CEML has a program for women who need repair of their obstetric fistulas. These women are usually young and from backgrounds with little financial resources or education. They often leak urine or stool down their legs and this problem causes considerable discomfort, embarrassment, and rejection by their partners and family. Almost all of their babies died during the difficult childbirth that caused the fistula and they also carry this sadness with them. CEML works together with the Fistula Foundation to provide operations, a teacher, and a stipend to support the women. The stipend is enough for basic needs but the women usually don’t have enough money to buy the large amounts of pads or disposable diapers that they need to get through the day.
We approached this group of about 10 women who are currently here being treated for fistulas to see if there was something that they wanted to discuss as part of an educational class. There was no definitive consensus and the women had to keep running out of the meeting due to leaking urine. The obvious response was to create a re-usable pad sewing lesson to help the women sew their own pads that they could wash out and re-use every day. I am from Northern California and teaching a Do-It-Yourself Reusable Pad workshop seemed to make perfect sense to me but I wasn’t sure if I wasn’t placing my somewhat “hippy/environmental” solution in a cultural context where such an activity would seem too embarrassing or unusual.
I was very pleased today when the activity turned out to be a hit. During a 3 hour time period each woman hand-sewed a medium and/or a large pad. Each on them had to cut the pattern out of a large piece of flannel (a tablecloth which we found in our hospital break room) and sew all the components together. The pad has an inner compartment where a large rectangular piece of cloth can be doubled over several times and placed inside. This design helps to absorb the maximum amount of urine and also helps the pads to dry quickly on a clothesline. It was a joy to sit around a large table with 10 women happily sewing and chatting in various languages. I understood very little of what they said to each other but helped them whenever I could in Portuguese to describe how to get a better stitch or strengthen a weak area. They begged for more sewing tomorrow. I told them that I would be at the Pediatric Hospital tomorrow and they happily told me “we can do it ourselves now.” These are probably the happiest words that a person in public health can hear! With the help of another flannel tablecloth and some thin towels bought by my roommate Sandy they will create more pads tomorrow. Hopefully the protection from these pads will help them to be able to avoid embarrassment and allow them to live more freely while they await an fistula operation that will hopefully solve their problem.