March 10, 2007
Going home dry
Dr. Sue Makin with four women who had vesico-vaginal fistulas
repaired at Mulanje Mission Hospital.
Yesterday was a big day for four women from
Mozambique who have been waiting patiently at Mulanje Mission
Hospital to have their urinary catheters removed. It was a big
day for me too, as I got up early to get to the hospital to assist
them. These young women have been leaking urine uncontrollably
for six months to two years. The injuries to their bladders had
occurred in villages in Mozambique due to prolonged, unattended
labor. They all somehow survived this painful, life-threatening
ordeal, and they all had stillborn babies.
When I arrived at the hospital at 6:00 a.m.,
I asked the nurse on duty to ask the patients to come to my office
so I could remove their catheters. The nurse told me that one
could not walk very well. This woman not only suffered injury
to her bladder but the nerves to her legs were also injured by
the prolonged childbirth. I told the nurse to bring her in a wheelchair.
The other three came with some trepidation because they thought
they were going to have another painful experience.
It was a simple procedure to deflate the small
balloons in the catheters and remove them. During this time, there
was a knock on the door and the fourth woman came in. She had
limped over to the office with her stick that she uses for walking.
I wondered if I should help her onto the table so I could take
out her catheter. The other women helped her a bit toward the
table, but she got up on the table by herself.
It was all smiles for the ladies after their
catheters were taken out and they were not leaking.
Why, in the name of heaven, is this tragedy
still happening in developing countries? The answer, I think,
has many parts. Some of the factors are: the dreadful lack of
skilled birth attendants, lack of transportation for women with
prolonged labor in the villages, lack of knowledge about danger
signs in childbirth, and general ignorance about the special needs
of women planning to give birth. The World Health Organization
recommends that every woman have a “birth plan.” The
plan includes where she plans to be delivered, who will help her
get there, how much money she needs for the birth, and what to
do in case of emergency.
The underlying problem for women living in poverty
is that they have no money at all to set aside for childbirth.
Most of them have no power in their family to ask for money to
be set aside—and perhaps their husbands have no money anyway,
or they don’t care or understand. So women continue to do
their job, fulfill their obligation to conceive and bear children,
and continue to hope for the best when labor starts. I am amazed
and filled with admiration for their courage, the way they take
what comes their way stoically and matter-of-factly and continue
to get the job done as best they can—like the fourth woman
who dragged herself to my office and climbed up on the table with
two arms and one leg working.
Here’s some good news from Malawi and
Mulanje Mission Hospital where I have been working as an obstetrician/gynecologist
for the Presbyterian Church for the last eight years. Our nursing
school trains nurses and midwives who are skilled birth attendants.
Forty will graduate this year. We are part of a pilot program
to upgrade the skills and knowledge of midwives already working
at health centers so that they can improve outcomes in childbirth.
All care for women with vesico-vaginal fistulas who come to our
hospital is free of charge, including helping them with transportation
to and from the hospital. The program is supported by generous
donations from well-wishers around the world. One of our clinical
officers here in Mulanje has shown a special interest and aptitude
for the surgery necessary to repair the fistulas.
As I was talking to the four women who were
going home yesterday, I asked them to tell any women they might
know of in Mozambique or Malawi who had the same problem to come
to our hospital because we want to help them. They told me they
know many women who are leaking urine in the villages. May God
help us to help them.
Faithfully,
Sue Makin
The 2007 Mission Yearbook for Prayer &
Study, p. 337 |
