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.

On July 4th, the United States celebrated Independence Day. The day was observed with fireworks, picnics, and concerts. July 4th commemorates the date in 1776 when the original 13 colonies declared their independence from Great Britain. The day is associated with pride, freedom, justice, and peace.
 
On July 26th, Liberia will observe its independence from the American Colonization Society. Liberia’s national anthem includes the words, “Long live Liberia, happy land! A home of glorious liberty, By God’s command!”
 
Many women who suffer from obstetric fistula don’t feel as if the words “freedom,” “peace,” “happy,” and even “justice” apply to them. Their freedom is restricted, not by another nation, but by the constant leaking of urine or feces (sometimes both). They feel no peace as they have to scrub sheets two or three times a day, or clean their bodies and clothing even more often. They are sad, not happy. They are not at peace. Their situation is frequently caused by the injustice of limited healthcare or funds to pay for prenatal care.
 
Dignity:Liberia exists to give women freedom from the fear of developing a fistula by providing them with prenatal care by a medically trained midwife in its maternity waiting home, House of Hope and Dignity.  Should the expectant mother require emergency treatment in a hospital setting, we will have the ability to transport her to the nearest hospital by ambulance. 
 
The words associated with the national ambitions of both nations apply in a very personal way to the mother and her child: a freedom from fear, peace of mind, pride and happiness at the safe delivery of a child, long life for both mother and child.
 
So many of us take access to skilled medical care for granted. However, that is not always a given. It takes a dream to reach this goal and it takes support to help achieve the dream. Please do your part in making this dream become a reality. Thank you!

Imagine you live in a rural village in Liberia, where pregnant women rely on the traditional tribal midwife (TTM) to deliver their babies. She’s an old woman. She delivered you, and you’re 16 years old!  Your best friend, Fatu, is a year older than you.
 
Fatu got pregnant last year and when the pain grabbed her (when she went into labor), she relied on the TTM, just as your mother had when she delivered you and your younger siblings. This time something went wrong. Fatu was in labor for 5 days. The baby was stuck in the birth canal. You listened to your friend screaming in pain. Finally, the TTM said Fatu needed to get medical treatment. 
 
When Fatu came back to the village, she was not the same. She was no longer the bubbly, outgoing friend you once knew. She had lost her baby and suffered an injury called obstetric fistula, causing her to leak urine. You hardly see her anymore because she’s ashamed of the smell it causes. When she did let you visit, she told you not to rely on the TTM when you get pregnant. She said you need to have a trained midwife tend to you.
 
Dignity:Liberia’s maternity waiting home, House of Hope and Dignity, is built: all interior and exterior work has been completed, it is painted inside and out, there is electricity, running water, rooms that can sleep two patients and beautiful landscaping, but no ambulance. The Ministry of Health requires that we have one before we can open our doors. 
 
Why?  Keep reading.
 
While in Liberia in March, Dignity:Liberia’s founder and president, Kathi Gutierrez, met a young woman who had just given birth. The mother told Kathi they had to cut her open for the birth of her boy whom she named “God’s Gift.”  When she arrived at the hospital, they couldn’t find a heartbeat. They thought the baby had died in the womb. After the baby was born by C-Section, he wasn’t breathing. They took the baby upstairs to their NICU and worked on him. Eventually he started breathing! The nurses told the mother that God had special things in store for her baby.
 
Even with pre-natal care, things can go wrong during the delivery of a baby. If our medically trained midwife determines an expectant mother at our home needs to deliver in a clinic, we will need to be able to quickly and safely transport her by ambulance. 
 
We hope the story of “God’s Gift” will inspire you to make a gift. For information on how to help us get our ambulance, go to our GoFundMe campaign, or go to our giving page. 

I find people have good hearts.  They want to help, but they have to know there’s a problem.  Someone has to tell them.  I recently made a presentation to the Brenham Evening Lions Club about Dignity:Liberia.  Some had heard of Liberia but knew nothing or little about the country.  They certainly had never heard of obstetric fistula.  However, they were eager to learn and were very interested in the pictures and information that I shared.  This made me wonder how our recent Dignity Advocates heard about Liberia and obstetric fistula.
 
Kay Green remembers reading about Liberia in an article in the Southern Baptist Women's magazine, Mission Mosaic.  A friend of hers, Carol Gutshall, contacted Dignity:Liberia’s founder and president, Kathi Gutierrez, who subsequently did a program at the Baptist Home, a nursing facility.  Kay’s ladies group began to sew dresses and reusable menstrual pads.  They later participated in a sewing day at board member Linda Thornsberry's church, First Baptist Church of Lee’s Summit.  
 
Susie Calaway learned about Dignity:Liberia and the obstetric fistula problem in the country from Kay.  They made their first trip to Liberia in 2019 and a second trip in 2020 just before the global shutdown due to the COVID pandemic.  They recently returned from their third 3rd “sewing trip” in March of this year.  Susie also participated in the “building trip” in 2021, when American and Liberian volunteers worked with the paid construction workers on House of Hope and Dignity, our maternity waiting home.  Kay and Susie shared what they learned about obstetric fistula and became part of the solution. 
 
After the recent workshops in Liberia, some of the participants passed on what they learned with other women and girls.  A young lady who attended one of the classes held on the Lott Carey Baptist Mission School campus, taught a class in her community, sharing what she learned.  Similarly, a group of young women who are members of an organization called TEAM – Together Everyone Achieves More, attended one of the 2024 reusable menstrual pad workshops in Monrovia and subsequently organized their own a reusable sanitary pad training sessions.  Following a class in Telecom community in Kakata, Margibi County, they received permission from Liberia’s Ministry of Justice to hold classes in women’s prisons.  They shared pictures and video with board member Anne-Marie Mueller.
 
The song “Pass it On” includes the line, “It only takes a spark to get a fire going.”  You can be that spark!  Spread the word about obstetric fistula in Liberia and what Dignity:Liberia is doing to combat this injury.  Long-time supporter Miatta Caine recently wrote an article for TLC Africa.  There are other ways to spread the word: repost this blog on your Facebook newsfeed talk about obstetric fistula in small gatherings with friends.  How did you hear about obstetric fistula?  How did you learn about Dignity:Liberia?  Pass it on!

During the reusable menstrual pad workshop, Dignity:Liberia posted a number of photos taken by Matthew Walters and various team members to our Facebook page.  Today’s blog includes favorite photos taken by team members on their recent trip.
 
Dignity:Liberia board member Linda Thornsberry, who led the workshops, told me that on her first Saturday in Liberia, she attended an event sponsored by the Academy of Women Entrepreneurs (AWE), that included a small market of items made by women and a meeting held by the organization.  Several members gave short talks.  They were interested in Dignity:Liberia and asked Dignity:Liberia’s Founder and President, Kathi Gutierrez, to give a short talk.  Linda spoke with several AWE members after the meeting.  On the following Monday, five or more AWE members came to the Rotary Sewing Workshop in Monrovia.  One of Linda’s favorite photos is of her with one of the students.
 
Kay Green’s favorite picture is one of her with Susie Calaway, dressed for the last day of teaching with their “class necessities” (pin cushions, patterns, etc.).  They are long-time friends who get to share a common love for mankind in faraway lands.  Kay and Susie have missioned together in Hawaii, Nicaragua, Ecuador, and Liberia.  Liberians have stolen a piece of their hearts. 
 
Jenneh Wilson does not have sewing skills, but helped by serving as a supply runner, making gift bags, and managing registration. She set up the chairs and fans, got water and food, and helped with sewing as best she could.  Her favorite memory, however, was helping deliver a baby by c-section with Dr. Kebah at Trinity Medical Clinic.  It was a life-changing experience that filled her with love and joy.    
 
Jill Gordon wrote that there were too many touching moments to just pick one.  However, she greatly admired a “creative thinking young man” who showed her weaver bird nests, babies, and an egg.  He then he piled a bunch of lizards in her hand.  She wrote, “He’s destined for great things.”
 
Susie Calaway’s heart is into helping ladies in their pregnancies, and trying to prevent fistulas, so it was a great privilege for her to step inside the maternity home, House of Hope and Dignity.  She was surprised to see Friday, whom she met on the “building” trip and just had to hug him.  Her favorite picture is of the two of them looking out from the maternity waiting home.  She also walked the grounds, talked to a neighbor lady, who is planting a garden down past a well named “Rick’s Well,” after one of the Dignity:Advocates who helped with construction in 2021.  She enjoyed reminiscing of the time she spent bagging plant cuttings under Friday’s direction, and the excitement she felt of “being a part of it all.”

Kathi Gutierrez shared the story about visiting a little hospital around the corner from where the classes were being taught in Kakata.  They met a young mom who had just given birth.  Kathi asked the mom if she could see her baby.  The mother was very proud of her baby boy whom she had named God’s Gift.  She said they had to cut her open.  Kathi told her that she had the same cut when she had her son.  Kathi felt moved to pay the mother’s bill after finding out how much it was.  The nurses grew excited and told the woman “See? We told you this baby has destiny with God.”

As Kay wrote, the team was there for a mission - to equip girls and women to overcome the stigma of period poverty and to learn a solution to help them live a successful life.  She added, “If only one student passes the skill forward, the chain reaction to changing Liberian women's lives has begun.”
 
This has already happened!  Anne-Marie Mueller, another Dignity:Liberia board member, wrote  that the ladies from the first class held in Monrovia had formed a group TEAM – Together Everyone Achieves More – and have already held a "reusable sanitary pad training session in Telecom community in Kakata, Margibi County."  
 
Quoting Kay again: “I believe we finally have taught the correct group to keep the sewing and teaching going without us. It has been a great blessing to work with this like-minded, mission group to influence the ladies of Liberia.”  
 
Keep an eye on our Facebook page.  We will soon share photos of TEAM as well as a young lady who attended a class at Lott Carey who are keeping the “sewing and teaching” going.