When Florence Banda got pregnant at twenty, the father of her child denied their relationship and abandoned her. She stayed with her mother throughout her pregnancy in their village in Malawi.
When her labor pains began, her mother took her to a traditional birth attendant in their village. After Florence went through labor for two days without any progress, her mother finally took her to Mchinji hospital on the third day, where her baby was delivered stillborn. At this point, Florence began to leak. She stayed in hospital for one month after delivery but nothing was done about her fistula. When she was discharged, she finally realized it was urine she was leaking. She used pads so she wouldn’t be embarrassed in front of her family and friends, but generally she stopped attending social gatherings, and sat at home alone.
In 2008, she got married to a man who promised her mother that he would take care of her no matter what her condition was. They stayed together for four years but the mother-in-law made her life difficult. Due to the mother’s influence, Florence and her husband separated in 2013 and he found a new wife. This was very painful for her.
Through a friend of her mother’s, Florence found out about the Fistula Care Centre at Bwaila Hospital. Florence was examined there and given a date for an operation, but unfortunately she missed her appointment because of financial problems. She finally had her operation in early 2014, and it seemed to be a success, but her fistula symptoms returned shortly after. She had her second fistula operation in April 2014 which was a success.
Florence, who is now 27, can now attend social gatherings and move freely. She says she appreciates everything because her life is back to normal.
Isatu Kamara grew up in Ribbi, Sierra Leone. Pressured by her father, she got married young and became pregnant three months later. After eight months, her husband sent her back to her family. When Isatu went into labor at a local hospital, she wasn’t able to give birth, so they sent her home. This was the beginning of a string of very bad luck for Isatu. Despite her family’s attempts to help her deliver her baby with traditional medicine, they weren’t successful, and she grew sicker and sicker—she couldn’t walk and her baby stopped moving inside her. With her health at an emergency level, she needed to get to the maternity hospital in Freetown immediately, but her father couldn’t afford the ambulance. Finally, her sister and the baby’s father took her to Freetown, where she received an operation. Unfortunately, when Isatu regained consciousness, she discovered her baby was dead and she couldn’t control her urination or her bowels. She lay in bed in misery for days, while her family ran out of money and she drew close to death. It was only at this point that the hospital contacted the Aberdeen Women’s Centre.
Isatu arrived at the Aberdeen Women’s Centre on New Years Eve of 2013. The 18-year-old was severely malnourished, dehydrated and suffered from infected wounds. She had a double fistula following a tortuous five day labor and the death of her baby. She was unable to walk because the nerves in her legs were badly damaged. “I’ve never seen a young girl in such a state,” says Ann Gloag. “She was just skin and bones and she had these huge bedsores. She was just touch-and-go for two or three weeks.”
Before going in for surgery Isatu needed to be nursed back to health. The staff tailored a feeding program, physiotherapy and expert wound care specifically for Isatu, and she slowly began to heal and build strength. Using a cane, she was able to start walking again.
After nine months of care, Isatu was finally healthy enough to be operated on. Her fistula was so severe that she received three surgeries during a two week “fistula camp” where an expert surgeon was flown in to perform over fifty complicated surgeries. While Isatu’s surgery was a success, her fistula is still not completely cured and she now manages her condition with a ‘plug’ provided by the AWC – a common way of dealing with remaining incontinence. During her healing process Isatu enjoyed the daily arts and crafts activities that are offered there. This past November the hospital celebrated its largest Gladi Gladi celebration ever—and Isatu was the center of attention. “She was just a complete miracle,” says Gloag. “I really did not think, at one point, that she’d come through.”
Yata Lahai was born in a happy family in the southern area of Sierra Leone. Her father was a farm manager employed by the government. Just before the civil war began, Yata was raped by a schoolmate. She didn’t tell anyone because she was afraid the boy could harm her if she did. She soon developed signs of early puberty, and she was pregnant. Her society perceived her as being immoral—and the sentence for this was exclusion. Despite this, her father defended her and kept her at home. Yata’s mother, however, wanted her thrown out of the family out of the village. To make matters worse, Yata’s father was killed in the war during her pregnancy, leaving her to a merciless society that did not care what happened to her.
When Yata went into labor, her mother called in a traditional birth attendant. Her labor continued for four days and without a delivery. Finally, the attendant referred Yata to a dispensary where a nurse’s aide was the only practitioner. The nurse’s aide was able to deliver the baby, but it died shortly after. Yata was so sick that she couldn’t get out of bed. She had fever and her both legs were paralyzed. In the same week she realized she was leaking urine.
Meanwhile the war was drawing nearer and there was no means to for Yata to travel to seek treatment for a complication like fistula. Her mother died in the hands of the rebels.
Years later, a nurse from Yata’s village brought her to Freetown for treatment, Yata was operated on and her situation improved, but she still wasn’t well. Her other attempts to get help were unsuccessful, and she started to despair. Luckily, Hawa Hawatouri’s organization, Haikal, offered her a place to live and learn some business skills. When the Aberdeen Women’s Center teamed in 2013 with Haikal as partners in fistula care, they met Yata and she was brought in for a successful surgery. After 23 years, she was finally dry. While at the AWC, Yata was reunited with an old friend, Bernadette Fofanah, who had become a nurse during their separation.
Unfortunately at that point the doctors discovered that Yata had a tumor. Happily, Dr. Martin Salia removed her tumor, and after nearly a quarter century, Yata was finally cured. She returned home and has been doing well. Tragically, Dr. Salia was stricken with Ebola, and died.
Vanesia comes from the small village of Mphendu in Malawi. She is over 70 years old, but does not remember the exact year she was born. She has had five pregnancies, but only three have survived—one baby was stillborn and the other died when they were two. Vanesia says she got married in her early twenties and she delivered her first three babies at home. It was the third one that caused her fistula. She labored all night before being taken to the hospital. In the early hours of that morning, she was given a cesarian section and delivered a stillborn baby. A few days later she discovered that she was leaking urine. She was told to go home and come back to the hospital later but when she went back she received no help and was told to go away again. Exasperated, she never returned to the hospital because she thought she would only be turned away again and there was nothing that could be done for her.
Vanesia lived with Fistula over forty years. Unable to support herself, she turned to begging. In 2010 a former patient went to her and informed her about the Fistula Care Centre at Bwaila. She reluctantly went there not knowing that would change her life completely. Her operation was a success and she is now cured and has returned to her village.
22 year old Carolynne Nkomo is from Nakaru, Kenya, which is a three hour bus ride from Nairobi. She first developed a fistula in 2003 when she was 12 years old. She was in labor in her village for four days because there was no money for her to go to hospital. At the end of the four days, she gave birth to a dead baby girl. She immediately realized she was leaking and was ostracized by her family and friends—they believed she was cursed. Only her grandmother agreed to have her live with her but it was a miserable existence. She felt completely alone in the world.
In 2007, when she was 16, Carolynne decided to come to Nairobi to try and find work. When in Nairobi, she heard on the radio that free surgeries were available to help women and girls who were leaking and went to the hospital. She was operated on in November 2008 and it was a success. She returned to Nakuru where she and her husband had a healthy son, who is now three years old.
When Carolynne got pregnant again, instead of going to the hospital for a C-Section, as she was told to do, she decided to give birth at home. This time, her baby girl survived , but she developed another fistula. She was operated on again last year at the fistula clinic at Kenyatta National Hospital in Nairobi and is dry again.
Carolynne now works in a factory and her husband who works on a flower farm in Nakaru.
When she was about four, Tomolero was given away by her parents to an aunt and uncle who lived in Freetown. In April 2014, at age 9, she was brought to the Aberdeen Women’s Centre in Freetown, both paralyzed and incontinent, a common symptoms of young, small fistula patients or victims of violent rape. There was evidence of physical abuse and she had been kicked repeatedly. She said she had been raped by her uncle and badly beaten by her aunt. Scans from a government hospital suggested that her pelvis was broken and damage had been done to her spine. The AWC medical team examined her and established there was no fistula and that her incontinence was most likely linked to her injuries.
It became clear that Tomolero desperately needed an MRI to establish the extent of her injuries and the damage that had been done to her – but there is no MRI scanner in Sierra Leone. Once she received her MRI, it revealed that she had an aggressive form of child cancer and was weeks away from death. Initially the prognosis was bleak but, once all the tests had been done, the prognosis became very positive and so it was agreed that she would start treatment. Tomolero then spent almost a year as an in-patient in a children’s hospital. For eight months she had chemotherapy – she lost her hair and at times was gravely ill. When the chemo was finished, she continued to be very ill with an infection.
Happily, by February she was well enough to be transferred to the rehabilitation ward to have intensive physiotherapy and by May 2015, she was well enough to go back to Africa. During her year in the hospital, Tomolero learned to speak English fluently and celebrated her 10th birthday.
Today, she is in remission from her cancer, back at school and can now walk with the help of a walking frame and leg supports. She receives intensive physiotherapy every day and, although she will always need medical care and likely her wheelchair, she remains hopeful that she will one day be able to walk with crutches. Tomolero has a remarkable faith which has sustained her throughout her life and the horrors that have happened to her. She is seen by all who meet her as an exceptional child who will go on to do great things in her life.
In order to protect her privacy, her real name is not used in the film. The name “Tomolero” was suggested by Nobel laureate Wole Soyinka. Roughly translated, it means: “to the child belongs the right to gentleness and the caring hand.”
11-year-old Mary Yafet comes from the Kasungu district in Central Malawi. She doesn’t have fistula—she has a congenital abnormality. She received an early temporary fix for her problem, but was told to return to the hospital when she was two to have it checked. Once she reached that age, her mother, Charity, took her to a hospital in Johannesburg, South Africa, but before they could operate they discovered she had a hole in her heart, which required immediate care. Out of money after the operation, Mary and Charity returned home to Malawi. At this point, Mary began to leak uncontrollably. Her friends avoided and laughed at her. To make matters worse, Charity became sick herself and was unable to speak clearly.
When Charity happened to hear about the Fistula Care Centre at Bwaila, she was very excited to hear that women and girls with symptoms like Mary’s were being welcomed for free medical care. She phoned and was told to come right away. The doctors took tests and said that Mary would need an operation.
Mary was taken into the operating room but unfortunately the surgeon felt that Mary’s body needed to develop further in order to be operated on and so she returns regularly to Bwaila for examination. At this point, there is little the staff can do beyond keeping an eye on her until she grows older.