Stand Up for African Mothers

Recently, The Times of London reporter Rosemary Bennett wrote a piece on Christine, a nurse who works with Amref Health Africa assisting in Vesciovaginal Fistula (also known as VVF or simply "fistula") repairs. VVF is a horrific injury cause by complications in birth when a health worker such as a midwife is not around to assist. Read more in this excerpt from The Times article:

When Christine M. started work as a nurse at Kenyatta National Hospital in Nairobi, the fortnightly “VVF” clinic was discussed in hushed tones. Colleagues warned her to stay away, calling it dirty, smelly work. The women who came were in a dreadful condition and they would haunt her dreams. Curiosity got the better of her.

“Yes it was terrible. These women were in a dreadful state, neglected, often thrown out by their families, usually divorced, some living totally isolated for 20 or 30 years. Some of the younger ones had tried to commit suicide. It was a shock as a newly qualified nurse,” she recalls.

She struggled to understand why these women’s lives had gone so badly wrong and discovered that they had been debilitated by childbirth. Vesicovaginal fistula is among the worst injuries of childbirth and is prevalent in rural Africa.

Malnutrition, early teenage pregnancy and female genital mutilation conspire to increase the risks of a difficult delivery. When a baby gets stuck in the birth canal, the only option when the nearest clinic is a day’s walk away is to labour on. The infant’s head cuts off the blood supply to the mother’s tissues, which disintegrate and tear. The baby dies and the mother is left with an injury that can destroy her life. Incontinent, smelling foul and leaking urine and sometimes faeces, she is invariable cast out of her home and community.

Christine was so moved by the plight of these women that she decided to make fistula repair her life’s work. She heard that Amref Health Africa was also dedicated to solving this little-discussed but devastating condition. Amref acknowledges that the repair work — surgery done with an epidural or under general anaesthetic — is expensive, with perhaps not the mass impact of vaccination programmes. However the effects of fistula are so traumatic that the charity runs camps in far- flung areas of east Africa, where dozens of women can be operated on in a single week when the team of two surgeons, an anaesthetist and two nurses arrive.

In the past 30 years, Christine has treated thousands of women, diagnosing fistula, preparing them for surgery and caring for them afterwards. She is also involved in training the next generation of nurses to take up the work. She has plenty of stories to tell. “There were two sisters who arrived separately at a camp. Both suffered fistula for more than 20 years but hadn’t dared to confide in one another. They were astonished to meet. Can you imagine being so ashamed you can’t even tell your own sister?” she says.

“There was a lady in her 50s who could not stop crying after her surgery. I kept telling her it was a success and she was dry. ‘I am so happy. Now I can wear a white petticoat,’ she said. ‘I haven’t been able to wear white for 20 years.’ ”

Younger women have gone on to meet new husbands and have children. Others, who she says were “dull, unhappy people”, have been cured of the depression they carried around with them for years.

Now approaching retirement, Christine says: “I really believe this is the best job in the world. It is sometimes hard to see people who have suffered so much. But I have transformed lives and that is an honour.”

To date, thanks to donors like you, Amref Health Africa's Stand Up for African Mothers campaign has trained 5,909 midwives who will help prevent injuries such as VVF during childbirth. 

Links:

• Amref Health Africa in the USA website