Saturday, May 10, 2014


Imagine the wet feeling of urine always running down your leg as you get up to welcome your visitors into your home.  Imagine the stench that plagues your clothes and anywhere that you spend more than a few seconds.  You wrestle daily with the desire to not drink water so you don’t leak as much volume… but then your pee is more concentrated and smells more.  Your family may have money, but they refuse to spend it on you because you are worthless.  You are nothing.  You just stink. 


That’s what it’s been like for Hawa for 8 years!  

Last year she was almost a success story after having had several surgeries here.  She was dry for a month.  I was so happy.  And then she leaked again.  

How do you measure success?  When do you just give up?  Why do some surgeries work and others don’t?  

I don’t know.  

I don’t know a lot.    

I don’t know why some surgeries work, and others don’t.  But I know I am persistent.  Sometimes that pays off too.  

And a lot of you are persistent.  

I posted on Facebook that I needed a little money to provide food for a fistula lady, and people wrote!  Money came in!  And I am so thankful for your prayers, encouragement, and every dollar that you sent.  

In the month of February we did 4 vesico-vaginal fistulas (google it).  Three were successes.  But not Hawa.   

Hawa came in originally with her bladder inside out.  The whole part that connects the bladder to the vagina under the pubic bone was gone.  Her left ureter was also gone.  She had a recto-vaginal fistula as well (an unnatural connecting tube between the rectum and the vagina, causing stool to leak into the vagina, which we have repaired).  

There were issues with all of her post-operative courses to say the least.  The first repair was a good one.  The tubing got kinked that goes from the foley to the bag.  Not good for fragile bladder/vaginal tissues.  The bladder fills with urine and the pressure on the surgical repair site causes breakdown of the surgical closure and leakage.  Still a lot of it took.  After this, her expired ureteral stent broke off in her one remaining ureter.  (We have since obtained some new ones from a generous company.)

The second surgery was another repair of her ever-present peri-urethral VVF openings.  We have done away with tubing by the way because of the kinking issue and lack of nursing.  Drip, drip, drip into a pan is the way to go.

Third and fourth more of the same.  Malaria with a post-operative course is no fun.  One of those times she developed a terrible cough, so that pretty much did us in.  Pressure (coughing) on fragile tissues is no good.  After her cough got better I repaired her 10 days post-operative (a no no because tissue is no good) to make number 5 because I was so annoyed the repair had broken.

Sixth surgery in February?  Went well.  Should have worked.  

She was dry for a week and a half.  But now she’s still got one tiny little hole to the right of her urethra.  It’s way better than it was, true.  But not dry yet!   

How do we measure success?  Do we say, “Well, she is way better than she was!” ?

When do we give up?  

I don’t want to give up because I know it will work the next time.

So… we will do it again.  But this time more severe.  I will open her up abdominally, do a supra-cervical hysterectomy (to take away her menstrual cycle), repair her fistula vaginally, and close her vagina to take away tension on the urethral area (have done lots of vaginal flaps that have helped her but not good enough).  

Unless someone else has any bright ideas!  : )  Or unless one of my Uro-gyn friends wants to come visit and help!  

I’m making her wait two months for the next surgery.  Book your tickets now!

In the mean time, she’s “my daughter.”  You who have sent money support her.  Every Sunday I give her $10 for the week to feed herself and her little boy.  For now she just hangs out at the hospital on her mat.  The hospital supports her because every VVF surgery we do is for free.

So thank you all for supporting Hawa.  She’s your daughter too.  Thank you for being part of her success story.  

It’s just not finished yet! 

Stay tuned in June and July.

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