My first stint in VVF Land is completed! Although we've had VVF patients on the wards for a few weeks now, I hadn't been assigned to them until last Tues.
The first night was quite busy and hectic. I came away with the realization that it really is all about the pee - what does it look like? what color is it? how much? where is it coming out of? does it smell bad? (not that pee ever smells good) are there blood clots in it? After asking myself these questions about multiple patients every hour for nine hours; I didn't even want to go to the bathroom myself, because I had seen more than enough pee!
I think VVF land is more emotionally challenging than the other surgeries, at least for me it is. The patients must be checked every hour for the first 24 hours after surgery to make sure they aren't still, or start back, leaking and that they have at least 30ml of urine. 30ml of urine an hour is the minimum to indicate healthy kidney function, and that the person isn't dehydrated. We give each lady a 1.5 liter water bottle on admission and encourage them to drink 2-3 L per day. This helps them to keep their kidneys flushed out so that they aren't as prone to infections, and to help insure adequate hourly output.
It's always a bit anxiety inducing each time I check the chux pad under each one; will it be wet? or dry?? I always breathe a small sigh of relief and happiness when they are still dry. Although it may not seem like a big deal to some people, I know how much hope these beautiful ladies have put into having this surgery. One girl that is with us is only 19 years old, she has been wet for five years. It's saddens my heart to think of a 14 year old going through this. First of all being pregnant, and then, not only losing her baby, but also having this horrible stigma attached to her, and living her young life not knowing if she will ever be able to be healed or if she will have to live the rest of her days with this curse. Although this isn't how God intended it to be, a woman's worth (here) is largely based on her abilities as a wife and especially her ability to bear children.
It is the most amazing thin to see the radiant joy on the faces of the ladies that the surgery has worked for. But at the same time the sadness and loss of hope written on the faces of the ladies that haven't been healed, is heart breaking.
Once a week or two, there is a dress ceremony to celebrate a new life for the ladies that have had successful surgery. Each lady is given a new dress - to symbolize her new life. Clementine - a Togolese lady that works on the ship, plans and organizes the dress ceremonies. She takes the ladies to another ward and helps them get all dressed up with makeup (if they want) and their new dresses, then they sing and dance as they come back down the hall to the VVF ward. The Dress Ceremony has begun!
Getting ready for the ceremony!
It is a time of singing, dancing, telling their stories, and thanking God, and immense joy. The crew are invited to attend and join in with the celebration. I haven't made it to any this year, but I can remember from last year how exciting it is. I like to observe all the different people. The ladies in the ceremony and how they are glowing. Then there are the ladies that have just had surgery and still aren't sure if it has been successful but are so very hopeful. Also there are the ones who haven't had their surgery yet, but you can see the hope in their faces that soon they will be the one up there dancing and singing. And then, there are the ones that have had their surgery, and it hasn't been successful. I always wonder what is going through their minds, sadness, disappointment, despair, even jealousy maybe? My heart goes out to them as I watch them watching the joyous dancing and singing, even though at the same time, their hopes have been shattered. So I silently pray for them, that even though they haven't been physically healed, hopefully they have experienced the love of Jesus through us while they are here, and that they will still have eternal hope.
Telling her story
This is my prayer, that each patient will see the love of Jesus through us; through me and through each crew member that they come into contact with.
Ready to have her surgery!
Playing games on the ward
Lead VVF surgeon - Steve Arrowsmith