Every year, an estimated 100,000 women in the developing world will develop fistulas, a hellish condition that occurs when a woman runs into difficulty in childbirth. The baby is either too big to come out, or the woman's body too small to allow passage. After hours of hard labor, the baby dies, and the woman's inner tissues are ruptured, causing her to leak urine for the rest of her life. This means she loses her home, her family, her standing in society. It means her life becomes hell on earth.

The women in this picture once had fistulas but now have had their lives restored. We ran this story in the November issue of the Companion. Some days I come to work and wonder why I bother--it's just another day in the grinder. When I wrote this story, I knew that my work matters. (The names of the women in the story have been changed for the sake of confidentiality)

Thank You For Restoring My Life
The Covenant Companion
November 2005


Once Rita had a home, a family, and a future. Then, almost without warning, she became an outcast, an unclean woman. Something went haywire with her monthly cycle, and her flow of blood would not stop. In her village in Ghana, this meant she was cursed. Rita’s husband forced her from their home. Her family abandoned her. She ended up on her own, begging for alms at the edge of her village.

In Africa, millions of women live like Rita, cast out because of uncontrollable bleeding, or more commonly, because of obstetrical or vesicovaginal fistulas (VVF). These fistulas are created when young or small women get pregnant and have difficulty in childbirth because the baby is too big to come out.

“In our country, a doctor could just do a caesarean section, but in poverty-stricken countries this isn’t possible,” says Jim Sundholm, director of Covenant World Relief. Instead, the baby gets stuck. The woman continues to push until the child’s head crushes and tears the mother’s urethra and other tissues. The baby dies and the mother is left permanently injured.

“For the rest of her life, she leaks urine—which means she is always unclean. Remember this is the third world—there are no washing machines,” says Sundholm.

As many as 100,000 women are stricken with fistulas each year, according to the United Nations. Nicholas Kristof of the New York Times describes what life is like for these “twenty-first-century lepers.”

“[I]f she survives at all she is told to build a hut away from the rest of the village and to stay away from the village well,” Kristof wrote. “Some girls die of infections or suicide, but many linger for decades as pariahs and hermits—their lives effectively over at the age of about fifteen.”

Mercy in Sierra Leone
It’s not only young girls who are affected by fistulas. Fatmata, age sixty, lived with the shame of a fistula for twenty years, after complications while delivering her fifth child. After three days of labor at a midwife’s house, she was taken to a hospital for a c-section, but it was too late. The child was already dead. When she left the hospital, she began to leak urine. Her husband abandoned her. She moved in with her brother’s family but, full of shame from her condition and not wanting to be a burden to them, she left there soon afterward.

Sia was twenty-eight when she became pregnant with her second child. The baby was breech and became stuck. For twenty-four hours, Sia lay on a hospital bed, the baby partially delivered, waiting for a doctor to come. By the time the overworked medical staff could attend to her, the baby had died, and Sia’s internal tissues were badly damaged. Her husband and brother tried desperately to find help for her, taking her from hospital to hospital in a vain search for someone who could treat her.

Finally, Sia’s husband divorced her. Her brother cared for her as best he could, but Sia felt all hope was lost.She stopped eating and prayed that God would take her life. She thought about ending it herself.

Both Sia and Fatmata were trapped —their lives destroyed by this dreadful condition, with no hope for the future. Then they found healing and restoration at a VVF surgery program, sponsored in part by Covenant World Relief.

The program is run by Mercy Ships, a Christian charity that operates a fleet of hospital ships. A $180-dollar operation can change the lives of women stricken with fistulas. But hospitals equipped to do VVF repairs—and operations for conditions like Rita’s—are few and far between. There’s a major hospital in Ethiopia and another in Nigeria, but many more are needed.

With the help of Covenant World Relief, a new women’s hospital has started up in Freetown, Sierra Leone.
Covenant World Relief first began working with Mercy Ships in 2003, following a visit to Ethiopia by Sundholm, where he first came in contact with women who suffer from fistulas. Soon afterwards he was approached by Mercy Ships to help fund surgeries in Togo, where one of the hospital ships was docked. That first year, Covenant World Relief underwrote the expenses for sixty surgeries.

The next year, another request came from Mercy Ships, this time for help in starting a women’s hospital. “Mercy Ships was offered an opportunity to take over a brand new hospital in Freetown, Sierra Leone,” Sundholm says. “They realized there was a need for a women’s specialty hospital—and knew the number of women who needed this repair—so they partnered with several groups to start the program.”

The women’s hospital was a perfect match for Covenant World Relief. The program serves the “poorest of the poor,” says Sundholm, and was a program that needed short-term, start-up funds. Covenant World Relief makes yearly grants and can’t fund programs over the long haul. But it can provide a strategic influx of funds to get new programs up and running.

The Aberdeen Clinic and Fistula Center, funded by a Swiss foundation, Covenant World Relief, and the Worldwide Fistula Fund, opened in May and within its first three months had already completed 100 surgeries. The clinic will also pay for two future caesarian sections for women who receive a VVF repair—an essential step because of the importance of having children in African culture, says Sundholm. The new hospital will also serve as a training hospital for doctors and midwives across West Africa.

Celebration of new life
After the surgery and recovery is completed, the Mercy Ships hold a dress ceremony for each of the women—a celebration of the healing that has come to their lives. The women and hospital staff gather together, and each woman is given a new dress. Prayers are said for each woman, and then a group of women take her back to her village to begin a new life.

Sundholm was invited to attend one of the ceremonies in Togo. About forty women who’d had surgery were there, and he watched as each one received a dress and the prayers of the staff. When Rita got up, her nurse introduced her and told some of her story—how she had come from northern Ghana, walking hundreds of miles all alone. How she had crossed the border into Togo and walked all the way to the shores of the Atlantic Ocean, and then stood in line with 5,000 people, hoping to be chosen to have the surgery.

But when Rita got up to speak, she said that the nurse was mistaken—she had not come alone. And she told this story:
When I began to bleed and the bleeding wouldn’t stop—my husband removed me from our home because I had this curse.

My family abandoned me because I had this curse. I ended up alone and begging for alms at the edge of our village. Then I heard about the possibility of a surgery on the shores of Togo, so I began to walk. But I was not alone.
When I began to bleed, God was with me.
When my husband removed me from my home, God was with me.
When my family abandoned me, God was with me.
When I sat and requested alms, God sat with me.
When I began to walk, God walked with me.
When I stood in line, God stood with me.
When I was chosen for the surgery, God was with me.
In recovery, God was with me.
Even today, God is here, for I see God in your eyes.
I want to thank you for doing what God told you to do. You have repaired and restored my life.

When he heard those words, “you have repaired and restored my life,” Sundholm says he thought immediately of Isaiah 58:12, where God’s people are called to repair and restore life. That verse is the focal point of all that Covenant World Relief does, he says.

“In the New Testament,” he says, “Jesus is known as a savior. And Jesus saves people in their entire person. When he said, ‘you are forgiven’ to the paralyzed man in Matthew 2, Jesus also restored and healed that man’s life.”

As followers of Jesus, we are called to bring healing to the lives of others, says Sundholm. “Just as Jesus Christ has repaired and restored our lives, so we restore others.”

Seeing Rita dressed in a brilliant yellow and black dress and head scarf, Sundholm saw living proof of the healing that Jesus can bring to people’s lives.

“She was so energetic that she began dancing with joy,” Sundholm says. “I started to get worried, thinking, ‘please don’t dance, you just had surgery.’ But her face was radiant with joy. I won’t say there was a complete transformation of her life—because she obviously had been tough—how many people are going to get up and walk hundreds of miles in hope of a cure.

She had strong faith and trust in God—but you could tell that her life had been restored to her.

“When she said, ‘I want to thank you for doing what God told you to do,’ she meant all of us—Mercy Ships, the church, Covenant World Relief, and everyone who gave to Covenant World Relief. Thank you for doing what God told you to do.”