An African Adventure: Hope Reborn

There is one surgical program we specialize in here on the ship that is pretty foreign to people in the states.

{I heard a story that Dr. Steve Arrowsmith (our VVF surgeon from Michigan) got a call one day from New York about a patient they had with an odd case. Turns out, she had a VVF and Dr. Arrowsmith was the only doctor in the US that hospital knew who could perform her surgery! That's how uncommon this is back home....}

VVF (vesico-vaginal fistula) is common in Africa because of the lack of obstetric care. The Mercy Ships program, aptly titled “Hope Reborn,” will give hope to women who have been suffering from an extremely debilitating condition for many years.

VVF is caused by difficulties during childbirth. Because there is no hospital near them, when some women go into labor they writhe in agony for several days before giving birth to a stillborn child. The prolonged labor causes a hole to form between the bladder and the vagina, making it difficult to live a normal life: they are wet constantly from their urine leaking. It is an involuntary discharge of urine, and therefore they carry with them an unpleasant odor.

This condition is a stigma in African society. It is a prevalent problem but discussion of this condition is swept under the rug and dismissed. Women with this condition are usually shunned and separated from everyday life around them. If more doctors knew how to repair the fistula it would stop the suffering of hundreds of women.

We have an entire VVF team on board including 2 surgeons. The surgeons are performing 6 surgeries per day, which is amazing.

Mercy Ships has a grant with the US Government in which our surgeons on board are able to train other surgeons in Africa.The surgeons come to the ship and watch our surgeons, and learn. This is a fairly simple procedure. All it takes is teaching local doctors how to do it. The ship is a wonderful training platform and the hope is that many African doctors will return to their clinics and perform surgeries on women locally----so they don't have to travel so far to the Africa Mercy.

I met Akissi at the Hospitality Center where she was clinging to her friend, Alizma. Elaine and I realized that we had a "double" story---2 friends from the same village (12 hours north of here), were going through this process together!!! (Jackpot!! writer's dream....)

Here is Akissi's story.

Akissi is a spirited teenager. Her gleaming white teeth shine bright each time she breaks into one of her contagious smiles. Some things get lost in translation, but not Akissi’s gregarious behavior. When asked for a photo, she swiftly poses with clenched fists showing off her buff arms, and that award-winning smile to top it off.

Akissi’s life has not always been filled with smiles and laughter. She grew up in a rural village in the northern part of Togo. From a family of farmers, she learned to work long days under the brutal sun at a very young age. Her beauty, however, and her smile were things that set her apart.

At sixteen she moved to Cote d’Ivoire to be married to a man there. When she got there, she became pregnant. When she went into labor, she struggled for several days before finally going to a hospital. She received a cesarian section, but the baby had died during strained labor. Devastated that she had lost her child, Akissi’s bright and bubbly spirit was suppressed.

After the C-section, Akissi noticed that she could no longer hold her bladder when she had to go to the bathroom. Her urine was released without her control and she knew this was very bad. Her condition is called vesico-vaginal fistula, or VVF, and is very common in countries where there is little to no obstetric care. A hole forms between the bladder and the vagina and the woman is no longer able to control her urine.

At this point the man that Akissi was with saw no use in her, and he sent her home.

It was a very long voyage from Cote d’Ivoire back to her village in northern Togo. Akissi tried very hard to cover up her condition. The others on the bus could sense a foul smell coming from her, and she was humiliated.

Once she was back with her family in her village Pkaple, Akissi struggled to endure everyday life. Her vivacious demeanor was stifled and her head remained bowed in shame. There was, however, a small glimmer of hope. Akissi met someone who had a similar problem to hers. Alizma was close to Akissi’s age and they became fast friends because they were going through the same situation.

Akissi and Alizma heard on the radio that doctors from Mercy Ships were coming near their village to see women with a leaking problem like their own. Akissi felt this may be her opportunity to get help. She went to the screening with Alizma, and they were both given a date to make the journey to the hospital ship in Lomé.

This was exciting news for both girls. They were given hope that Mercy Ship doctors could perform surgery to make them dry. Mercy Ships arranged transportation for the women from the Northern territories to get to Lomé. When Akissi arrived she was overwhelmed by the bustle and commercialization of a large city, but she remained focused and hopeful that in a matter of days she would have her life back.

After screening on the ship Akissi was graded a level 1 VVF, meaning she was one of the easiest to repair. VVF surgeon Dr. Steve Arrowsmith performed surgery on Akissi and closed her fistula. When the nurses removed her catheter a few days later it was confirmed that the surgery was a success: she was cured of her problem. For the first time in a year and a half, Akissi was dry.

Akissi was overwhelmed with happiness.
A few days later Akissi took part in a ceremony honoring the women who were blessed with successful surgeries. Drums, clapping and singing echoed through the ward as the women filed into the room in traditional African dress. Akissi wore a cobalt blue gown with touches of golden yellow. Her face was lit up with joy.
Akissi stood up, amongst her peers and a large crowd attending the ceremony, and said, “Thank you to all the doctors and the nurses. Now, I can be among people. I no longer hide at home. Thank you Mercy Ships for all you have done.”
Thanks to the entire Mercy Ships VVF team, Akissi will return to her village and look forward to a normal life: A life free from shame and filled with her jovial and cheerful spirit.