Last week I heard about some significant good work being done in Kasai – made more important by the backdrop of the suffering that it alleviates. In Congo (and in many developing countries), many women get a fistula in one of their organs as a result of poor medical care for childbirth or related to rape or sexual abuse. The fistula is usually in the bladder, the rectum, the vagina, or a combination of those or other organs. The result is usually that the woman ‘leaks’ urine or feces constantly. This means that she smells, and is therefore often ostracized by her family or community.
In October, just last month, one hundred vaginal fistula surgeries were performed during an intensive two-week period at Good Shepherd Hospital, the largest hospital run by the CPC in Kasai. Dr. Leon Mubikayi, a gynecologist and specialist in this type of surgery, came under the support of SANRU (an organization in Congo focused on rural health) to visit Good Shepherd Hospital, doing up to 10 surgeries a day during his visit. While about 50 of the patients came from Kananga and the surrounding areas, another 50 came from distant rural regions of a radius of about 200 miles, including Tshikapa, Luisa, Luebo and Mweka.
Nurse Kapinga Annie is in charge of the maternity, gynecology, and prenatal care division at Good Shepherd Hospital. She reported that most of the women received a fistula during childbirth. Some tried to have the baby at home in a rural area, and when complications caused them to stay in labor for multiple days, the baby died and their bladder or other organs were punctured in the process. Others did go to a health center, but the center and its staff were not equipped to deal with the complications. Five of the cases treated were fistulas received during surgery – usually a hysterectomy.
Nurse Kapinga Annie (far right, standing) with patients
who received surgery in October for fistula repair.
The surgery to repair a fistula can often take several stages or multiple surgeries, depending on the degree of complication or the size of the fistula. For example, a woman named Lusamba from the region of Katende went to the health center to deliver the baby. It was her first pregnancy. She was in labor for 2 days before they referred her to the nearest hospital, where a C-section was performed. By that time, the baby had died from the trauma of labor, and she had a large fistula. Her husband left her because of the shame she brought on him, always smelling like urine. Now, 7 years later, she has had 3 surgeries and the fistula is finally completely repaired. She praises God and is overjoyed for this victory.
Of the 100 women treated, 17 had been living with a fistula more than 10 years. Another 21 had been living with a fistula more than 5 years. Three of the people treated were children. Two of them (aged one year and two years) were born with a congenital fistula. The third, a 13-year old girl, was impregnated by her brother-in-law. She delivered the baby, but with severe complications and a resulting fistula.
Nurse Kapinga said that it was a significant effort on the part of the hospital to provide the materials and staff for this intense period of surgeries. Dr. Mubikayi also came with some equipment, medications, and materials (such as specialized thread for sutures) donated for these surgeries. The staff changed the sheets on the beds of these patients twice a day. They also washed their clothes to ensure that the patients felt a sense of dignity and felt clean and free from the smell of urine. Even though additional beds were put in the ward, because of the unusual number of patients some were placed two to a bed for recuperation. Dr. Mubikayi has come before to perform fistula surgeries, but this is the highest number ever performed in one visit. Dr. Mukendi, a staff doctor and gynecologist at Good Shepherd Hospital also does perform fistula surgeries occasionally, but the added experience and expertise of Dr. Mubikayi was helpful for the volume and degree of complication of some of these surgeries.
We are grateful for the significant impact in the lives of these women, achieved through the partnership of several organizations, including Good Shepherd Hospital. Nurse Kapinga said that the need for fistula surgeries in Kasai continues to be high, and she hopes that people in rural areas could be motivated to deliver babies in a medical facility, and that there also could be more training for the maternity staff at these health centers. We pray that these women who have found physical healing will also now be accepted back into their communities and families after many have lived for years in isolation and shame.
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