by Jon Banke
21 May 2010

Aïsha is just 15 years old, but like many girls in her culture, womanhood came early. While her counterparts in many parts of the world worry about the next math test or the latest fashion, Aïsha bears a far heavier burden. Married at 14 and expecting a child at 15, these days should be joyful ones of watching her infant son grow and develop, gazing in wonder at his first tenuous steps, sharing milestones with her husband and the village. Precious times to cherish and savor. They should be—but they are not.

Instead, Aïsha has suffered a cruel double blow. Her son died at childbirth, and to make matters worse, she has been unable to control her bladder since that terrible day. She smells. It is unpleasant to be near her. To her despair, her husband has divorced her. The village wants as little to do with Aïsha as possible. She lives alone in a dilapidated hut on the fringe of the village, where her mother brings occasional food and conversation. Aïsha lives an isolated existence in a society that places high value on community life. The weight of this tragedy threatens to crush her.

The life Aïsha grew to love and treasure has been destroyed. How? Through the simple fact that she gave birth before her body was fully developed in a country with little to no accessible emergency obstetrical care. In such cases, the girl’s underdeveloped pelvis is not yet ready to accommodate the baby’s head. The birthing process then becomes obstructed, causing the destruction of the tissues between the birth canal and bladder or rectum. A hole (or fistula) is the tragic result, resulting in continuous leakage of urine and/or feces. This dreadful condition is worsened by the dire lack of doctors and medical facilities capable of repairing these injures. As a result, most babies do not survive childbirth and innumerable girls and women like Aïsha are condemned to lives of hopeless misery.

Niger has one of the highest incidences of obstetric fistula in the world. Tens of thousands of women and girls in Niger suffer from this condition, which can occur in various forms, affecting both bladder and bowel control.

In early 2007, SIM Niger set out on a path toward partnership with the Worldwide Fistula Fund (WFF), with plans to build a fistula clinic onto SIM’s existing Health and Leprosy Center in the village of Danja. With two experienced fistula surgeons as key members, WFF brings world-class expertise to this partnership. Eighty-five years of ministry in Niger (as well as an ideally-situated medical facility at Danja) represents SIM’s side of the collaboration. The high-quality and free care provided to these precious women is a tangible demonstration of the compassion and hope so greatly missing in their lives.

	Ariel view of the clinic's foundation..

The partnership was formed, the foundation was laid, plans began to take shape, and SIM and WFF were poised to move forward. A few months later, unexpected delays arose and progress was stalled. As we waited—so eager to begin ministry to these needy women—we also prayed, like many around the world. We knew the apparent obstacle was not an obstacle to God.

After almost one year of waiting, God removed the hindrance last September, paving the way for the work to move forward. Once again, we are making progress toward construction of the clinic. With hearts of gratitude, we eagerly anticipate the day when SIM and WFF can begin to regularly alleviate the suffering of countless women—and demonstrate to them the goodness of God in Jesus Christ.

*Note: This article was originally published in Serving In Mission Together, issue 127.