John and I arrived home in the US last night, to spend a
night in Boston with Aaron and Rachel.
One of Rachel’s first questions to me:
‘Were you working with women who had experienced obstetric fistulas? I
read a Mother’s Day article in the NY Times last Sunday about that.’
Yes! I did, and
because she had read the article, Rachel was familiar with the work I did on
Africa Mercy.
I have worked with Dr. Arrowsmith in Liberia, and now one
of his esteemed colleagues, Dr. Lauri Romanzi in Togo. The nurse who was the team-leader in our
Africa Mercy VVF surgery outreach has worked at the hospital in Niger. There’s much work still to be done to correct
and prevent this horrible problem hurting so many women in sub-Saharan Africa,
but I’m thankful to have been a little part of the solution and to myself have seen and worked with former VVF patients who are in the 'paying-it-forward' mode.
I am so grateful Rachel kept the article. It is copyrighted, and I hereby give credit
where credit is due.
Nicholas D Kristof, Saving
The Lives of Moms The New York Times, Sunday, May 13, 2012.
This is a Mother’s Day tribute to a mighty woman and to
the doctor who gave her back her life – and also a celebration of a grand new
woman’s hospital that you as readers helped to build.
The woman is Mahabouba Mohammed, an Ethiopian who was
raped at about age 13. She gave birth
alone: after many days of labor, the
baby was stillborn and she suffered an obstetric fistula.
A fistula is just about the worst fate that can happen to
a woman or girl. It’s a childbirth
injury that causes her to leak urine or feces continuously through her
vagina. In Mahabouba’s case, she also
suffered nerve damage in both legs so that she couldn’t walk.
More than two million women and girls have fistulas
worldwide. They are the lepers of the 21st
century, among the most voiceless and shunned people on earth. Fistulas were once also common in America (a fistula
hospital was once located in Manhattan where the Waldorf-Astoria Hotel is now,)
but today they normally afflict only people in poor countries of Africa and
Asia.
Mahabouba smelled foul, and villagers thought she had
been curse by God. They put her in a hut
at the edge of the village and took off the door – so the hyenas would get her
that night.
When the hyenas came, Mahabouba used a stick to fend them
off. The next morning she set off crawling
to get to an American missionary who lived more than 30 miles away. The missionary took her to the Addis Ababa
Fistula Hospital where she met Steven Arrowsmith, and American urologist from
Grand Rapids, MI.
Arrowsmith, now 54, has devoted his life to helping women
and girls with fistulas, and he has almost certainly repaired more fistuals
than any other American doctor. But
Mahabouba’s case was unusually complicated – much of her tissue had rotted away
– and she was in a deep depression.
“It was painful to be within three feet of her, because
she was so miserable,” Arrowsmith recalled.
She was also illiterate and did not understand the main Ethiopian
language or the ways of cities.
He laughs now as he recalls the time his wife, Jan, a
family physician, took Mahabouba to a prosthesis shop to get a leg brace so she
could try walking again. Everybody else
in the storehad lost a leg or two from land mines, and Mahabouba grew
panicky. Fearing that she was about to
hae her legs sawed off, she tried to flee.
In the end Arrowsmith performed a $450 surgery on
Mahabouba to repair her fistula. While
she recovered she began to help out in the ward. Smart and capable, she was given more
responsibilities, and by the time I met her in 2003, she was on the hospital’s
nursing staff. She’s a wonderful example
of how such women can be turned from squandered assets into productive
resources.
Mahabouba has become very close to the Arrowsmiths,
calling them Mommy and Daddy. When she
won an apartment in a lottery in the Ethiopian capital, she was thrilled
because, as she told the Arrowsmiths, “Now that I have a place, I can take care
of you when you’re old.”
Then there was the Liberian woman who, after her fistula
was repaired, named a grandchild “Doctor Steve.” In Niger, the women have affectionately named
Dr. Arrowsmith “Chief of Urine” – and all this makes him think that has the world’s
best job.
“People in America can’t believe I left urology to do
this, but this is about changing live” which is better than “listening to men
tell me about the quality of their erections,” he said. “I’ve had my family held at gunpoint, I’ve
had malaria, I’ve had a serious exposure to HIV, I’ve been separated from
family, and I’ve spent about a million hours crammed into coach class on
airlines, but it’s worth it. I’d much
rather live a meaningful life than a comfortable one.”
Left untreated, women and girls with fistulas become
pariahs. Their husbands divorce them,
and they are moved to a hut at the edge of the village. They lie there in pools of their waste,
feeling deeply ashamed, trying to avoid food and water because of the shame of
incontinence, and eventually they die of an infection or simple starvation.
But there’s renewed hope for these women. The Fistula Foundation has been underwriting corrective
surgery in many countries, and the United States Agency for International
Development is helping as well.
Representative Rosa DeLauro, a Connecticut Democrat says she will introduce
a bill on Tuesday that would create a program to eradicate fistulas
worldwide.
For years, Dr. Arrowsmith has been dreaming – along with
Dr. Lewis Wall, a fistula expert at Washington University School of Medicine in
St. Louis – of establishing a fistula hospital in West Africa. After I wrote about their organization, The
Worldwide Fistula Fund, a couple of years, ago, Times readers responded with an
outpouring of support – some $500,000.
This is what your contributions achieved: The hospital recently opened in Danja, Niger. More than 60 women with fistulas were waiting
at the ribbon-cutting, and a surgeon from the nearby country of Burkina Faso is
working through the backlog.
The hospital has also started an outreach program to
provide prenatal care, family planning and other help for maternal and child
health. The aim is to save lives as well
as prevent fistulas.
Now Dr. Arrowsmith and Dr. Wall are trying to raise
$500,000 in annual operating costs so that the hospital can perform up to 1,000
fistula repairs a year.
“It’s a very small amount of money for the difference it
can make in somebody’ s life,” Dr. wall
said. “the problem is that an amount
like that, less than the cost of an iPad in the States, is too much for the
average Africa who suffers the problem.”
This Mother’s Day, we’ll spend $18 billion on Flowers,
dinners and spa treatments – all of which is merited. But it is also an occasion to celebrate much
more modest gifts that have created a hospital with transformational power.
You see the power of such a gift when you watch Mahabouba
attend to frightened ashamed teenage girls with fistulas. And Mahabouba will soon spread her wings
further: the new fistula hospital plans
to bring her to Niger so that she can help train the nursing staff, paying
forward the gift that she received.
