VVF Land

VVF, what does it stand for? Vesicovaginal fistula

Wikipedia explain it as this "VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault"

The ladies waiting to be seen on screening day!

In normal terms it means that there is a hole between the bladder and the vagina, this means urine leaks through the vagina, therefore the ladies have no control of their urine.

How does this occur? Mainly it occurs when a woman is in labour for a few days, the baby gets stuck in the birth canal, the baby's skull puts pressure on the pubic bone, the surrounding tissue dies due to the pressure which then leaves a hole. The fistulas can also occur in other areas such as the rectum, uterus, urethra and ureters. This problem mainly occurs in under developed countries where obstectric care is minimal. For a lot of the ladies they have to walk for days to reach the hospital and then they are faced with huge bills.

Dress ceremony

They come to the ship to have surgery so the hole can be closed so then they can pass urine normally, instead of leaking all the time. The ladies come having had a difficult life, most of them would have had to grieve for the baby that died, but the main problem is that the families and communities they lived in before the problem started have rejected them. The community sees this as a curse so they do not want the woman to be there. They struggle to live as they cannot get a job, who is going to employ someone who constantly is peeing and therefore smells all the time of urine???.

Most of the husbands leave them as well, there is no one there to love them and care for them, while they themselves are thinking why me?
The first few days on the ship they are quiet and withdrawn, but as time passes there is a change in them, they start smiling and singing along to the worship. They start chatting to the other ladies who are in the same situation as them. Us nurses and crew members who come and visit them show them the love they have not experienced for a long time or maybe never, they start hugging you and kissing you and saying thanks! I have come to love these ladies so much, they may have had a physical and emotional change but I have also learnt so much from them; there is always hope!
Unfortunately not all have had a successful surgery and it is very hard to see them discharge knowing that they are going back to the same place they came, but hopefully they will know that there are people who love them unconditionally and more importantly that God loves them for who they are.

After they have had their surgery and are doing well they are ready for discharge. We have a dress ceremony for them, this symbolises the new them.. They receive a new dress, a bible, soap, mirror and lotion. At this time they can give a testimony, there is usually a tear shed as they tell what they have gone through. It makes you think how lucky we are in "the west". These ladies have had it rough but they still thank God.

One of the ladies who is dry and is celebrating in the dress ceremony!

I have had shifts where I was so busy and things kept going wrong, and at one stage I really did not want to carry on nursing the VVF ladies, but I carried on and I am so pleased I did. I really want to say thank you to the people who help me through this difficult time. The pleasure I have now of knowing these ladies is great, they give you a big smile when you walk in to the ward and hug and kiss you, and I am so blessed to have been a part of their lives!

The last 4 ladies on the ward

Mark 5:25-34