When you're broken

Before I delve into the wonderful weekend that I spent in Ghana, I wanted to devote an entire posting on something that I feel is so important, so tragic, and so completely unheard of in the Western world. Vesicovaginal fistula, or VVF.

VVF is most commonly caused by obstructed labor. Women may be in labor for days at a time, usually with very little help. Most women are told to squat, which they might do for most of this time. After a few days of this, the baby dies. Eventually the dead baby's head bones contract enough for the woman to expel the fetus. The labor has ended, but the woman's problems are just beginning.

The prolonged pressure of the baby's head on the woman's bladder causes tissue death. This forms a hole, or fistula, between the woman's bladder and vagina. This causes constant leakage of urine. Sometimes a fistula forms between the vagina and the rectum as well, causing fecal incontinence in addition the urinary incontinence. In extreme cases, there can be severe damage to the nerves, thus crippling the women.

Women with this condition are most often alone, having been abandoned by their husbands and rejected by society. They are reduced to living on the fringes of society, begging or working in the field to make a living. Their smell is offensive, and they have no way of managing it.

This is not a small problem in the developing world. It has been estimated, according to the website emedicine.medscape.com, that the number of unrepaired VVFs in the country of Nigeria could be as high as 1,000,000. This happens with great frequency due to several reasons. First, poor roads and distance bar rural women from access to proper health care. Lack of defined health care infrastructure causes a shortage of properly trained midwives who could identify problems as they arise. Many of these cultures encourage girls to be married before age 14, which means the girls are usually pregnant before they are fully developed.

About 90% of VVF cases can be treated and completely cured by a simple surgery. The Africa Mercy performs many of those, and we're doing it right now. The last 10% can never be fully cured because the damage to the bladder was too extensive or because scar tissue has blocked things beyond repair.

After the women receive the surgery and are officially declared "dry," the women are given a new dress. They call it the "garment of praise." There is a special ceremony where the women are presented with the dresses. Some women have had these problems for over 20 years. They are all truly grateful and excited for the new opportunities they have.

For more information on this tragedy that is befalling mothers in developing countries you can check out:
http://emedicine.medscape.com/article/267943-overview

I just read this book, and it is incredible:
http://www.amazon.com/Hospital-River-Story-Hope/dp/0825460719

Another resource:
http://www.fistulafoundation.org/index.html

Information on Mercy Ship's involvement:
http://www.mercyships.org.nz/what-we-do/our-progammes/vvf-surgery.html

Please pray that the procedures will be a success for all the women and that they will come to know Christ's love.