My parents gave birth to me, but you gave me life!

Post date: Mar 4, 2011 8:34:36 AM

WIG Magazine February-March 2011

The Story of Patom

by Dr Leila Srour

Patom is a 25-year-old Akha woman. She was born in a remote mountain village and never had a chance to attend school. When she was a child, only boys went to school. Girls had to stay at home to work, so she never learned to speak Lao. Patom's mother had seven children. Three of them died in childhood with "fever".

Patom married at the age of 16 and moved to her husband's village, where her first child was born. It died after 15 days. She explained, "The chicken's foot was eaten by a dog and that caused the baby to die." The next year, Patom had prolonged and difficult labor with her second child. She wanted to go to the hospital, but her husband did not agree. When she was finally taken to the hospital, the baby, who had already died, was delivered with difficulty. Even though the doctor advised her to stay in the hospital for a while, she was taken home immediately. Seven days later, she was incontinent.

Patom and her family did not understand why she was incontinent. She was suffering from a vesicovaginal fistula (VVF), an abnormal hole between the bladder and vagina which results in continuous urinary incontinence. The problem is rare in developed countries but is a common complication in women who survive days of labor and who are said to have a fate "worse than death."

Patom's husband was angry, took another wife and Patom was forced to return to live with her parents in their village. A relative took her to Vientiane for surgery, where she was hospitalized for two months. Unfortunately, the first surgery was not successful and she remained incontinent for three years.

With support Patom went to Vientiane for a second surgery and another two-month hospital stay. The second surgery was successful! Two years later Patom met Gaysone, a principal in a Muang Sing school. They married and moved to her village where he became the primary school teacher. Patom became pregnant. When she went into labor, they had to walk for four and half hours on steep mountain trails in the middle of the night to reach the closest hospital. The hospital was not equipped to help her. In the morning she had to take a tuk tuk and travel for another two hours to the provincial hospital, where she delivered a healthy baby boy.

Bryan, my husband, and I went to visit her in January this year. As we hiked the steep mountain trails, straining our muscles and endurance, we could only marvel at the ability of a full-term pregnant woman, surviving such a risky trip while in labor! We found the happy family in their thatched roof bamboo home, surrounded by jungle and mountains. Their son, Phontid, is now three years old and an active, healthy child. Gaysone has 18 students, half of whom are girls!

Patom said, "My parents gave birth to me, but you gave me life! Before the surgery I had no life. After surgery I have life and a family."

Not many people know about this common and preventable health problem that affects millions of poor women in developing countries. It could be eradicated with increased education for girls, improved nutrition and family planning, as well as more medical services for women, emergency obstetric services and facilities to repair fistulas. Sadly, another Akha woman was not cured after two surgeries in Vientiane. She is still incontinent. Because of the smell she is shunned by her community and lives alone in a hut outside the village.

WIG volunteers have supported the care of VVF patients during their two-month hospitalizations. Thank you very much for restoring their lives!

Reference: L Lewis Wall. Obstetric vesicovaginal fistula as an international public health problem. Lancet 2006; 368:1201-09.

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