Two Million Tears: Africa’s Silent Epidemic

“I have no friends and my family won’t speak to me. Wherever I go, people run away from me due to the horrible smell that comes out of me because of the condition I have.” – Madeline, a 13-year-old girl from Zaria, Nigeria.

These are the words of a young lady, a teenager – barely – from Nigeria. After 24-hours in labor on the dirt floor of a hut, miles away from the hospital and doctors who could help her, she gave birth. But instead of a healthy baby, she was left with a stillborn son and a large tear that constantly leaked urine and feces.

The hurt of a dead child coupled with her new condition was too much for Madeline’s husband and family to bear. She was thrown out of her home and abandoned by everyone she ever knew.

This year, 130,000 girls and young women in the third world will develop what is known as a “vesico vaginal fistula” – a condition mainly caused by prolonged or unattended birthing labor. This devastating circumstance — known commonly by the acronym VVF — can be prevented with the proper medical care and fixed with a specialized, but relatively routine surgery. Yet sadly, most local surgeons are not trained to treat these young women; thereby they live out the rest of their lives without help, suffering silently; they hesitantly walk through their villages carrying a white, plastic bucket because they have no way to control the constant leakage.

This “leakage?” VVF leaves a woman – typically a very young girl – continually dripping urine and other vaginal fluids from fistulas, abnormal connections or tears formed between the bladder and vagina. Not only are these young women in immense physical pain, they also deal with tragic, emotional damage – in the form of complete rejection from their families, friends and communities; they become social outcasts.

While AIDS, famine, and war grab national attention, the growing VVF epidemic goes virtually unnoticed. Though the exact magnitude of the fistula problem worldwide is unknown, estimates have put the number of women living with the condition at nearly four million; at least two million of those live in Nigeria.

“Two Million Tears: Africa’s Silent Epidemic” tells their story.

To get at the heart of this devastating problem, The KBTV team and I traveled to northern Nigeria, the country hit worst by VVF. At a small hospital in Kaduna, in the southern region where 70 percent of the country’s VVF cases are, we followed a team of American surgeons and health care practitioners on a medical mission to repair dozens of women with VVF. We also delved into the stories of some of their patients, very young women like Madeline, who have known nothing but sorrow. From their journey to the hospital, to the operating table to the recovery room, we have followed their road to recovery and what it means for other women with VVF.

Part of the reason this epidemic has largely been ignored is the culturally sensitive nature of VVF. Some 97 percent of VVF cases are caused by prolonged obstructed labor during childbirth, which often occurs when women have no access to health care. However, a large proportion of these problems are the result of girls having children before they are fully developed. African culture, like many others in the developing world, practice early marriage; UNICEF estimates that 42 percent of girls in Africa are married before age 18.

In some African countries the figure is much higher, such as in Nigeria where there is a 76 percent incidence of child marriage, and in some areas of West Africa and in Ethiopia, girls are sometimes married as early as 7. African governments, such as that of Nigeria, are beginning to address the massive VVF problem, especially with the push of the United Nation’s millennium development goals, help is coming slowly. Africa is severely lacking the medical professionals trained to do these kinds of procedures.

It is organizations such as Physicians for Peace that make a difference by not only embarking on these missions – but raising awareness.

KBTV Productions, through our feature-length documentary “Two Million Tears: Africa’s Silent Epidemic.” We seek to bring light to an issue that has remained in the dark.

The Pod

In the blog prior, I mentioned "The Pod."  

 I'm not really certain about how much I can write about it but suffice it to say that I went on a spiritual retreat – somewhere in New Mexico – and I learned a heck of a lot about the architecture of how I can embark on being happy. Of course, now I just have to execute it. Let's also say that Liz Brown of the www.kbtvonline.com "Liz Brown Series" was involved.
 

I did something called a Sweat Lodge. I did lots of other stuff as well, but one of things that happened on my journey was that I met three people, Hope, Scot and Whitney. All of whom I know will be lifelong friends and all of whom have been doing this spiritual gig for eons. I was the newbie.

I couldn't take photos; and I don't want to write too much because apparently it takes the energy out of The Place. So I'll leave it to your imagination.  

 To be continued …

The Nightmare

You see I didn’t realize that I had completely stopped sleeping. Night after night, every night, I'd go from snoozing with...some enemy...my enemy...to the Torturous Recurring Nightmare. I'd be strolling through winding paths at some swanky, insane asylum in northern Massachusetts. The dream always began with me walking the grounds of the asylum. Then it all gets a little hazy.



In the morning I would slip out of bed, feeling relieved to know it was only a dream – but terrified that I'd dreamt it yet again. This is when I streak off to work (the office twenty feet away) terrified by the dream. What's it supposed to be telling me.

I'm terrified of my life, by the silence and the solitude; petrified of my unrelenting loneliness, like a decaying limb that needed to be amputated. Terrified by the fact that I have to walk into life and pretend everything is fine.



Everything is normal.

Everything is just fine.

But all of this was before … it was before I met the “Pod.”

To be continued …

I looked in the mirror on Tuesday morning and the eyes of a refugee stared back at me. Gaunt, haunted and several other unflattering – rather unhealthy – adjectives come to mind.

I can’t take it anymore.

What? I wasn’t sure.  
 
The only thing I knew was that I had been working too much and playing too little.  

As luck or chance or The Spirits would have it my antidote to my perceived crappy life was just around the corner – in the form of a “Pod.”

Yes … a “Pod.” And, in fact, my life is not crappy.

 I had – with great enthusiasm – agreed to meet Liz Brown of the KBTV-Liz-Brown-Series-Fame (www.kbtvonline.com) in New Mexico. We were set to embark on a spiritual retreat with three others, who had been friends of Liz’s for a long while. Scot, Hope and Whitney and I all met for the first time at the airport in Albuquerque. 

 It wasn’t until the next day that I realized how special these new friends really were...are.  

 To be continued ….

Barfing in Nigeria

Let me set the scene: We’re in the operating room and I’ve never even seen an operating room – unless I was on the table! It was full of rows of steel beds covered with a piece of cloth. Young girls with sad eyes sitting and recovering from the operations to fix their fistulas.



I conducted roughly nine or ten interviews with these young girls. Clearly, I don’t speak the language where we were in Zaria, Nigeria, but we somehow communicated.

Suddenly I was overtaken by the stench, the smell of urine, feces and blood – it became overwhelming. My cameraman Renato told me that suddenly all he heard in his Mickey Mouse head phones was “BLEEEHHH." He’s doing an extreme close up on a baby and he hears another "BLEEEHHH" and Renato tells me he asked himself “Where the hell is she?” At the time he was going in close on the baby.  

Then Renato tells me all he sees is this little white hand, with perfectly manicured fingernails that's attached to a 5-foot-eight 120-pound woman (me), push Dr. Sa-ad Idris, a gigantic-jolly-intensely-talented-Nigerian surgeon, out of the way and watches her sprint down the aisle past rows of very confused Nigerian girls. About 30 yards later I found a sink and just started puking – puking my guts out. I haven’t puked like that since I had the ‘flu last fall.

Well. What does my pal Renato do? He chases me down the aisle while I am running, and dry heaving at the same time. It’s actually hilarious when I look back on it. On the tape, all you can hear is me puking and Renato laughing his ass off as he pulls in on an even tighter shot of me puking. He laughed and said: “This is great TV.” 

The following morning Frances, one of the EMT nurses, said to me: “That cameraman, I thought he was your friend. You seem so friendly together. Why would he film you when you were vomiting, instead of helping you?” She was truly confused. 

“It’s just TV honey,” I replied, dryly. “It’s just great television.” 

Physicians for Peace: Nigeria

I am back from Nigeria; what an experience. Among the many lessons I learned was that we have so much to be grateful for here in the United States – education, health care, social services. Hey, it’s not perfect. But I think we often forget what to be thankful for. Well, sometimes, at least I do.  

According to costofwar.com we have spent 

$536,637,282,851 on the war in Iraq.

All I could think of when I was in Nigeria was if we spent that amount of money – the huge waste of capital in Iraq – with NGOs such as Physicians for Peace we could spread international goodwill and help out those less fortunate. Perhaps then the international community would be less inclined to bomb us.  

So, back to Nigeria. I tagged along on a mission with Physicians for Peace. Ron Sconyers is the CEO and he was the one who delivered the invitation. I accepted. 

I was there for eight days. And, for lack of a better description, it changed me – forever. I’m including a photo album with this blog … because the old cliché is that pictures are worth a thousand words. 

Being a scribe myself, I sort of resent that, but it’s the truth. What I experienced was unimaginable – for me, anyway – and the pictures tell it better than I can.  

We began in Abuja – the capital. I flew out there with my camera man/director/producer Renato Moore. We pulled two back-to-back red eyes. LA to London; London to Nigeria. Not fun. 

My idea was to get there early to acclimate but we just hit the ground running. We then traveled to Kaduna and down to Zaria. The story I was covering was that of a medical condition called VVF: “A VVF is an abnormal communication between the urinary bladder and the vagina that results in the continuous involuntary discharge of urine into the vaginal vault...” 

Okay. Now let me tell you the short answer. A young girl gets pregnant and the baby is often stillborn. Because of the obstruction in delivering the baby, she basically ends up with a tear between, I don’t want to be too graphic here, but let’s just say the tear is from the front to the back – where we ladies sit.  

She spends her time walking down the road dripping feces and urine. When we attended the clinic in Zaria, I saw a line of young girls that looked like children to me – with buckets – sitting in line for an operation. 

Let me tell you about the team. These doctors, nurses, an EMT technicians, etc … do the flight on their own dime. They are folks in the medical practice and they are at the top of their game; they are volunteers.  

Jaya Tiwari is the Director, Global Health Programs, Physicians for Peace. She made the whole mission work. She was the project manager from HEAVEN!  

What was fascinating for me, was that very few of the people knew each other before the mission, I knew Renato, of course,  but by the end of the trip it felt like we were a family – in an amazing, amazing way.  

Well, you already know about Brigadier General (Ret..) Ron Sconyers; who is a man to be recognized and admired. 

The Team Leader was Ogubuike Emerjuru, M..D. – a doctor who was so smart and talks so quickly that I was very much minding my P & Qs. Then there was Dr. Margie Corney, M.D, who I just fell in love with. She’s an OBGYN from Virginia..  

Dr. Mark Helbruan, M.D. was also a special soul. I got really, really sick and he and Evan took care of me. Evangeline Epper, RN was one of the nurses on the mission and she quite literally spent 24 hours with me after I threw up my guts – over and over – but that’s a story for the next blog! 

Frances Dargan, S.A. was a dream. I am still getting my feet wet about the whole OR thing … but, let's just say, I would want Miss Frances by my side if I was lying on the gurney! 

I have to send special kudos to Nurse Tim Harrison, RN, EMT.  When I was barfing up my guts in the OR he threw an IV into me with saline and an anti-nausea injection. He’s what is called a “flight nurse” meaning he does medicine on choppers. His sense of humor? So dry. I just love him. Full stop.  

Enjoy the pics!  

To be continued!  

Kate The Misanthrope … With Hope?

Two members of my team came all the way from Florida to visit me this weekend. Team? Huh? They are the crux of the KBTVonline team but, hey, they are also my best friends. There are times when they refer to me as their “boss,” and I look over my shoulder and wonder about whom they’re speaking. Then, I’m like: “It’s me! Who knew?”

Kirsten Gundersen — the queen of art direction — and Rachael — my managing editor and definitely my better half — arrived on Friday night, and we had a fantastic weekend.!



I have come to believe, at the ripe old age of 41 years old, that loneliness and fear are my primary demons.

Meeting people and connecting is so difficult for me. I’ll be given a business card, and I promise to follow up. But I usually don’t. I’m not sure why though, because I love meeting people and hearing their stories. The checkout gal at Albertson’s, I know her entire life story. She doesn’t even know my name.

Instead of reconnecting with these men and women that I am genuinely interested in, I just return to my office and crawl back into my shell. Again, I don’t know why.

And it’s not because these people I meet aren’t interesting, intelligent, attractive, funny and scintillating. It’s not that.

It’s me. I’m beginning to believe that I’m like my father. (Which is terrifying, by the way!) He spent his life in his attic office. I used to call him Anne Frank.

All that said, moving to LA with no family, no friends, no staff — I had no idea how difficult it was going to be.

But it’s gotten a lot better.

Kirstin and Rachael coming out and bonding with Renato — my new supervising producer — and Dave Freeman — I call him my cutter, but he is really my Final Cut Pro editor — made all the difference.

The pictures tell the story …