Anna

The fans whirr overhead on this hot day in Dar es Salaam as Anna lies on her hospital bed nursing her one year old.  It’s not the first time Anna, 25, has been to CCBRT Disability Hospital and she is comfortable being here, safe in the knowledge that the nursing staff will be kind to her.   

In 2005, Anna went into labour with her first child.  She was living at her mother’s house after her boyfriend left her when she fell pregnant.  After two days of contractions she was forced to walk for two hours to the nearest dispensary.  The family lives in a rural area and there was no car available to take her to medical help.

“I was crying with pain at this time,” says Anna.  “There was nothing to take away the pain and I became very afraid.”  At the dispensary they said they couldn’t help her – by now she had eclampsia – but they allowed her to travel in their supplies vehicle to the district hospital.

Once she arrived there, the staff said she was not ready to give birth so they waited one day.  By then, Anna was unconscious and the baby was delivered by vacuum extraction; stillborn. 

“I never saw my son,” recalls Anna as she thinks back to that frightening time. “By the time I woke up seven days later, I was unable to walk and was in unbearable pain.  I just couldn’t stop crying.”  Her catheter was removed after 10 days but without it, Anna found that urine and stools were passing through her vagina and she had no control over the flow.

The prolonged labour had caused a hole to appear between the bladder and the vagina (Vesico-Vaginal Fistula - VVF) and the rectum and the vagina (Recto-Vaginal Fistula - RVF). Occasionally, this debilitating condition can lead to infections of the bladder and the kidneys and can be life threatening.   Anna was told to go to a government hospital in Dar es Salaam for surgery but with no money for treatment, or for transport and fear of the long journey, Anna just went home.

“My mother looked after me at home but my other relatives and friends stopped coming to see me. They said there was a bad smell and they were ashamed to be associated with me.  I couldn’t even help the family in fields.  We are farmers so we depend on the food we grow.  For many months, I stayed like this.  Just inside the house.  It was a horrible time.”

CCBRT’s mobile outreach unit was alerted to Anna’s situation when they were visiting the area.  “The people from CCBRT came to my house and told me that the leaking could be controlled with surgery. I was so relieved.  They gave me money for the bus to Dar es Salaam so soon afterwards I made my way there.”

At CCBRT, Anna was operated on to repair the fistulae.   Just before she left CCBRT, the doctor gave her some ‘rules for life’ one of which is the importance of having a caesarean section if she was ever to get pregnant again.   “In 2008 I did fall pregnant and although I was very frightened in case the problem returned, I remembered what CCBRT told me so I made sure I had a caesarean section.”

Following the birth, Anna returned to CCBRT to be treated for severe stress incontinence and Anna is now completely dry.  “It is a good feeling,” Anna laughs, “I don’t want to go back to those days after my first child was born.  Now I have a healthy daughter and everything is good.  I am so grateful for the kindness I found here at CCBRT.”