There's a Place for Me

 

Imagine being newly married and pregnant. Imagine having a difficult and long labor without access to an epidural or pain medication much less a cesarean section. Now imagine you experience a stillbirth and then realize in the days after that not only are you having normal postpartum bleeding, but you are also unable to control your bladder. In fact, you are wet all the time. You begin to smell of urine, and your skin becomes calloused with exposure to the acidic urine. You stop drinking water, as the dehydration lessens the wetness. This causes the smell to increase with the concentration of urine and puts you at risk for kidney stones. Imagine your husband calls you “detestable” and refuses to let you stay with him. Your friends abandon you and laugh at your condition. You go back to your family without the expected grandchild or niece or nephew, and after a short time, they also decide that they cannot stand being around you or their house smelling. Imagine having no place to go, being utterly alone. The following three paragraphs are three different first-hand accounts, translated as closely as possible from their mother tongue to French and then English. Grab a tissue.

“I was expecting a child and for a whole week I had labor pains so I was taken to the hospital of [omitted for privacy] after having already labored in a health center. And I delivered a boy and the urine started to pour out of my vagina, but my son was killed mysteriously by the sorcerer. Now it has been 29 years that I’ve had this sickness. After having it, I started to be uncomfortable, as I had to wash all the time in order to not smell like urine. I couldn’t stay in the community because I smelled like urine, I avoided the church because I was wet just sitting down, and even my business I could no longer do because I was not going to be received well knowing that I would dirty their chair or their bed with urine but that also, I smelled like urine. My husband heard the news on the radio and we came. After this operation, I think that this time I will be healed and I have not had any more leakage of urine this time. It is a good thing. I will be able to get my life back and I will be happy.” -29 years after symphysiotomy, a process by which the pelvic bones are separated/broken apart at the cartilage in the front in order to expedite a delivery when a cesarean section is not feasible.

“I was suffering from abdominal pain and the doctors said that I had appendicitis and an ovarian cyst and that it was necessary to operate, but one week later, it hadn’t happened. We had changed the hospital and they told me that my vagina didn’t form all the way and they operated. Urine started to pour out of my vagina. We put in a vaginal compress and the doctors assured me that there would be no further leakage but it continued and as the days passed, there was a lot of urine and also poop that came out of my vagina. We returned to the hospital but they said they could not do anything more for me. Other girls my age laughed at me, I was uncomfortable to see girls my age who were in good condition and not me, and everything made me so sad that I got a stomach ulcer. I believe that I’ll be healed after this operation and that I will wait. I will be very happy to feel that all the openings were closed and I will be able to live like all the girls my age and think of getting married and having children and even my parents will be happy. We heard it on the radio, that’s why we came.” -young woman with transverse vaginal septum (a congenital malformation) who had a large 7cm left ovarian cyst and 3 separate fistulas: one into her bladder, one into her rectum, and one from her bladder to her upper vagina.

“Everything started in 1981 by the first pregnancy that I had and the infant was blocked by the head at the entrance of the vagina and the labor was long before I could deliver and the baby was dead. It was after that difficult delivery that I developed the fistula. My husband abandoned me after that, telling me that I leaked urine from my vagina and I was gross and he said a lot of other hurtful things before he left me. My brothers abandoned me, telling me that my urine leaked out of my vagina and that no one could look at me anymore or love me anymore, in the family or in the village and to live I was forced to sell my goats and chickens to be able to eat. I spent my life thinking of my situation, my state of being and my son that I lost who could have helped me. Instead, I was alone. For 41 years, I tried to get fixed and was operated on 3 times and that didn’t work. So, when I heard the information [about the fistula campaign] I came. I believe that this time I will be healed of this sickness and I will live my own life. I cannot do anything more.” -delightful older woman who came alone, without a fistula but without ability to control her urine as her urethra was destroyed.

This year, our fistula campaign presented more women with complex fistulas, malformations, double and triple fistulas, multiple prior repairs, no urethra, and bizarre presentations after symphysiotomy. For one, we even had to reconstruct a urethra out of skin from the inside of her mouth. These complex ones are done primarily by expert fistula surgeon and urologist Dr. Paulin Kapaya of Kinshasa, although we all work as one team with two operating tables in the same room in order to be able to discuss difficult steps and share ideas. We operated for 8 days instead of 6 as we had in previous years. Dr. Sarah Kennedy and I spent most of our days operating, as you might imagine. Thankfully the third member of the US part of our team, Katherine Krosley, was able to get out into the community, take part in a public health class at the nursing school, visit health centers, watch normal labor and delivery, experience the malnutrition center, and perhaps most importantly, spend some quality time with the fistula patients post operatively.

If you know Katherine, she is quite a talented musician. She can make up a song on the spot, infuse it with humor or sadness, and brilliantly deliver. Many people in Vanga were blessed by her songs. Each year after all of the surgeries are completed, we have a party to celebrate all the work we have done and all the work the postop and kitchen teams have yet to do. We always debrief about the campaign as a whole, both its strengths and weaknesses. This year, a strength that was highlighted was the psychological and spiritual healing spurred on by the time that Katherine spent with the patients, singing and playing guitar with some of the medical students and nurses, and hearing some of their stories which we have highlighted. Perhaps no one interaction made more of an impact on Katherine or the patient herself, than when she sang to woman who was utterly alone for over 40 years.

She sang… 

Who the Son sets free, is free indeed. I'm a child of God. Yes, I am.

In my Father’s House, there’s a place for me. I’m a child of God. Yes, I am.

There’s a place for me. We can’t even imagine the pain, the loneliness, the shame she has endured. Though her situation is difficult and complete physical healing which we trust in will be a miracle, she can know now that she is not alone. She’s a child of God. She may not be completely continent, but she can know she is completely loved. There’s a place for her, just as there’s a place for me.