Celebrating Mother's Day

Last May I celebrated my first Mother’s Day as a mother: I am blessed with a delightful, healthy baby girl. Motherhood has made me appreciate all mothers, yet I find myself thinking about women whose dreams of motherhood were dashed by difficulties and loss.

In March I met a group of 17 such women in Niamey, Niger. Each one had dreamt of motherhood, felt the joy of kicking in their wombs, and talked to their growing babies as they went about their days, just as I did. Yet while I was in the care of an experienced doctor and delivered at a hospital, most of these women were in rural areas without any medical attention. They labored and labored, but nothing happened: Their babies were stuck. Emergency care came too late, and their babies died.

This tragedy was compounded when they soon discovered they were leaking urine: They had obstetric fistula. They couldn’t control the flow, even if they didn’t drink much or used cloth to soak up the mess. For some, their husbands and family members stood by them in spite of their smell, but many were shunned. They’d lost their babies, their health, and their relationships, too.

Fortunately, each woman found hope. Most fistulas can be repaired, and they’d heard about surgery at Lamordé, a hospital supported by the USAID-funded Fistula Care Project.

At Lamordé the women wait for fistula surgery in a plain space jammed with simple bed frames, without power for fans or air-conditioning in the sub-Saharan heat. Next door is space to cook or find shade to rest. Some women had been there more than a month.

At first glance, fistula repair surgery seems straightforward. A trained surgical team in an equipped hospital is all you need, right? But in much of Africa, there aren’t enough doctors to serve large, dispersed populations. Motivated surgeons need time to train, especially because of the complexity of repair: no two fistulas are alike. One fistula surgeon in a hospital is often not enough, because that doctor may be called away. Moreover, fistula repair is never an emergency, and understaffed and overburdened hospitals contend with competing priorities.

As I talked with each woman, I was amazed by her patience and endurance. After all they’ve been through, can’t we shorten their wait for surgery?

I have the privilege to work for EngenderHealth, which manages the Fistula Care Project. More than 11,000 women have had their lives transformed by fistula repair to date. Fistula Care equips hospitals and support training for local surgical teams in order to reduce client backlogs. We’re working on solutions like supporting travel for trained surgeons between hospitals, as well as encouraging quality improvement measures like better communication and record keeping.

Each of the 17 women I met has now had repair surgery. All are recovering, looking forward to going home and to rebuilding their lives. Many wish to have another child. I hope that they, too, will soon join me in discovering the joys of motherhood.

Carrie Ngongo is Senior Program Associate for the Fistula Care Project. She won an honorable mention for the essay above in the "Half the Sky" contest at the New York Times.

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