Shushans story
Shushan*, beautiful with soft curls and a sweet very pretty face walked daily to and from the mountain spring from whence water had to be fetched at intervals throughout the day, the earthenware jar was heavy without water so imagine the weight with water. Little eight year Shushan did this without complaining because this is the girls lot in Ethiopia. In addition to this there was wood to be gathered to fire the meals that had to be cooked in the very smoky kitchen. Stinging eyes was something to live with, not to mention the cough from the smoke. The magnificent view from her families little hut was lost on Shushan because she had little time to consider this. Recreation was the local church where she could go and kneel for a few moments. It was at the church that a young priest first spotted this beauty and requested the father for her hand in marriage, Shushan was nine years old…
“Please mother, father let me go to school, just for a little while so that I can learn to read,” was Shushan’s plea. But no, this was not possible.
“My daughter, we cannot refuse a priest, any one else it might be possible, but not a priest…” said her mother with tears and the father turned away silent.
Now she exchanged the location only, for her job was the same but now her boss was the mother of the priest. She was learning how to meet the needs of this new family, conforming to their ways similar but yet different from her own home.
After a few years Shushan’s periods started so now she was ready for her husband, the priest. Within a short time she was pregnant. Her young and small body of fourteen heavy with the baby continued the work of carrying wood and water as well as cooking and serving. Years of heavy work too early on in life allowed only for a small delicate bone structure, a stunted pelvis but Shushan knew nothing of this, how could she?
Far from any hospital, marketplace or school, high in the remote Simian Mountains of Ethiopia in a small village hut Shushan went into labour… All the village women came and gave advice, the men stood outside or visited with friends or went to church. Men do not get involved in ‘women’s affairs’… After five days of horrible suffering and pain out slithered a dead baby.
Shushan’s birth passage was so badly injured, the tissue was mostly dead and over the next week a heavily infected discharged caused her now dead bladder tissue to come out and a hole into the rectum causing her body waste to leak continuously with no self-control at all.
Shushan became a horror even to herself, the stench was horrendous, the illness debilitating, the ostracism the most painful of all. A priest marries for life, there is no possibility of divorce for him so he looked around for the best possible solution and found out about the Addis Ababa Fistula Hospital.
His child bride was still too sick to move so after three months he brought her to the hospital.
When the doctors examined Shushan they already knew that she had no bladder left to rebuild. So first her rectum was repaired with an excellent outcome. Now what to do for the non-existent bladder?
An ileo conduit was recommended, which meant a stoma or a small opening onto her abdomen from whence the urine would flow into a plastic bag, which would need to be emptied throughout the day for the rest of her life. For this she would need to stay near to the hospital for an ongoing supply of bags and any medical care required due to her overall condition.
Shushan was fifteen when this was first discussed with her, she cried because of this great loss of any future normal existence. She talked with others who had been through the same things, she saw the stoma in others, she observed how they managed their stoma, she saw that they lived a valuable life as a staff member at the Addis Ababa Fistula Hospital. Then she accepted that this was the best for her. She talked to her husband about it and the fact that perhaps her would not want her back…
It is now one year since Shushan had her operation, she has managed her stoma very well, and she has learned to read, to write and to count. She lives at Desta Mender, the hospital’s village farm where the women grow vegetables, look after the cows that give the hospital milk, and collect eggs from the hens for themselves and the hospital. She is still very beautiful and sweet. Her family has come to visit her and presently she is visiting her family in the village. Her husband still wants her back despite the stoma, so we are trying to see what can be arranged to bring them together. As of this writing nothing has been finalised.
The great tragedy of this story is that all this could have been prevented if there was someone to identify Shushan as high risk - her age, her size, her lack of education, under nutrition, her history of heavy manual work all contributed to her becoming a statistic for childbirth injuries.
If there had been a school to broaden her source of information; if there was equality of nutrition for boys and girls; if both boys and girls shared heavy work, so that girls also guarded the animals and threw stones to keep birds off the crops and boys also carried heavy water pots and wood; if there was a health centre neared then two days walk away; if girls did not get pregnant so soon; if girls were not married so young; if there were telephones in every village; if there were roads with good means of transportation; if there was money enough to take emergencies to hospital sooner rather than later… if…
Because of all the ‘ifs’ Shushan could have died, but instead she was forced into a living death but for a place called the Addis Ababa Fistula Hospital where though normality was not possible, hope was given…
Ruth Kennedy, Addis Abeba, 20th
January 2004
* the name has been changed
