What do these four girls have in common? (select one):

    A) They are teenagers
    B) They gave birth to healthy babies
    C) They are happy
    D) They did not suffer obstetric fistula
    E) All of the above
 
If you selected E) All of the above, you selected correctly.
 
Famata, 17, was carried to the hospital, where she gave birth to a baby boy. Grace Binda, 16, delivered a boy, who weighed just over 6-lbs. Mama Vah, a 17-year-old-girl, gave birth to a baby boy weighing about 7-lbs. Jangar Paye, also 17, gave birth after attending all of her ante-natal classes at Hope House. 
 
All of these new-moms are teenagers, who gave birth to healthy babies they could take home to nurse and raise. They did not suffer fistula while in labor, and they will be able to have more children in the future.
 
Six years ago, I met a 20-year-old Liberian who gave birth while in her teens (18), but had a very different outcome. Because the Traditional Tribal Midwife (TTM) didn’t realize that the baby had gotten stuck in the birth canal, she was in labor for a week before being carried to the hospital. By the time she received professional medical care, the fetus had died, she had suffered both a vesicovaginal fistula and a rectovaginal fistula, and had been leaking both urine and feces for two years. Her injures required a hysterectomy; she will never be able to conceive another baby.
 
Our wonderful staff at Hope House work hard to prevent these sad outcomes. They do outreach in the nearby villages, encouraging teenagers to wait to have children. Should they become pregnant, they encourage them to seek prenatal care. They have built relationships with the TTMs, encouraging them to have their patients deliver at Hope House. These traditional birth attendants often accompany the expectant mothers to the home when their time comes.
 
Pregnancy is dangerous for teenagers for a number of reasons, including the following:

• Teenagers’ bodies are not fully developed; their pelvis may not be wide enough to deliver a baby, which can lead to obstructed labor. Unaided, this can lead to obstetric fistula.
• Since their bodies are still developing, they need extra nutrients, particularly iron, or they could develop anemia.
• Teens also tend to have underweight babies and give birth prematurely.

 
Dignity:Liberia is already preventing fistula in rural Liberia!  But we won’t stop there. Our clinic, which we expect to open next year, will offer fistula repair surgery. We hope to return smiles to women who did not smile after their labor and who haven’t smiled for a long time, by stopping the leaking, smell, isolation, and shame. A gift of just $5 will help us reach that goal. Thank you!

We recently shared a picture on Facebook, of pregnant women and girls sitting on the porch of Hope House, watching a video on the importance of breastfeeding and the proper technique. This class is offered to expectant mothers staying at Hope House, our maternity waiting home. There are other topics offered on the videos, but so far only breastfeeding has been taught.
 
Dignity:Liberia feels strongly about educating our patients and their families. Community outreach by our nurse-midwives and other staff always includes education. They stress the importance of prenatal visits, taking vitamins, being immunized, and delivering in a clinic or hospital under the care of a medically licensed nurse-midwife (or doctor in some circumstances). They teach classes on basic hygiene and many other topics. During follow-up visits to babies born at Hope House, the staff make sure the mothers are following recommended procedures for caring for their infants.
 
A different type of training, but also important to the women who come to us, is skills-training. Earlier this year we held discussions with an instructor who previously oversaw classes in tie & dye, pastry making, and soap making at the Phebe Rehabilitation Center in Gbaranga. You may have seen images posted on our Facebook feed of tie-dyed fabric hanging on clothes lines and of fistula survivors making soap. Or you may have read about the Laughing Balls they learned to make as part of their pastry-making class.
 
Not only would skills-training keep expectant mothers from getting bored and leaving the home prior to giving birth (this has happened with 2 patients), it would teach them a trade that would allow them to earn a living, increasing the likelihood of their being able to afford better care for their newborns and other children.
 
To make a donation in support of our efforts, go to our Donate page. Remember, you can now give via Zelle using the Zelle tag Dignity:Liberia. If you are interested in funding one of the skills classes listed above or providing other major support, please reach out to us on our Contact Us page or email me at [email protected], and someone will get in touch to work out details.
 
Thank you for supporting education!

My pastor recently delivered a sermon based on Jesus’ parable about the mustard seed, illustrating how small acts can lead to big things. Since this is the height of summer where I live, and my zinnias are blooming in profusion, I started thinking about how they too are small seeds (about 6 mm long) yet just a few can fill a flowerbed with a bright display of color. Once the blooms fade, I let them dry, then scatter the seeds and have even more flowers. I have been amused for a couple of years to see zinnias growing out of the cracks in our sidewalk. This year I also found basil growing from the cracks – the seeds had fallen from last year’s herbs!
 
Recently we’ve been sharing our clinic’s construction progress with some photographs and videos on Facebook. We have been blessed by long-term substantial support from Lakeland Community Church in Lee’s Summit, MO, and last year we received a significant gift from First United Methodist Church in Brenham, TX, which covered the cost of our ambulance, with enough left over for the clinic. We have been awarded grants restricted to capital projects and operational costs for the currently operating Hope House (our maternity home), from Rotary International, Friends of Liberia, and The Butterfield Foundation. For over a decade now, we have received widespread support from individuals. Individuals – you – have supported us with prayers, monetary gifts, donations of goods, and have organized birthday fundraisers on Facebook, in addition to telling friends about the work Dignity:Liberia is doing.
 
Some people have commented that they wish they could give more but you know what? Any gift you give, even the small ones, are like zinnia seeds; they add up and they multiply! None of our board members – U.S. or Liberian – are compensated for their service, nor reimbursed for travel. We give from our hearts just as you do. Your donations have built our amazing big belly (maternity) home and are building our clinic. Just like zinnias, your support is helping our care reach the “cracks” in society. Please keep those gifts coming by going to our giving page. By the way, if you prefer to donate via Zelle, you can send your donation using the Zelle tag Dignity:Liberia. Thank you.

Mr. William S. Tamba joined the staff of Hope House in October 2025. He hit the ground running – seeing patients, providing community outreach, co-hosting educational and information-sharing sessions for Traditional Tribal Midwives (TTMs) at our compound in Todee, and even providing me with pictures and information for publicity and other purposes. I asked if I could interview him for this blog, and he readily agreed.
 
Originally from Lofa County, Foyah District, Liberia, which borders Guinea and Sierra Leone, William speaks Kissi in addition to English. One of 15 children (he  has 7 brothers and 7 sisters), he enjoyed playing football (soccer) as a child. He continues to enjoy sports, but also enjoys reading, listening to music, and attending church.
 
William’s favorite subject in school was science, particularly topics on fertilization and puberty. The joy he gets from caring for others and making a difference in their lives guided his decision to go into healthcare. He had not heard of obstetric fistula, prior to starting his career in healthcare, but he has long held an interest in caring for women and finding solutions to their problems. He wanted to become a medical doctor, specializing in gynecology, but this wasn’t feasible financially. Instead, he took advantage of a scholarship offered by the Phebe School of Nursing, specializing in midwifery, which had a connection to his dream of becoming a gynecologist.
 
I asked William what difference he believes is being made by Dignity:Liberia’s community outreach. He said the outreach has convinced the TTMs of the importance of babies being delivered in a healthcare facility. He has noticed fewer home deliveries (which can lead to birthing injuries), an increase in antenatal or prenatal care, a reduction in neonatal deaths and maternal deaths, reduced complications during delivery, and fewer teen pregnancies. He wrote that the beneficiaries and their families are a living witness; many of them cannot stop thanking and praying for Dignity:Liberia.
 
Although he is frustrated by the lack of support by a few community leaders in the fight against home deliveries, he feels that overall, the community outreach he does for Dignity:Liberia has brought great relief to the people of Todee and the surrounding communities. It has greatly reduced many health challenges people were experiencing. The most rewarding aspect of his outreach has been convincing the community midwives to stop delivering babies in the villages. Dignity:Liberia helps them with the cost of transportation and provides a meal when they attend quarterly meetings on our compound, which has encouraged their participation and has led to a change in viewpoint.
 
While William is heartened that his work through Dignity:Liberia has made a difference in the lives of pregnant women and provided them with healthy deliveries, he is saddened at other health care issues in the communities. Many of the mothers that he visits have seen their children, many under five, die from preventable and curable diseases. He believes that the health care system in the region has some serious challenges.
 
I hope you've enjoyed getting to know William as much as I have. He is a great asset to Dignity:Liberia and our efforts to prevent obstetric fistula in Liberia.

Woodpeckers are known for hammering at wood with their beaks (at 1,200 times the pull of gravity).  My husband and I have one that frequently visits our bird feeder. The feeder is a flat tray that hangs from a shepherd’s crook by three chains. Recently, I watched in fascination as a wren landed on top of the shepherd’s crook while the woodpecker was eating, and threatened it with such ferocity, that the woodpecker retreated beneath the feeder, clutching the sides with its feet (the wren had a nest in a nearby wren house). The next day, I saw a squirrel running back and forth on top of a nearby trellis, trying to escape the wren’s wrath.
 
Similar to the wren, Dignity:Liberia is small. Our US Board of Directors consists of 9 people. While we now have a 3-member Board of Directors and 11 paid employees in Liberia, we are still considered small. 
 
Before I witnessed the mama wren warning all intruders to stay away from her nest, I would have expected her to retreat. Woodpeckers and squirrels are bigger than the tiny bird and appear stronger.
 
Dignity:Liberia has long enjoyed the support of individual donors and a few churches. However, most foundations look at our wren-sized organization and put their money on the “woodpecker” and “squirrel” organizations seeking funding. Fortunately, some foundations realize that size doesn’t matter as much as determination and zeal; in the past three years, we have received foundation grants. The result? A maternity home that is delivering babies and preventing fistula, a collaborative effort between traditional tribal midwives and Dignity:Liberia’s nurses, experienced and trained in midwifery, and a dedicated fistula clinic whose construction is progressing as expected. We are small, but we are achieving some great things. Size does not necessarily matter. 

While waiting for appointments at my gynecologist’s office, I used to enjoy looking at the doctor’s bulletin board, covered with pictures of babies that she had delivered. At some point, due to privacy concerns, she took down the display. Dignity:Liberia’s bulletin board is Facebook. We receive permission from our patients before posting pictures of them and their newborn babies.
 
I recently received pictures of three babies born in April. Two were delivered at Hope House. The third patient was transferred to a local hospital for delivery by C-section. Kulah Tokpah was grateful to Dignity:Liberia whose intervention resulted in her delivering a healthy baby girl. She appreciated the excellent, professional care she received from our nurse-midwives. After examining her, they determined she was at risk for complications if she delivered naturally. She told nurse-midwife Patricia Kollie Kpalo, R.N. that she wanted to name the baby after one of the people who had made all this possible. Patricia asked me if Kulah could name her baby after me. I got tears in my eyes. What an honor. I told her yes!
 
Board members and the staff that work at our compound in Todee are the face of Dignity:Liberia, but there is a foundation of support, without which we could not function. There are churches whose leadership and congregations made it their mission to help prevent obstetric fistula in Liberia. There are foundation boards that voted to support our funding requests. There are countless volunteers in Liberia and the United States, who have donated their time and talents to fistula survivors, as well as to the women who come to Hope House for prenatal care and delivery. There are Traditional Tribal Midwives who decided to work with our medical staff in the care of the women and girls from their villages. There are individuals who have supported us financially. This is only a partial list of all the support we have received.
 
Last week, people around the world celebrated Mother’s Day. From Mother’s Day 2025 to Mother’s Day 2026, 18 women gave birth at Hope House while 20 who had complications were transported to a hospital. Today we celebrate you for your part in giving so many women a happy Mother’s Day.

Two Questions:

1. Do you recall the content of the blog that featured this mother and baby?
2. Do remember something specific about this mother and baby?

 
The blog, Our Impact on Maternal Health in Liberia, highlighted the purpose of our ministry, which is to bring restoration and hope to women with fistula and their communities through healing, education, and prevention. It included quotes from Dignity:Liberia’s founder and president, Kathi Gutierrez, as well as from Becky Mueller, CNM who stated, “Our impact on maternal health in Liberia has begun, one woman and child at a time.” You may not remember all that. I write most of the blogs, and I certainly didn’t, so I looked it up on Dignity:Liberia’s  website. However, I did recall that this mother (Famatta) was the first to give birth at Hope House, and that her baby was born on Easter Sunday 2025.
 
A picture truly is worth a thousand words. So much is happening at Dignity:Liberia’s Todee compound right now: births at Hope House, meetings with TTMs (Traditional Tribal Midwives), construction of Dignity Clinic. There’s also outreach to the surrounding communities. In order to help you keep up with these goings on, we will soon begin posting on Instagram (handle: @DignityLiberia). This will allow you to get updates shortly after they happen.
 
Stay tuned!  We will advise you on Facebook once we launch our Instagram account.

One year in elementary school, we made big envelopes from construction paper, decorated them, and put our names on them in preparation for the Valentine cards our classmates would give us. Most of the cards were store-bought, but some were handmade. I enjoyed seeing the different greetings I had received.
 
Many Americans spend about $252 on Valentine’s Day, though adults between the ages of 35 and 44 often spend over $300!  According to the National Retail Federation, that includes candy, flowers, greeting cards, an evening out, and jewelry. This past Saturday was about romantic love.  
 
According to an article that appeared in Psychology Today*, the Greeks had 7 types of love including philia (the kind friends have for each other), storge (familial love), and agape love (a love that is similar to modern altruism). Agape love includes selflessness, sacrifice, and unconditional care for others.
 
Dignity:Liberia’s supporters demonstrate love with each donation they make. The medical team at Hope House cares deeply for the welfare of pregnant women and teenage girls, working tirelessly to educate them and encourage them to get prenatal care and give birth in a clinical  setting. Yes, they are paid, but their dedication to the efforts to provide safe deliveries and to eliminate fistula goes beyond a paycheck. Certainly Dignity Advocates and others who travel to Liberia sacrifice time, money, and comfort (airlines don’t allow a lot of leg room and Liberia’s heat and humidity can be a bit draining). On both sides of the Atlantic, we care for each other as brothers and sisters.
 
I end phone calls with some of my friends and family by saying, “Love you!”  I will also end this month’s blog by saying to each of you, “Love you!”
  
 
 
 
 
 
*Neel Burton, M.A., M.D., (2025, November 16), Did the Greeks Really Have 7 or 8 Words for Love?, Psychology Today