Galcayo is dusty and hot, when you look around this is the type of picture that someone who has never been here probably has of Somalia. But amongst this harsh backdrop today is a great day at the hospital, they are doing measles vaccinations and ambulatory therapeutic feeding, it is crowded with mothers and children, more than 150 children, the place is a buzz. The children really are very sweet, you just want to pick them up and play with them although as soon as they see our funny coloured fair skin (which most of them have never seen before) they usually burst into tears, so I let go of that idea.
Sometimes you hear the funniest things in the field. Today as I was stepping out to meet some women who had arrived from Mogadishu I was stopped in my tracks by the midwife Sarah, with her hands in the air, crying 'thank god we found a fistula'!! Not quite as strange as it may sound. It's actually more of a statement that they found someone eligible for the surgery, someone they can actually help.
You see this is not purely a medical issue the social consequences of fistula are incomprehensible. First of all you dribble urine down your leg, all day every day. Of course you wash and wash and wash but you can not get rid of the smell and often your husband rejects you, maybe you are lucky enough to have your family take you in, but the stench sometimes means that even they drive you out, out of the house, to sleep under a tree or sometimes out of the family. Some of these women are with out any support, living in isolation and humiliation; it is incredibly tragic, especially when you think it is preventable. The team here have been trying to identify women for weeks that may be eligible for the surgery. There is a sense of nervous excitement amongst the midwife and the surgeons who will be involved. If they are successful it could change these women's lives.