Missionary doctors like to write journal entries about their patients; and I suppose I am no exception. This story of Naomi (not her real name) typifies a problem that is gaining more and more attention in the media in recent months; a condition that many women in Africa suffer from and cry out for help:  traumatic fistulas.

 What is a fistula?

A fistula is a condition caused by mismanaged labor or sometimes violent rape as often seen in rebel-occupied Congo. Fistulas result in involuntary loss of urine as well as severe social stigma and distress.  Women who suffer from this condition (in the hundreds where we serve) are often put out of their homes, left by their husbands, and shunned by their communities.  Many consider the social isolation worse than Aids and indeed the lives they live are akin to modern-day lepers.

 A child becomes pregnant

Naomi came from a particularly poor family and was married off at age thirteen by her uncle who was paid a handsome dowry for her by a middle-aged man from another town.   Six months later, Naomi became pregnant and her husband was unwilling to send her to the local clinic for prenatal care as he was embarrassed about getting such a young girl pregnant.   Instead he sent her back to her village to have the baby, to the same family that was so impoverished that they had sold her off in the first place.  Several months later when Naomi went into labor her cousin walked her over to the thatched hut of a traditional midwife to give birth as her family had no money to send her to the hospital.

 Naomi spent four agonizing days in labor.  She was told to push, had others sit on her abdomen, and eventually the baby died.   On the 5th day she was put astride a bicycle and two persons pushed her to the hospital where the child was removed by c-section.  Unfortunately Naomi’s troubles did not end there.

   Prolonged care and no cure

After a long stay at the public hospital, further prolonged by the fact that no one visited her or could pay her bill, she was discharged and reluctantly walked back to her husband’s village.  However she now had a sizeable fistula (tear) from her traumatic labor and was incontinent of urine. She smelled constantly and could not keep her clothes unsoiled during the day or bedding clean at night. Her husband kicked her out of their home and her own family did not welcome her back.  She was rejected by a husband she never wanted and a family who sold her off ….and bore the emotional and physical scars of bearing a child while still one herself.  Her hope for a normal life was over.

 A pariah in her own village

For eight years she was a pariah in her own village surviving in a small mud dwelling at the edge of town fixing clothes with a sewing machine her grandmother gave her….repairing clothing of other children and other husbands.  

One day she heard that a team of visiting doctors at a mission hospital was repairing fistulas such as hers.  She took her sole possession (her sewing machine) to the hospital with the intent of bartering it for surgical care. She was successfully operated on and returned home 6 weeks later; physically healed and with her sewing machine in tow.

 A second chance

We may not be able to remove the scars of those tender teenage years or repair her life as easily as we have her fistula; but we have given Naomi a second chance of reintegrating into a community and an indelible message that she is precious and loved indeed; not only by our network of friends, churches, and supporting partners, but more so and especially…. by Jesus Himself. 

And behold, a woman who had suffered from a hemorrhage for twelve years came up behind him and touched the fringe of his garment and said to herself; “If I only touch his garment I shall be made well”  Matthew 9:18-26