New life, new lives in Nigeria

The following article originally appeared in the Biblical Recorder, the news journal of the North Carolina Baptists 

NORTHERN NIGERIA - Her smile was like moonlight in the darkness when Aisha looked up from her village chores to see again the missionary doctor who had given her a new life several years before.

The smile on her daughter Habiba's face was more shy, but there might have been no child to smile if not for Dr. Andy Norman, who had journeyed more than 7,000 miles, all the way from Boone, N.C., to see Aisha's child.

Norman first met Aisha at Evangel Hospital in the city of Jos, on a high plateau in central Nigeria. Like many other young women, Aisha had come to the hospital in quiet desperation, damaged and shamed through no fault of her own, leaking urine after prolonged labor and the delivery of a stillborn child in the bush, and forced to live as an outcast because of her disability.

Aisha came, as another young woman named Salamatu came, because they had heard that miracles happen in Jos. They came with hope of finding restored health for their body and renewed acceptance by the people of their villages.

Missionary doctors like Norman bestow such gifts through skilled surgical treatment, and with a bonus. Many of the young women also find spiritual healing through the accepting the love of Jesus Christ - and a few have even given birth after an injury that often results in both shunning and sterility.

Norman, a Georgia native who lives in Boone and attends Mount Vernon Baptist Church, served with his family for more than 12 years as International Mission Board (IMB) representatives in Nigeria. A skilled gynecologist, Norman practiced at a teaching hospital in Ogbomoso (pronounced og-BO-ma-shah) from 1990-2000 before the family moved to Jos, where they spent two additional years family health issues led to their return to the states.

In Jos, Norman worked at ECWA Evangel Hospital, which is affiliated with Sudan Interior Mission and managed by the Evangelical Church of West Africa (ECWA). He was seconded to the ECWA Evangel VVF Program because of his love for the Fulani people and his interest in helping women injured in childbirth.

While his wife, Judy, maintained a guesthouse, Norman spent about half of his days doing medical work. Much of his remaining time was spent traveling among villages of the Fulani (or Fulbe) people, learning the language, building relationships and looking for ways to share his faith in Christ.

A journey “home”

Injured women often made long and costly journeys through treacherous roads to find hope and help at Evangel Hospital. Changing the pattern, Norman recently set out on a similar journey, in reverse, to seek out some of those women. He had heard reports that three of the women treated at Evangel Hospital with a particular surgical procedure had gone on to have other children - a rare occurrence given the extent of their gynecological injuries. Norman wanted to find them and document their cases for an article in the scientific medical literature, as well as to tell their stories in other ways.

Norman departed Christmas Day, 2005, accompanied by his youngest daughter. For Catherine, or “Cat,” the visit was a homecoming to the land where she had grown from kindergarten through high school. It also provided an opportunity to test her budding skills in photojournalism.

The pair first visited friends in Ogbomoso, assisting with several surgeries and spending time in a leper colony on the outskirts of town. They were allowed to use a Toyota pickup belonging to the mission for their long journey from Lagos to Jos. A young Nigerian friend named Segun came along as their driver.

The trip was not uneventful. While traveling, the Normans struggled to find fuel at fair prices. In one town, they were accosted by a band of young “revenue collectors” who extort money from travelers by charging for “permits” for things such as having a radio in the truck or a sign on the door.

When the driver didn't stop, the boys threw nail-studded boards at the truck. About six miles down the road, one of the tires went flat and they had to hire a local “vulcaniser” to repair the tube.

The Normans arrived in New Bussa at dusk. Accompanied by a pastor friend named Jilani, they departed early the next morning on the long trek to Jos, on an upland plateau in central Nigeria.

At Evangel Hospital, Norman spent days poring over surgical logs and disorganized medical records, searching for information about the former patients he had come to find. The women had come to the hospital with vesicovaginal fistulae (VVF, see related story on page 9) that failed to heal with traditional repair techniques and were subsequently deemed irreparable. In developed countries, surgeons typically resolve an unrepairable VVF by creating an abdominal ostomy and routing urine to a leak-proof, external collection bag. In the rural Africa, however, body image is so important that women with abdominal ostomies find only rejection upon a return to their village. They become pariahs, and some have reportedly committed suicide. In addition, appliances needed to maintain the ostomy are either not available or too expensive to obtain.

In some places, such as The Fistula Hospital, an Ethiopian center recently promoted by talk show host Oprah Winfrey, there are residential villages for women who have had an ostomy repair, but they must remain in these centers far from their families and their hometown.

Wanting to help women return to their villages and be accepted there, doctors at Evangel Hospital opt for a more practical solution. They perform a complex surgical procedure that diverts urine into the sigmoid colon, which is surgically expanded to form a pouch.

Norman performed a number of such diversions while serving in Jos, and had been told that at least three patients had subsequently delivered healthy babies by cesarean section. Norman knew of only one other case that had been documented in medical literature.

Happy Reunions

Hospital records were found for only two such patients, rather than three. Armed with very meager information, Norman and several companions set out into the bush country to find them. They had visited the area before, but in an area without proper roads or directional signs, were not certain they would be able to find the villages again. Both villages were miles north of Jos.

The difficulty of finding the former patients was compounded by the nature of their condition, which families tried to keep quiet, and by the fact that women sometimes gave more than one name.

They went first to the general area where the farthest village was thought to be. After driving for over four hours to reach the area and an additional two and a half hours of riding in circles on bumpy dirt paths, they decided to enter the region from a different direction.

As they stopped to ask someone for directions to the area where the Fulani people live, Norman prayed for some kind of lead. A taxi of sorts passed them by, then stopped about 100 yards further down the dirt track, and backed up. He looked into their truck and asked, “Is there any problem?”

When they explained to the driver who they were looking for, he replied (roughly translated from Fulani) “I am the man who took that girl to Jos. I can take you to her village: follow me.”

They followed him for about two miles, Norman said, then the man parked his taxi, climbed into their truck, and guided them for another mile along a bumpy path until they reached the family's compound.

There they met Aisha and her 22-month-old baby girl, Habiba. As a child, Aisha had moved with her parents to Saudi Arabia. Her father had sent her back to Nigeria to marry, but her first pregnancy was very difficult, the child did not live, and she suffered a debilitating birth injury. Aisha was divorced by her husband (because she had been a troublesome wife). Her uncle, who had arranged her marriage, sent her back to Saudi Arabia. When her parents could not find adequate medical treatment for her there, they returned her to Nigeria to live with her uncle. She tried several hospitals in her home state before hearing that help for VVF sufferers was available at ECWA Evangel Hospital.

After Norman performed a successful diversion procedure, she was married again and gave birth to Habiba, who was nearly two years old when the Normans found her.

Aisha welcomed the Normans with exuberance and the family killed a chicken in their honor, to be fried in butter and served with rice and beans. “They flowered us with gifts and smiles,” Cat Norman said.

Aisha had professed faith in Christ during her hospital stay, Norman said, though she had no nearby place to worship or other believers with which to have fellowship. Because the culture is predominantly Muslim, women like Aisha typically can not tell their fathers or husbands about their new faith - but they often tell the other women, younger siblings, and children.

Norman left a cassette tape player with tapes of the Gospel of Luke in the Fulfulde language. Like the rest of her family, Aisha has no formal education and could not read a printed Bible.

From Aisha's village, the Normans went 2-3 hours to another village in search of a woman named Salamatu. They had been to her village several times, so it was more easily found. They were told, however, that Salamatu had gone to a market, more than five miles away. The Normans arrived at the market in time to find her, dressed in bright colors, walking up the path with a huge bowl and a larger bag balanced on her head. She had brought rice chaff for sale as animal food.

Salamatu and her mother, who had attended her while she was a patient in Jos, were overjoyed by the Normans' surprise visit. They excitedly told them about her little boy, who had remained in the village. In Cat Norman's words, “It was beautiful to see that she could now go to the market like the other women,” because her condition prior to the surgery had left her confined to a single hut, in painful disability.

Salamatu's husband had not divorced her following the prolonged labor, stillbirth, and the injury that had left her incontinent. Instead, he separated himself from her and took another wife, as allowed by Islamic law, which permits up to four wives. Her parents cared for her and after her successful surgery, her husband accepted her again, and she gave birth to a son. Like Aisha, Salamatu had become a quiet believer during her stay in the hospital. The Normans left a tape player and the Gospel of Luke with her also, in hopes that she would grow in her faith and share it with others.

The smiles on the faces of women like Aisha and Salamatu tell the story of what it is like to suffer as an outcast, but then find a new life of healing, acceptance, and faith. The work of caring surgeons like Norman offers them new life, and in rare cases, even new lives.