared her
heartrending story of loss.
Once the infection was
brought under control, staff members gave her instruction and care in the areas
of health and emotional well-being, as well as good nutrition. Finally the day for her surgery came.
Following a successful pubo-coccigeal ligament sling (FMS) surgery, she
experienced an improvement but started to leak urine a short period later. After medical consultation, she underwent 3
weeks of physical therapy with dramatic improvement. During this time, she
continued to learn embroidery as an income-generating skill in the
reintegration program.
When the leaking
resumed one day, Maria burst into tears as the surgeon declared that the
recommended course of action was not surgery but physical therapy. During
individual psychotherapy sessions with DFC’s psychologist, the problem became
apparent: Maria had been diligent in practicing two exercises following
discharge, but was unable to demonstrate the core pelvic strengthening
exercises. She had forgotten some key exercises!
Competent medical
care, specialized surgery, skillful physical therapy, and thoughtful,
individual sleuthing from a caring psychologist worked together. A hopeful
Maria emerged dry and continent after relearning her exercises and
demonstrating recall of these in physical therapy sessions. She resolved to continue
her exercises and returned home, confident and triumphant.