On Easter Sunday, we had our first delivery! The baby’s mother checked into Hope House (previously called House of Hope and Dignity) the very weekend that she went into labor. The plan had been to take her to a nearby hospital for delivery, but as so often happens, the baby had other plans, and there was no time to transport her. Midwife Patricia Kollie, R.N., attended the birth with assistance from nurse-aide, Korto Kollie.
 
“Dignity:Liberia is a ministry dedicated to bringing restoration and hope to women with fistula and their communities through healing, education, and prevention.” Although we have never wavered from our goal, it may have seemed forgotten, while we while focused time and energy on funding requests and building updates. This birth brought our purpose back into focus. This is what it’s all about!
 
Said Dignity:Liberia’s founder and president, Kathi Gutierrez: “I had tears in my eyes. I look at the picture of the mother on a bed in a dress someone lovingly made, with blankets made for her child, pillowcases and sheets made and given, and a healthy baby. So wonderful!” Look closely at the pictures, which the mother gave us permission to share. You may see one of your contributions!
 
We are so blessed for the baby’s safe birth. Both the mother and infant are healthy. Said Becky Mueller, CNM: “Our impact on maternal health in Liberia has begun, one woman and child at a time.” Every time a woman gives birth by a delivery that does not cause obstetric fistula, we have made an impact. While we celebrate this birth at Hope House, we have just started construction of Dignity Clinic, whose main purpose will be to repair fistula. Additionally, C-Sections will also be performed at the clinic.
 
We need your continued support. We need you to share this marvelous story. We need you to reach out to those you know who might be able to partner with us or open doors to a foundation with introductions. If you can make another monetary donation, even $5, we would be grateful. Your support is making a difference.
On Easter Sunday, we had our first delivery! The baby’s mother checked into Hope House (previously called House of Hope and Dignity) the very weekend that she went into labor. The plan had been to take her to a nearby hospital for delivery, but as so often happens, the baby had other plans, and there was no time to transport her. Midwife Patricia Kollie, R.N., attended the birth with assistance from nurse-aide, Korto Kollie.
 
“Dignity:Liberia is a ministry dedicated to bringing restoration and hope to women with fistula and their communities through healing, education, and prevention.” Although we have never wavered from our goal, it may have seemed forgotten, while we while focused time and energy on funding requests and building updates. This birth brought our purpose back into focus. This is what it’s all about!
 
Said Dignity:Liberia’s founder and president, Kathi Gutierrez: “I had tears in my eyes. I look at the picture of the mother on a bed in a dress someone lovingly made, with blankets made for her child, pillowcases and sheets made and given, and a healthy baby. So wonderful!” Look closely at the pictures, which the mother gave us permission to share. You may see one of your contributions!
 
We are so blessed for the baby’s safe birth. Both the mother and infant are healthy. Said Becky Mueller, CNM: “Our impact on maternal health in Liberia has begun, one woman and child at a time.” Every time a woman gives birth by a delivery that does not cause obstetric fistula, we have made an impact. While we celebrate this birth at Hope House, we have just started construction of Dignity Clinic, whose main purpose will be to repair fistula. Additionally, C-Sections will also be performed at the clinic.
 
We need your continued support. We need you to share this marvelous story. We need you to reach out to those you know who might be able to partner with us or open doors to a foundation with introductions. If you can make another monetary donation, even $5, we would be grateful. Your support is making a difference.

You may wonder how the various board members became affiliated with Dignity:Liberia. The connection to Liberia goes back a long way. On a recent trip we dedicated a memorial wall and held a small memorial service for several people who have inspired our volunteer work in Liberia. The location is on the Ricks Institute campus where all had served. I will write chronologically.

The Rev. Emil William “Bill” Mueller and Agnes Ann Southern Mueller, RN arrived in Liberia in 1961 as some of the first Southern Baptist missionaries to the country. They each had felt “called” to mission work since they were children. Meeting in college they found a common goal. They felt that their work was a partnership with the people and with God. Agnes felt her job that was committed to helping others was also a ministry. Bill ministered and spent many years as an administrator at Ricks. They served at Ricks and in Yekepa, departing Liberia in 1973.

Bill, Agnes, Charlie and Becky as Home (U.S.) Missionaries in Kentucky 1961 prior to going to Liberia as Foreign Missionaries.

In 2012, I returned to Liberia for the first time in 34 years. It was an emotional trip for me. Much had changed. The country was recovering from two brutal civil wars: its infrastructure was in shambles, Monrovia’s population had exploded, and the streets I had once walked as a teenager no longer looked familiar.
 
I was traveling with the newly formed nonprofit, Dignity:Liberia, to offer what support I could to women and girls with obstetric fistula, a preventable birthing injury that results in urine and/or stool incontinence. We got to know fistula survivors and those awaiting fistula repair surgery and tried to lessen their sense of shame, but our long-term goal is to end fistula in Liberia. Thirteen years later, I am amazed at what has been accomplished! We’ve touted those accomplishments as they happened, but I recently compiled a list and was astounded to see that we have…
 

• Held immunization clinics and distributed reading glasses in Charles Luke Town and provided them with funds during the Ebola crisis
• Donated medical supplies to numerous hospitals
• Started a scholarship, provided supplies and other support to the Phebe School of Nursing
• Donated educational supplies, dresses, sandals and other necessities to fistula survivors at the Phebe Rehabilitation Center
• Constructed a Palava Hut at the Phebe Rehab Center
• Dug a well in Cooper’s Town
• Participated in “End Fistula” campaigns sponsored by the UNFPA
• Distributed menstrual cups in collaboration with the Peace Corps
• Held workshops on sewing reusable menstrual pads in partnership with the Ministry of Health and in collaboration with the Rotary Club of Monrovia, which resulted in some participants taking their newly learned skills into their own communities and the Liberian prison system
• Built a modern maternity waiting home, House of Hope and Dignity, that opened for business in January 2025
• Installed/built a generator house, a kitchen, a Palava hut, a borehole well, a public water station, and a septic system on our 6-acre compound
  
• Employed two nurse-midwives who are traveling to nearby communities and cultivating relationships with the villages’ Traditional Tribal Midwives and residents.

 
Look over the list. Do you see one of your contributions? Did you sew dresses? Have you served as a Dignity Advocate?  Did you tell someone about us? Do you pray for us? Have you donated money? Are you an in-kind donor? Did you raise money through a birthday fundraiser? Maybe you convinced a business to give provisions. Perhaps you gave medical supplies. Did you help fold business cards or pack a container? We have accomplished so much with your help.     
 
This month we begin Phase II of our 3-phase building project: the construction of a fistula clinic with 2 operating rooms that will be used for fistula repair surgery. Women who suffer from fistula in this rural community (or who travel from elsewhere), will have their injuries repaired, restoring their sense of dignity. When necessary, delivery by C-section will also be done in the clinic. In April, we will build a public restroom on the compound for visitors to use. 
 
Thank you for blessing us with your continued support as we build our clinic in this rural area of Montserrado County. 

“A cheerful heart is good medicine, but a crushed spirit dries up the bones.”
--Proverbs 17:22
 
Many Liberian women, who suffer from fistula, have had their spirits crushed. Ostracized by family, rejected by friends, unable to work, leaking body wastes, and giving off an offensive odor, they feel extreme hopelessness or depression and have “dried bones.”  A number of them have considered or even attempted suicide.

Those who spent time at the Phebe Rehabilitation Center learned they were not alone. More importantly, they were surrounded by trainers with cheerful hearts. Even the women who were still leaking and hadn’t healed physically, responded to the cheerful hearts and experienced emotional healing.

“If you find it in your heart to care for somebody else, you will have succeeded.” 
--Maya Angelou
 
Dignity:Liberia’s goal is to eliminate obstetric fistula in Liberia. At House of Hope and Dignity, expectant mothers will be provided with hands-on medical care from nurse-midwives.  These medical professionals are not the only ones who have found it in their hearts to care for somebody else. You too have found it in your hearts to care for others in numerous ways. The home was mostly built by professional construction workers, but volunteers donated time and labor as well. It was furnished using funds from your donations. It was decorated with curtains that were lovingly sewn for the home. The expectant mothers will lie on bedsheets donated by you. Prenatal care and safe delivery will go a long way to helping us succeed in reaching our goal.

“A beautiful heart, like the rays of the sun, touches many"
--Chinese Proverb
 
We are now concentrating our efforts on building a clinic with two operating rooms.  The ORs will allow for safe delivery of complicated births, but will also be used to provide fistula repair surgery. Your beautiful hearts are touching many!

If you are able, and if your heart feels moved, please continue to support us as we work to build our clinic. Thank you for helping Liberian women with your cheerful, beautiful, caring hearts. 

In October 2021, I interviewed fistula survivor Mercy Benson who spoke candidly about the physical and emotional pain of an obstetric fistula. I can hear her downcast voice as she said:
 
               “We are in a rural area. Before the ambulance could leave from Monrovia and reach to
               our place and put me down to Monrovia, the time was already late.” 
 
Since then, my husband and I moved to Brenham, Texas from Austin. Brenham is considerably smaller than Austin and while it doesn’t have all the problems of a big city, it doesn’t have all the amenities either. I have Graves’ Disease, more commonly referred to as hyperthyroidism. It is typically managed by an endocrinologist. Brenham does not have an endocrinologist. The closest one is a 50-minute drive from where I live. Since my illness is well managed, the lack of a specialist in Brenham is not an issue. However, my eyes are now open to Mercy’s predicament: she lives in a rural area. By the time she could get to a specialist, it was too late for a safe delivery. 
 
Last year Dignity:Liberia completed House of Hope and Dignity, a maternity waiting home located in rural Liberia. Two licensed midwives work at the home, where the women who visit will receive expert care.
 
We are now focused on building a dedicated fistula clinic on our 6-acre compound. Once it opens, women suffering from obstetric fistula can come to us to have their injury repaired in one of two operating rooms. Additionally, women staying at our maternity waiting home will be able to have C-sections should it be necessary. Until then, women needing a Cesarian will be taken to a nearby hospital.   
 
Please continue to support our endeavors. Tell your friends, churches, co-workers, and others about this injury and what we are doing in Liberia. Financial support is always appreciated as well. You can donate by check, credit card, Pay Pal, or make a gift of stock. All the details can be found on our giving page.
 
Exciting things are happening in Liberia – and you are a part of it! Thank you!

In Barbara Robinson’s book, The Best Christmas Pageant Ever, the Herdman children were a pretty rough bunch who had never heard the Christmas Story. Through a series of events, they ended up participating in a church Christmas pageant. When the story of Jesus’ birth was read to them for the first time, they declared that the Wise Men’s gifts of gold, frankincense and myrrh were “crummy” gifts for a baby. On the night of the pageant, they presented baby Jesus with the ham their family had received from the charitable works committee. 
 
Similarly, you wouldn’t consider topping a load of sand with a bow, or wrapping a concrete block in Santa Claus paper and giving it as a Christmas gift. However, Dignity:Liberia needs these and other items to build a wall. 
 
When an expectant mother checks into our home, she will be outside the safety markers of her village and no longer in a familiar setting. She may feel anxious. A wall will remove one of the stress factors of an unfamiliar environment and provide reassurance to vulnerable young women. A wall says, “You do not need to worry. You are safe.”
 
The cost of building a wall around the entire six-acre compound is estimated to be $111,000.  The breakdown is as follows:

• Back wall: $14,000
• Each side wall: $40,000  

• Front section: $17,000 (includes a sliding gate for vehicular traffic, a small gate for pedestrians, and a security booth)

 
You have probably purchased your Christmas gifts and have them wrapped in pretty paper under your tree.  Can you make one more gift to Dignity:Liberia?  While the total cost for the wall is high, the price tag for each item ranges from 75¢ to $365.  Consider this: a gift of $15 would buy twenty 6” concrete blocks.  A carton of wire nails costs $30. The charge for a load of sand is $250.  Many of you helped build the maternity waiting home with small gifts. You can provide a secure environment and build a wall with similar small gifts.  There is no need to designate the funds; they will go toward the completion of Dignity:Liberia’s compound.
 
Our gift-giving at Christmas has some of its origins in the gifts presented by the Magi to the Holy Child.  This year, worship Jesus with gifts of sand, concrete blocks, and nails. Thank you!

Whenever I received gifts as a child, my mother had me write a thank you note. This blog is essentially our thank you note to all of you who support Dignity:Liberia with your time, talent, and treasure. Your material gifts, your wise counsel, your spreading the word about obstetric fistula by sharing our blog posts, or by writing your own comments on your social media platform, are appreciated.
 
Some nonprofits have categories to designate donor levels. The idea is to provide incentive to donors to give more in order to reap the benefits of the higher giving levels. Dignity:Liberia recognizes that each of you gives from the heart, and we are grateful for each gift, no matter its monetary worth.
 
Liberia’s National Day of Thanksgiving is the first Thursday in November, so it fell on November 7th this year. In the United States, Thanksgiving is observed on the 4th Thursday of November (the 28th in 2024). 
 
In both countries, friends and family gather to eat food. In the United States we include parades, dog shows, football, and a jump on Christmas shopping as well. The original purpose was to give thanks for our many blessings.
 
Dignity:Liberia is blessed and we give thanks to God that our maternity waiting home, House of Hope and Dignity, is complete. We give thanks for the architect, the volunteers, the paid workers, the women who fed the workers, those who oversaw the work in Liberia, those who traveled to Liberia and made decisions and gave of their time. We give thanks for those who believed in our cause and provided grant funding. We give thanks for those who collaborated with us on various aspects of the construction. We give thanks for those who donated supplies, made monetary donations, sewed receiving blankets and curtains, and those who donated seeds and plant cuttings. We give thanks for those who donated sheets for the hospital beds. 
 
We give thanks for those who worked long hours to ensure the house was ready for inspection. We give thanks for the women who made sandwiches and baked treats for those who attended the grand opening.  We were so blessed by those who attended the joyous event. We give thanks for qualified applicants to work in the home.  Most of all, we give thanks that Liberian women in the Todee Junction area will be able to have prenatal care from medically trained midwives and avoid suffering from fistula. 
 
Finally, we give thanks that we can now begin Phase 2 of our project which is to build a dedicated fistula clinic.  We are truly blessed!

For years Dignity:Liberia has worked with fistula survivors. We have taken teams of volunteers who have done a number of activities and socialized with survivors of all ages. Year after year we met new survivors, and sadly, saw many familiar faces when we returned to the Phebe Rehab Center on subsequent trips. World renowned fistula surgeon, Dr. John Mulbah, has repeatedly stated that obstetric fistula is a preventable injury, provided a woman has access to proper prenatal care and delivery in a clinical setting.
 
Dignity:Liberia wants to prevent obstetric fistula from occurring in the first place. For years we dreamed of building a maternity waiting home in rural Liberia to lessen the likelihood of this birthing injury. Once all the questions of where to build, who would build, how the home would be operated, etc. were answered, we raised funds, engaged an architect, purchased building supplies, hired workers, ran the project on a daily basis, and dealt with setbacks. Project oversight from across the Atlantic took time.
 
The Liberian Daily Observer described House of Hope and Dignity, the completed maternity waiting home, as a modern facility where expectant mothers will receive “critical care and support.” We celebrated our delivery with a grand opening which was well-attended by many dignitaries and honored guests, many of whom were vital to the success of our project.  
 
We have long planned to have a dedicated fistula clinic where women will be able to deliver babies by C-section, should it be required, and doctors will be able to perform fistula repair surgery on women and girls who suffer from this injury.
 
We were expecting for a while, but now, we have delivered! We invite you to watch the video, which includes a view of where our fistula clinic will be built. We are still basking in the glow of having completed our home and ask you to celebrate with us once more, before we ask for future donations. This could not have been done without your help! We are humbled and grateful for your ongoing support.  

September is National Suicide Prevention Month and a time to remember those living with depression.
 
September 2024 marks six years since Kathi Gutierrez and I conducted our first recorded interviews with fistula survivors. I had been involved with Dignity:Liberia since 2012, and had spent time with survivors: singing with them, learning some of the trade skills they were taught, helping them with a reading class, and doing crafts. I also watched as they danced joyously and showed them pictures of my family and pets. I understood on an intellectual level that an obstetric fistula causes constant leaking of urine or feces (sometimes both), but I had never asked how their injury made them feel.
 
By asking probing questions such as “how did this [fistula] happen?” and “what makes it hard,” I finally felt in my heart, the pain caused by the peepee poopoo disease. I did not realize that most survivors had delivered stillborn babies and that they had had hysterectomies due to tissue damage. Their responses, some delivered with downcast eyes, helped me understand that some were smiling to mask their pain, while others were smiling because they had found joy at knowing they weren’t alone. We spoke with 12 survivors who opened up about the injury that had caused them so much pain and shame.
 
Their stories were very similar. Constantly leaking urine, Beatrice cried all the time and washed frequently. Only her mother knew about her fistula because she was ashamed. Another survivor told us that before having her fistula repaired, she had to change her clothes 9 or 10 times a day. Yet another told us that even with in a supporting environment, there was a temptation to commit suicide.
 
Fanta told us that during her labor, a traditional tribal midwife tried unsuccessfully to force the birthing process. When they finally took her to the hospital, her baby had already died. Helena told us she would encourage friends to go to the hospital to give birth. Similarly, Hawa would advise her pregnant friends to have their baby in a hospital or clinic.
 
Dignity:Liberia’s maternity waiting home, House of Hope and Dignity will allow Helena and Hawa’s friends to do that. The home is on the cusp of becoming operational. However, we are raising funds for an ambulance, which we are required to have before we can open. Per Dr. John Mulbah, a world-renowned OB/Gyn in the area of obstetric fistula, the injury is preventable with such a home and medical care. It will be a game changer!
 
We are so grateful to all of you who have stayed with us on this journey. It has been longer than hoped and your companionship means a lot. It helps to know that you are supporting our efforts to fight depression and end suicidal thoughts brought on by this avoidable injury!
 
Click on this link if you would like to hear the fistula survivors’ stories. 

When you share knowledge you usually never know if you inspired anyone or made a difference. This past February board members of Dignity:Liberia and talented volunteers traveled to Liberia to teach several sessions on how to sew washable/reusable menstrual pads and holders. Classes were full and learners were serious. Approximately 435 persons attended classes. Ages of learners ranged from 6th grade to women with families. Women talked about making kits for themselves and family members, or even to make kits to sell in the market. Boys told me they were going to go home and teach their mothers and aunties. Obviously, there is a big need and much interest.
 
Several of the volunteers have taught these classes before. But I was new to the project. So new that a young woman in my first class said, “ah, we are cohort one” and nodded her head. She proceeded to tell me that she and the other women at the table intended to teach these classes in rural areas and other high needs locations. I was hot and stressed and didn’t take it all in. Yes, cohort one challenged my teaching skills. We shared contact info but I didn’t assume I would ever hear from her. Little did I know that she indeed had big plans.
 
The lady who talked to me was Samkay Karworzohn and she is the president of “TEAM, Inc” in Liberia. It is a small NGO that is involved with many organizations that support women and children. Their name stands for “Together Everyone Achieves More”. Areas they have been involved in include substance abuse prevention and awareness, mental and reproductive health, and social inclusion of vulnerable groups. The women are mentors and advocates.

Before I left Liberia Samkay reached out to me as promised. She wrote about “period poverty”. She told me women are shunned if they try to go out in public with no way to collect their monthly flow. They cannot work or go to school for that week so fall behind. Their mental health suffers. Samkay wanted to make a difference. She knew these kits were important.
 
I returned to the U.S. in March. Samkay busied herself trying to find partners and teaching locations. She stayed positive.
 
On April 5, 2024 TEAM held its first class in Kakata. This is a small town about an hour northwest of the capitol. 40 women and girls attended and 95% were able to finish their project. TEAM provided the fabric, plastic and pattern as well as needles and thread. A success but just the beginning.