Yes, after six weeks (or there abouts) of plastics I am back into the world of maxillo-facial surgeries and NG feeds! The first night back was fairly busy as I reacquainted myself to this genre of care but the last two nights have been fairly quiet. ...Hence, this update at 2am my time! We have only 8 plastics in-patients left on the ward and have discharged several general surgeries (hernia repairs, cyst removals, etc) and max-fac patients over the last two days but tomorrow starts another day of admissions in preparation for Monday's surgeries.
In another week we will be starting two weeks of surgery for VVF (vesico-vaginal fistula) ladies. These surgeries are to repair holes between the birth canal and urinary and/or fecal tracks. There are many causes of VVF (or the other varieties of fistulas we'll see) but one of the main ones is the disproportion between the pelvis size and the size of the baby being born. The children here start working very young and often carry loads on their heads that would be heavy for you or I to carry. This, combined with poor nutrition, means that most of the energy they get from their food is put into their work and not into growth. So, often, they remain smaller framed. Also, sometimes these girls are married quite young (more so in the northern rural tribal areas) and have not yet finished growing themselves when they become pregnant. (A young woman doesn't stop growing until at least 18-21 yr of age.) Because of their smaller frames, the baby's head is too large to fit through the pelvis and becomes stuck. These women are often in labor for several days (one I've heard of was in labor for a week!) without medical clinics available or too far away to get to. With no one around to help, the baby dies and sometimes, so does the mother. If the mother survives, she soon realizes that her urine and/or feces leak constantly and she may also have some weakness or paralysis of her legs. Because of the leaking, no one wants her around and she is often rejected by her entire community, even her husband and family. The social shame, embarrassment, disgrace and rejection that go with these conditions cause untold emotional pain for these women. Some of these women come to us young (16-20yr). Others have had to deal with this for more than 20+ yrs! Along with the surgery, they have exercises to do and their bladders and muscles must be retrained to function properly. They also need lots and lots of complete support (emotional, social, spiritual, physical, etc.). Not all holes are able to be fixed and some may take more than one surgery but each woman comes here with the hope of being "fixed." There are many fears and expectations as well as emotional scars that each one must deal with. At the end of these two weeks, each woman receives a new dress to symbolize the new life that she's been given and we celebrate with them at the New Dress Ceremony. Though many of these women are unable to have any more children some do. They will never be able to have a natural birth again as that may cause the repairs to tear. So each woman is given a card stating that arrangements have been made with a local doctor to provide free c-sections should they have more children.
I have heard several of these ladies' stories--some ending with joy and happy reunions with husbands and families while others are unable to return home or bear children and must find other means to live--and yet God shows Himself faithful to each one. Along with providing them a new life through their repairs, we have the opportunity to tell them of another new life they can have through Jesus Christ. The joy you see in their smiles, knowing the pain they have already experienced, can't help but encourage you! Everyone here is looking forward to those two weeks!
Wow! I can't believe it! I have only three weeks left! One more week of max-fac and general surgeries then two weeks of VVF and my time here will be over! Though I am looking forward to being home, I have tried to enjoy every day for what it holds. My worst fear is that I'll get home and have regrets about opportunities I didn't take and what I didn't do. I already know that there will be several African friends that I will miss! Thank the Lord for heaven! I'll have all of eternity to see them again!
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