I suffered a long-overdue breakdown yesterday just before lunch. I decided reluctantly that I did want lunch, so I cleaned up my face, blew my nose, and headed to the dining room, more to find a friendly face than to eat. I sat with Trudi (God bless her!) and, while trying to give the gist of what had upset me, I started tearing up again. When I asked down the table for a napkin, one kind nurse asked what was wrong. "I work in B ward, with the VVF ladies". "Oh, enough said", she replied.
It is a well-known and understood fact amongst those who work in the hospital, and for most on the ship, how very difficult this season of VVF surgeries has been. For those far and wide who I have neglected to communicate with, I will fill you in a bit.
Vesico vaginal fistula, or VVF, is a result of obstructed labor causing a hole to develop in the bladder, resulting in a a constant leaking of urine after her baby has been delivered (often stillborn). This problem is almost 100% preventable, but too common in West Africa. It ruins women's lives. They can't work, they are often abandoned by husband and family. They live as outcasts, if they have the will to live at all.
VVF surgeries started on the ship in November. I transferred to B ward to work with the VVF ladies. There was a lot of excitement as exams were done and surgeries commenced. But one by one, most remained wet after surgery. Many were turned away by the first surgeon. "Have her come back for the second surgeon, she has more experience with difficult cases". So they were asked to wait. A good many waited with us on the ward, others at the local hospital. With every set-back, like the women themselves, the nurses clung to the hope that maybe the next surgeon would give a better prognosis. Most of the women here have had unsuccessful repairs locally. Subsequent repairs create scar tissue, increasing difficulty with each surgery.
Our third and final surgeon began exams on Monday, surgery on Tuesday. Six of our twenty on the ward were given a "no"straight off.
One of those turned away is just 20 years old. Diarraye is a beautiful young lady with a mischievous grin and quiet affection. She was married off young. Her first pregnancy caused her fistula. Her baby was stillborn, her husband eventually left her. She cannot work with the condition. She has no education. Her prospects are dire. After she was told there was no possible surgery, there isn't any healthy tissue to reconstruct, Diarraye lay on the floor wailing, inconsolable. By the next morning she sat in her bed, more sedate than usual, but with the same half smile as usual. Quiet acceptance of a fate beyond her control.
There aren't words to describe the heartbreak, the sheer unfairness of it all. Tragic things happen all over the world every day, but this is PREVENTABLE. As charge nurse on the ward I've tried to hold it together, dealing with issues as they come up, loving on each woman while she's with us, even if we can't help her medically. Yesterday, on my day off, there was no stopping the floodgates from opening, my tears flowing unchecked down onto my shirt, over my computer, streaking makeup down my face. A small relief to the sickness of heart I feel when I think of each one of these precious women walking away from this ship, unchanged and utterly hopeless. God, be their hope where they have none.
