Fistula Survivor’s Name:  Susan Dwanah
Interview Date:  February 25, 2020
Interview Location:  Phebe Rehabilitation Center, Bong County
Interviewer:  Kathy Beth Stavinoha
Assisted by: Emma K. Katakpah
 
Susan Dwanah is from Bopolu.  Her favorite color is pink.  She is the oldest child (the first) in her family.  She is 22.  She doesn’t know the ages of her 2 brothers and 1 sister.  Susan has no children. 
 
I sensed a lot of pain and reluctance to talk about her experience.  At one point during the interview, I felt compelled to tell her she should not be ashamed.  She has a sickness.  She has a lovely smile and laughed when we joked about her doing my hair and when I showed off my limited Kpelle. 
 
Susan was in pain (in labor) for 3 days.  Then “they were on her” and she got the pee pee problem (fistula).  She had a C-section to remove the baby who was stillborn. 
 
Emma Katakpah explained that Susan was assessed for surgery in December 2019, during the fistula campaign.  Her fistula is all the way to the bone, so it will require a special surgery.  It’s a very difficult surgery.  So, she is still on a waiting list to have her fistula repaired and she is still leaking.  She has been leaking since 2018.
 
Susan had been at Rehab for a month at the time of the interview.  Unfortunately, she hasn’t learned a trade because there is no material available.  The Rehab Center has run out of material.  Susan is hoping that they will be able to get things so she will be able to practice.  She wants to learn cosmetology and plait hair.  She can do some now.  The other girls who are at Rehab, had completed their courses and were only awaiting graduation.  When Susan goes back home, she wants to fix a place to do her business.
 
The fistula makes her feel bad.  Her grandmother is at Rehab with her.  Her former friends have abandoned her, but she has made new friends at Rehab.  They play ball together.     
 
Susan would tell pregnant women to go to the doctor so they would not get fistula.  They shouldn’t stay in the village.  They shouldn’t go behind the house 
 
Although not yet healed, Susan is a fistula survivor.  Hear her story in her own voice: 

When I was in the fourth grade, my parents signed a permission slip that allowed me to view a film strip entitled, “It’s Wonderful to be a Girl.”  That was my introduction to a woman’s reproductive cycle.  I don’t recall discussing it with my parents, but I do recall sitting down with my mother the following year, after watching a similar film.  She wanted to give me a chance to ask questions about what to expect when I reached puberty.  My parents wanted me to informed.  Despite that, I had no idea why my stomach hurt and why I had a headache when I had my first period.  My mom explained I had started menstruating, and made sure I had a supply of sanitary napkins.  Imagine not knowing.  Imagine not having anything to staunch the flow. 
 
While we were in Liberia this past February, we joined Steven Stauffer, Gender Coordinator for Peace Corps/Liberia, to hold a menstrual cup distribution which included an educational component.  Most of the young ladies in attendance were college students and better educated than the rural fistula survivors we encountered.  Still, they recalled having to figure things out on their own, or with the help of a female relative - typically an older sister, and not really understanding what was happening to their bodies.  They spoke of missing school as well.  All too often, this can start a downward spiral that ends with a young girl dropping out of school.  Fortunately, this was not the case with the menstrual cup distribution attendees.  
 
Even though this group of young ladies already knew what to expect each month, the educational piece included lessening the taboo of speaking about the woman’s monthly cycle, and provided an opportunity to ask questions that had not yet been answered.  The presentation also included instruction on how to use and maintain the menstrual cups.  With proper care, they can last up to 10 years, so this can be a huge money-saver. 
 
I interviewed three of the young ladies in attendance. 

Fistula Survivor’s Name:  Wilhelmina Davis
Interview Date:  February 25, 2020
Interview Location:  Phebe Rehabilitation Center, Bong County
Interviewer:  Kathy Beth Stavinoha
Assisted by: Emma K. Katakpah
 
Wilhelmina Davis is from Grand Gedeh County.  She told me “thank you, God will bless you,” in Krahn, her dialect.  She has five brothers and three sisters.  She has four children of her own.  Her oldest is 18.  Her next child is 12.  The third one is 10.  Her fourth child is 7.  They are all four boys.  Her youngest had been living in Grand Gedeh County, but she sent for him to join her at the Rehab Center.  Wilhelmina is 35 and has not been to school.  Her favorite color is blue
 
She got her fistula from going to the bush to give birth (giving birth at home).  The pain grabbed her (she was in labor), but those assisting with her delivery did not want to wait. They asked her how many hours she had been in labor.  They did not want to listen to her.  They were trying to force delivery by hauling the child (pulling on the baby).  The people said that something was coming from underneath her so they took her to Redemption [Hospital].  They gave her some medicine and sent her home.  She went to Dr. Mulbah’s clinic and he said she had a fistula. 
 
Dr. Mulbah repaired her fistula.  Dr. Mabry did a follow-up examination for some residual incontinence, but she said Wilhelmina no longer has a fistula.  She said she would be okay.  Wilhemina still leaks small small (a little bit).
 
She was feeling bad when she had her fistula.  Her big sister didn’t want her to feel bad.  She didn’t want her to be worrying.  She would hold her and talk to her.  She assured her that God would be with her and that God would help her. 
 
But her boyfriend didn’t have time for her since she had her fistula.  Since she was in Monrovia, he wouldn’t even call her.  Her sister was the one that took care of her.  She didn’t do anything to make her feel bad.  Whatever she wanted; her sister would do for her.  She gave her support.  She told her to come to the Rehab Center to learn a trade.
 
Her friends wouldn’t come around.  She couldn’t tell them her secret.  Because when you tell your secret, they’ll be “carrying your name around” (gossiping) so she’s got no friends.  She just kept quiet about it.  She said “My stomach is feeling all right.”  No one besides her sister knew of her problem (fistula), because if you explain your problem they’ll be “carrying your name all around.” 
 
She learned tailoring, soap making, and bread making.  But there hasn’t been any material for a year now.  She’s been at Rehab for one year.  She wants to go home.  She wants to fix soap and bread to sell for money so she can send her son to school.  She would be supporting her children. 
 
She would tell a pregnant friend to go to Phebe Hospital to wait until your time is reached [you’re ready to deliver].  If you’re pregnant go to the hospital to deliver safely to avoid getting a fistula.
 
Wilhelmina is a fistula survivor.  Hear her story in her own voice.

Fistula Survivor’s Name:  Mammie Davids
Interview Date:  February 25, 2020
Interview Location:  Phebe Rehabilitation Center, Bong County
Interviewer:  Kathy Beth Stavinoha
Assisted by: Emma K. Katakpah
 
Mammie Davids is from Nimba County.  She is 26 years old and is not married.  The second child born to her parents, she has one brother and five sisters.  When she was a little girl, they played kickball. 
 
She got her fistula in 2006.  After two years of leaking, she had a fistula repair operation.  She has had three operations to repair the fistula because of a recurrence, but she is dry now.  She was in pain (labor) for two days.  She was in Monrovia on GSA road.  The child (baby) was big, so she couldn’t deliver on her own.  They took her to the James Davis Hospital.  She had a C-section (the child operation) and came down with a fistula.  The baby died.  She has five girls.  Her first child was born in 2003 and the last in 2010.  Currently they live in Monrovia with her brother, who is taking care of them while she is at the Rehab Center.  Their father lives in Nimba. 
 
She and her boyfriend are not together now and her family doesn’t want to see him.  Her brothers and sisters have stuck by her.  When I asked what was hard about having a fistula, Mammie said that her boyfriend abandoning her made her sad.  When she went into labor, he cut himself off from her.  He would not come to the house, so her people got vexed (angry) and her family told her not to be with him.   
 
When she had the sickness (her fistula), she had to spend the whole day washing her clothes by herself.  She is dry now.  She is not experiencing anything anymore so she tells God thank you.
 
She said having a fistula “opened her brain,” (opened her eyes) because her boyfriend was bossing her around in Monrovia so she tells God thank you for opening her brain.  Fistula taught her tailoring, fistula taught her tie-dying, fistula taught her [could not understand], fistula taught her soap-making.  She can do everything now.  Her favorite is tailoring.   
 
She sees tailoring as her future.  When she leaves the Rehab Center, she and her children will survive on it.  She is building her own house.  At the time of the interview, it had reached roof-level.  When her house is finished, she will have her shop attached to it.  She will be able to conduct business from the house.  Her children can be home while she does tailoring and sells her clothes.
 
She likes to sing and dance.  She composed the words to a song that she sang for us in her beautiful voice.  Some of the lyrics are:
 
No money can buy your salvation
No man can do it for you
Your family member can’t do it for you beside God
You must be baptized and be born again
I fear no man by the grace of God
 
Mammie is a fistula survivor.  Hear her story in her own voice:

Fistula Survivor’s Name:  Fatu Moore
Interview Date:  February 25, 2020
Interview Location:  Phebe Rehabilitation Center, Bong County
Interviewer:  Kathy Beth Stavinoha
Assisted by: Emma K. Katakpah
 

Fatu Moore grew up in Chebiah with three brothers and three sisters.  She stopped attending school in the 8th grade.  I asked her to say something in Gola, her dialect.  She told me: “Hello.  How are you coming on? I tell God thank you.”  She is 20 years old
.
Fatu was in pain (in labor) for one week.  They took her to Tubmanville Hospital where she was told she was having “slow pain,” (pressure, not true labor) so she returned home.  When she started progressing, the TTM (Traditional Tribal Midwife) thought she had it under control but didn’t recognize when the baby got stuck.  By the time Fatu got back to the hospital, the baby had already died and they had to cut her open.  Her stomach started getting big so they took her back to the hospital where she was told her womb was damaged.  Following a second surgery, she came down with fistula. 
 
She had fistula since January 2019 until December when she had her fistula repair surgery.  She is not dry but is just leaking at night.  She will need another operation. * 

Fatu had both RVF (rectovaginal fistula), which was repaired in December, and VVF (vesicovaginal fistula) which will be repaired next.  She still experiences leakage in the night but she has panties (Depends) to stop the leakage.

Fistula makes her feel bad and lonely.  And she feels discouraged.  Her friends won’t come around her.  Some of her family are with her but some are embarrassed by her situation. 

She has learned how to make soap and bread, but there are no starter kits.  [Note: a starter kit would include the supplies needed to go into business.  Previously these were provided to Rehab Center graduates.]  So, despite learning a trade, she will stay at the Rehab Center.  When she does leave the Rehab Center, she hopes to keep making bread and soap in order to survive. 
 
She will tell her friends don’t allow any midwife (TTM) to screw you - to give birth by yourself.  If the doctor says you are not able [to give birth by yourself], please go to the hospital.  And the TTM shouldn’t allow you to give birth without assistance (to “born the baby by yourself if don’t able to born it by yourself”).  Fatu said you should go to the hospital and not just assume a doctor will make a mistake.   
 
She was in slow pain (feeling pressure) and was crying for the whole week. The fetus had already died.  She has no other children.
 
When she leaves the Phebe Rehab Center, she wants to be a student.  She likes Social Studies.   

Fatu is a fistula survivor.  Hear her story in her own voice.

*ADDITIONAL INFORMATION:
Because Fatu had both RVF and VVF, she will have to have multiple surgeries.  The rectal fistula is repaired first so as not to cross contaminate with stool, the vaginal surgery.  She also needed a colostomy bag.  Just prior to my leaving for Liberia, a friend donated some stoma bags to Dignity:Liberia.  We left those for Fatu.

Fistula Survivor’s Name:  Evelyn Jagbah
Interview Date:  February 25, 2020
Interview Location:  Phebe Rehabilitation Center, Bong County
Interviewer:  Kathy Beth Stavinoha
Assisted by: Emma K. Katakpah
 
Twenty-eight-year-old Evelyn Jagbah grew up in Sinoe County with her sister and two brothers.  One brother is 25 and the other is 15.  Her sister is 40.  They have the same ma and same pa.  She has had no schooling at all.  She has three children ages 16, 8, and 7; her oldest was born when Evelyn was 14 years old.  She likes the color green. 
 
She was pregnant.  She was going to give birth by C-section.  During the operation, she got a fistula which she had for more than a year.  She first said she is not leaking, but then said she is leaking small small (a little bit).  [Note: we believe her fistula is healed, but that perhaps she suffers from incontinence.]  She has had only one operation and they will not do another. 
 
Evelyn learned how to make soap and bread while at the Rehab Center.  When I asked if she would open a shop, she said there is no material and no graduation.  [Previously, the Rehab Center held graduation ceremonies for the survivors.  At graduation, the survivors received the materials they needed for their trade and some seed money to start their business.  However, there is no longer any funding for this.]  When she leaves the Rehab Center, she has no way to make a shop or to make anything.  She told us that the people who ran the program “don’t have time for you.”  She has the skills, but she has no way to use those skills or to start a business.
 
When I asked her what was hard (difficult) about having a fistula, she replied that when you get fistula, nobody will help you.  People won’t come around you.  They are afraid of you because you have fistula.  You can’t go among people.  You are lonely.  You’re sitting down.  You are crying.  But when you come here to the camp [the Phebe Rehab Center] you can be free and move around.  You’ve got no family.  They can be afraid of you. At the Center, they love you and accept you.  Because you meet other people here and you can associate yourself with them. 
 
Before coming to the Rehab Center, she felt bad.  The baby died.  She had this problem [fistula] and she was feeling bad.  She would advise a girl to marry a good man who would take care of her.  She asks people not to forget about them.  She said that the place they are in now, they “have no friend, no brother, no sister” and that we Dignity:Liberia) are the ones that are helping them and that we have not forgotten them.  We always remember them.  
 
She speaks Krahn.  I asked her to say something in Krahn.  She said: God will be with the people every time they are coming to us.  Because “they get nobody that are dependable for us now” and that we were the only ones coming.  “We say thank you.”
 
Evelyn is a fistula survivor.  Hear her story in her own voice.

I hope you’ve been enjoying the return of our series, In a Fistula Survivor’s Voice.  I had intended to start posting the survivors’ stories before now.  All of the survivors were interviewed on February 25th.  I had anticipated editing the videos and typing their bios after a brief readjustment to being back in the States - mid-March at the latest.      
 
Then COVID-19 started spreading across the world at an unbelievable rate.  On March 13th I was told that the university where I work was closed for the day and, over that weekend, learned that we would be working from home for a couple of weeks.  That time period has been extended.  In the meantime, we’ve been advised to wear masks, stay 6 feet away from people, and avoid unnecessary travel.  So many unexpected changes – we’ve all been through them.  Life, as we knew it, changed - seemingly instantaneously. 
 
So it is for women with fistulas.  When I listened again to the survivors’ stories, I was stunned at how quickly their lives had changed.  Many lost their babies.  They began leaking.  Some were abandoned by their husbands.  Some had hysterectomies and could no longer have children.  Many were shunned by their families and friends.  Their daily activities were altered, and their interactions with others were no longer the same.  Life, as they knew it, changed. 
 
If you heard Mary Padmore’s interview, you know that her fistula was an indirect result of a tribal birth attendant bouncing on her stomach in an effort to deliver the baby.  This led to a C-section (the baby was stillborn) and a hysterectomy, after which she started leaking.  Trained medical assistance in rural areas will decrease this type of birthing injury.  This is the reason we will build our maternity waiting home up-country. 
 
An update on our maternity waiting home:  COVID-19 has set us back a bit.  We are waiting to finalize the purchase of the land.  As long as Liberians are under quarantine, we won’t be able to complete the purchase.  We ask for your prayers on this.

Kathy Beth Stavinoha
Kathy Beth lives and works in Austin, TX.  She graduated from high school in Monrovia, Liberia in 1977.

Fistula Survivor’s Name:  Mary Padmore
Interview Date:  February 25, 2020
Interview Location:  Phebe Rehabilitation Center, Bong County
Interviewer:  Kathy Beth Stavinoha
Assisted by: Emma K. Katakpah
 
Mary Padmore is from Bopolu.  She has four brothers and two sisters.  She has two daughters who were staying with her at the Rehab Center.  Their names are Neema (5 years) and Yassa (3 years).  Her husband left her while she was pregnant.  She speaks Kpelle.  I asked her to say something in Kpelle.  She told me that her name is Mary, she is from Bopolu and her mother’s name is Kuma. 
 
When it was time for Mary to deliver her baby, her mother wasn’t there to help, so she went to her uncle who is who is married to a midwife (a tribal birth attendant with no medical training).  The tribal birth attendant (TBA) tried to force delivery by bouncing on the child.  The baby was stuck (possibly because bouncing on the belly causes the cervix to swell, which does not allow for the baby to exit).  She was in pain [in labor] for 3 days, after which the TBA then took her to the clinic. 
 
After an examination, the doctor told her she couldn’t give birth without assistance and called an ambulance to take her to the hospital for a C-section (“operate on me.”).  When the ambulance came, the doctor got vexed [angry].  He acknowledged that the TBA was trying to help, but she was doing the wrong thing and hurting the baby (she was “going to kill the poor child”). 

They first took Mary to Phebe Hospital, but there was no space available, so, they took her to Nimba (a three-hour drive).  They did the operation for the child (C-section) but the baby was stillborn.  The baby probably died during the trip to Nimba.  After 2 or 3 days, her stomach started swelling.  They took her back for a second operation where they removed her womb.  After that operation, she came down with fistula. 
 
Mary had her fistula for 7 months.  She had one fistula repair operation and is now dry.  While at the Rehab Center, she learned how to bake bread and make soap.  Once she graduates from Rehab, she plans to teach her family the skills she has learned.  She will also sell things at the market to help her family.
 
When I asked her what advice she would give other girls, she replied that she would tell her friends with fistula to come to the Rehab Center where people will come and help them.  She added that she would tell her pregnant friends to go to the hospital to give birth, to avoid getting fistula.
 
She feels less of a woman because she can no longer have children.  She will take care of herself.  However, if she meets a man who is interested in marriage, she will explain her problem [that she’s had a hysterectomy and cannot provide children] and if he accepts that, she will know he loves her and doesn’t just want her to provide offspring.

Fatu Tokpah - Part II
Fistula Survivor, Business Woman, Advocate
Interviewed on February 25, 2020 by Kathy Beth Stavinoha

When I asked Fatu if she had anything she wanted to say, she made a passionate plea to those who have funded the Phebe Rehab Center in the past.  At the time of the interview, the Rehab Center had not received funding for months. The teachers and other staff who remained, had not been paid in months. 

Transcript:
“I’d like to say, thank you all that came to see us again.  And I’d also like to say, we are begging you, we beg you so much: please don’t forget about us. I know that you cannot forget about us because there is a long distance that you cover to come to see us, so I bless God ever so much.  

And I want to ask all the organizations that were helping this process.  I want to ask them.  All of us that are up there, they are losing hope that they are no longer a woman again.  I want to ask them whatsoever that tie them up [whatever discourages organizations from helping] let God help them that they will think about fistula survivor.  So that they can empower us. Because our sisters up there, they want to come.  But every day they are listening to the radio that the Center is closing gradually.  The Center is closing.  No support now for this organization [the Phebe Rehab Center].  

As you can see here, this place used to be rich [flourishing].  We used to eat the best.  We used to play.  We used to learn the best.  But I came to see my friends.  I cannot see anything.  The classes are closed.  So I ask UNFPA to join Dignity, all organization to join Dignity, to support our friends. To support us.  It’s not easy when you have this problem. No one wants to associate themselves with you. In the community you will be alone.  Even your partner that put you in the problem, they will stay away from you.  This is where we come to feel like humans again.  So if this place closes, many women will die up there.  Many people will be neglected.  But when you come here, you learn.  You carry on your daily process.  People feel good.  People always pair like me. 

When I graduated from here, when I went, all of my parents came around me.  Friends who had not wanted to associate with me, they came around me.  They were so happy because when I left, I was very fat.  Shiny [in good health], because I ate the best.  So, I ask, I ask, I’m begging you, to please stand by us.  To stand by our friends up there.  To encourage our friends to come. And what will encourage them to come?  When they come, they see food.  Food makes you human.  They see things that we learn.  They will be encouraged to stay here.  Whenever they come for their surgery, they come, they see the place dry [deserted] like this, they will be discouraged. They will say, ‘better I go home and be dead.’  So, we’re asking you to please empower us.  Please, we are begging you.  We ask God to beg you to please do not forget about us.  Please stand for us that we will have hope again.” 

Fistula Survivor’s Name:  Fatu Tokpah
Interview Date:  February 25, 2020
Interview Location:  Phebe Rehabilitation Center, Bong County
Interviewer:  Kathy Beth Stavinoha

I first interviewed Fatu Tokpah in 2018, while she still resided at the Phebe Rehab Center.  While there, she learned how to be a beautician (“how to plait hair”) and how to make soap.  She has since graduated and returned home.  

Fatu now lives in Monrovia where she is in business, selling clothes at the market to make a living.  Her market day hours are from 7:00 in the morning till 6:00 in the evening.  
 
When she heard that Dignity:Liberia was going to be at the Rehab Center, Fatu traveled to Bong County to visit us and to see her friends who remained there.  During the interview, I asked her if she speaks any other languages.  She reminded me that she is Kpelle and that in 2018, she taught me how to say, Yaa-tuawe (hello) and Ku-maneeju (what’s up).  This year she taught me, Eecolekaye which means, “how do you feel in your body?”  I replied, “Thank God.”  That is to say, I am well. 
 
Her little boy, Joseph, was too shy to say hello.  She told me “this is my baby.”  She gave birth to him before coming down with her problem [fistula] and she blesses God ever so much that she and her baby survived, because most of her friends “that born their baby, the baby did not make it” [their babies were stillborn].  She also blesses God for her husband because he did not put her to shame, but stood by her.  She said, “By the grace of God I did my first surgery, I was not too successful, and the second surgery, God blessed me, I got well.” 
 
She encourages her friends [with fistula] to come to the Phebe Rehab Center because at home “you feel like you’re nothing now.”  She added that at Rehab, they will learn to do one or two things for themselves. 
 
Her interview is split into two parts.  In Part I, she brings us up to date on her life since leaving the Rehab Center in 2018.  In Part II, she makes a plea to those who have supported the Rehab Center for at this time, the Phebe Rehab Center has not received funding for several months.