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January 12, 2000
It Takes a Team
Greetings from Mulanje Mission Hospital where the rains have
come this January and the corn is growing. I am sending a photograph
that I hope will tell a story about some of our work here in Africa.
First, I will identify the people in the photo: on the right is
Miss Gwembere, surgical nurse, next is Mrs. Louka, one of our
patients; next is Mr. Gama, our senior clinical officer; and I
am the tall one. This is part of a surgical team that participated
in a successful operation for Mrs. Louka. We have taken this picture
to celebrate and remember. There are others who are not in the
photo because I could not locate them at the right moment. There
is Mr. Lingalawe, our medical assistant who gave the anesthesia
for the operation; Miss Kubwalo, another surgical nurse; the ladies
who keep the operating room clean and the instruments sterile;
and several other nurses and nursing students who helped with
ten days of intensive post-operative care.
Now, why is Mrs Loulka so special that would I want to take this
photo? She is one of thousands of women scattered around the world
who suffer from obstetrical vesico-vaginal fistulas. This problem
is unknown in the United States or anywhere that adequate obstetrical
care is available to the women who need it.
These fistulas result from prolonged and unattended labor. Often
the woman may be in labor for three to five days, and her child
is stillborn. She may have been carried for hours to days on a
makeshift litter or clinging to the back of a bicycle to a place
where she can find help. Her dead baby has to be extracted by
caesarean section or a destructive operation on the baby. She
herself is dehydrated, infected, exhausted, and probably thinking
that she is going to die. Her uterus has kept on contracting even
though the baby is too big to be born naturally. The pounding
action of these uterine contractions pushing the baby’s head
against the bones of the mother’s pelvis has caused something
like a pressure sore in the area between the vagina and the bladder
Women who survive this ordeal are left with a permanent hole
between the bladder and the vagina. This means that they have
no control over their urine flow. The urine leaks out of the vagina
as it is manufactured in the kidneys. These unfortunate women
are wet with urine all the time. Often their husbands leave them,
and they become outcasts in their own family and community. Many
of these women do not even know that they have a potentially correctable
surgical problem. Some of them think they have been cursed because
they caused the death of their baby.
Our hearts go out to these women. We want to help them and cure
them, if possible. It takes a real team effort to have a successful
operation. From start to finish and even for ten days after the
operation, all systems must be go for the thing to work. In the
middle of the night if the urinary catheter which is draining
the bladder after the surgery gets clogged up or comes out, the
whole operation can be a failure if a new catheter is not inserted.
This is one operation that can fail at any number of points along
the way. I try to explain this to the patients before operating.
Half way through Mrs. Loulka’s operation, I felt like the
thing was not going to work. There was too big a hole, and too
little healthy tissue to bring it all together. We plowed on because
there, of course, was nothing else to do.
Even on the tenth day when we removed the catheter, I felt like
it was a failure. Mrs. Louka was still wet. But then she came
back in a month and said she was only wet in the mornings, not
at night. Then a month later she came back with a big smile and
a chicken. The chicken rather messed up the decorum of the office
with her clucking and fidgeting, but it tasted good. Now it looks
like the operation is almost completely successful, and so, it
is time for the victory photo.
Like so many problems in life, it takes a team to reach the goal
together. When the lady who washes the surgical instruments after
an operation is sick, we may not be able to do another operation
until she comes back, or we find someone else to do it.
I want to thank you for being part of our love team at Mulanje
Mission Hospital. And the King will answer and say to them,
"Assuredly, I say to you, in as much as you did it to one
of the least of these My brethren, you did it to Me"
(Matthew 25:40)
And now a message from our sponsor, the Presbyterian Church (U.S.A.).
This message is only to churches that participate in the Directed
Mission Support (DMS) process of our church, which supports missionaries
overseas. Dear Friends, "Would you please use the pledge
form in the back of the DMS book for the year 2000? You can get
a free copy of the DMS book by calling (800-524-2612) and asking
for PDS #68700-00-050. The use of this form will help budget planning
immeasurably and make for fewer mistakes, less confusion, and
less frustration. And by the way. thanks so much for your support
because without it, I would not be here."
Dr. Sue Makin
The 2000 Mission Yearbook for Prayer & Study, p. 40
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