by Dr. Jon Fielder —
The road between Gidel Hospital in the Nuba Mountains of Sudan and the refugee camp in northern South Sudan is long and rough. About halfway through, the nausea really ramps up. Several times I have nearly fainted from dehydration.
So, if I am being honest, it was not the most welcome news that six women with obstetric fistula would be riding in the back of the Landcruiser. I knew the smell of urine would only add to the nausea and the baseline discomfort of the trip.
Those who follow African Mission Healthcare know that repairing fistulas and other birth injuries is a major part of our work in Uganda. L’Chaim Prize winner Dr. Sister Priscilla Busingye and her team regularly hold surgical camps sponsored by AMH. Women come from great distances when they hear of the services. Some have waited years. We are building a new maternity center with a gynecology ward that will expand access to this care.
My enthusiasm for the work seems to be inversely proportional to the distance from the actual suffering. I am more than happy to write grants and raise money. Put me in a vehicle for seven hours with those afflicted and my spirit flags.
In Dostoevsky’s The Brothers Karamazov, an elderly man lives alone in a hut. He reflects on his own hypocrisy:
“The more I love humanity in general, the less I love man in particular. In my dreams, I have often come to making enthusiastic schemes for the service of humanity, and perhaps I might actually have faced crucifixion if it had been suddenly necessary; and yet I am incapable of living in the same room with anyone for two days together, as I know by experience. As soon as anyone is near me, his personality disturbs my self-complacency and restricts my freedom.”
There’s a difference between caring for the individual as a distressed human being and managing a budget spreadsheet to help afflicted women in general. Both are necessary, but the latter risks alienating one from the grim and gritty reality of a broken world.
Upon climbing into the vehicle, the smell of urine was unmistakable. Not speaking Arabic or the local language, I smiled and greeted everyone with a simple hello. Speeding down the dirt tracks, windows down and sand in the air, the pungency abated.
When we stopped halfway for a break, the fumes returned. I gave the driver a few dollars so the women could take tea but was not surprised they preferred mangoes. I knew why. Caffeinated tea would just make managing the leaking that much more difficult. Imagine avoiding liquids despite the withering Sudanese sun.
Had I stigmatized these women in the same way so many other fistula sufferers have been treated? Not in my outward behavior. I merely rode in the front of the vehicle and bought mangoes. They jostled on the back benches. But God judges the heart. And in my heart, I was guilty.
In Uganda, we are developing a “continuous” birth injury repair service. It’s an attempt to move beyond the intermittent “camp” model. Eventually, we hope women will simply “walk in” for an evaluation and repair. But first, women must know the service is available. The plan is to do community education and screening to identify patients. Then a vehicle will pick up a group for transport to Priscilla’s hospital. After treatment, these initial cohorts will spread the word far and wide.
For a few hours, I had a limited glimpse of how fistula sufferers live for months or years. Sometimes even for decades. Now I understand why we need a separate vehicle. The public minivans are not a good option. They will most likely be full of people like me.
Back to Dostoevsky and an exchange between the Elder Zosima and a widow seeking solace:
“I love mankind so much that—would you believe it?—I sometimes dream of giving up all, all I have . . . and going to become a sister of mercy. I close my eyes and, I think and dream, and in such moments I feel an invincible strength in myself. No wounds, no festering sores could frighten me. I would bind them and cleanse them with my own hands, I would nurse the suffering, I am ready to kiss those sores.”
Zosima responds:
“I am sorry that I cannot say anything more comforting, for active love is a harsh and fearful thing compared with love in dreams. Love in dreams thirsts for immediate action, quickly performed, and with everyone watching. Indeed, it will go as far as the giving even of one’s life, provided it does not take long but is soon over, as on stage, and everyone is looking on and praising. Whereas active love is labor and perseverance…” [emphasis added]
Labor and perseverance. “[W]e also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope.” (Rom 5:3-4).
Every woman who suffers from a birth injury in Africa has had to persevere to reach treatment. She has hope for a cure. It’s for us to labor, in whatever capacity, to provide that care. Dr. Andrew Browning, one of Africa’s great fistula surgeons, performed the operations in Juba, South Sudan. When I wrote him to say that I had ridden with the women from Nuba, he replied that he was expecting six from Sudan. And they were expecting that he would end their pain.