My first day back at work...

Well, after my whirlwind trip back to the UK, I arrived back in Monrovia at 9pm on Monday. Unfrtunately, my luggage didn't arrive, but aside from that the journey was fine. I was back in the deep end with my first shift back being Tuesday at 2pm! I was working with the ladies who have had vesico-vaginal-fistula surgery.
The ladies have gone through labour which has for whatever reason become obstructed. As a result the baby is left in the birth canal for too long, tissue becomes ischaemic (dies) because of the pressure of the baby in the birth canal. This develops and causes a hole between the bladder and vagina and results in the permanent leaking of urine. In the western world, a lady would have had assistnace to give birth or a C-section long before any tissue was damaged. Not only do these ladies lose their babies because of the traumatic birth, they are left with the constant leaking of urine. Their 'purpose' in a country such as Liberia - to have sex with their husbands whenever they want, to produce children to provide for their future and to be mother and wife, is destroyed. Their inability to fulfill their 'purpose' means they become outcasts, and along with their constant pungent smell due to leaking urine, they become the despised of society. These women are destroyed physically mentally and spiritually.

To be honest, I was pretty daunted at the prospect having not yet looked after them, I wasn't quite sure what I was doing. But, I loved it!!! It was an incredibly busy shift, as their care takes a lot more intense nursing: checking of urine output and their fluid intake. The primary aim is to give the ladies wounds time to heal. The leaking of urine that has occured around the tissues means that it takes a very long time to heal. Another important aspect of their care is teaching them pelvic floor exercises, to enable them to have good control once their catheter is removed. The whole process is such a delicate experience. We spend a lot of time just being with these ladies because they have been void of personal touch and interaction because of their ailments. They are taught to knit and crochet too.

I spent a lot of time with my ladies teaching them to do their exercises, it is a very intimate thing for me to be involved with and we have to check very carefully they are doing it well. So I tried to make it as comfortable as possible, reiterating how important it was, and really encouraging them as they did it right. I even agreed to do the exercises at the same time with them (I am going to have the best pelvic floor I can tell you!), which caused lots of giggling and laughter as I empathised at how difficult the exercises are to do!

Tomorrow we will have a dress ceremony. More on that after it happens!!