Dispatches from the Africa Mercy #2: Transformations

In his second dispatch aboard the Africa Mercy hospital ship (currently in Douala, Cameroon), Dr. Sherif Emil writes about the Dress Ceremony, in which women who had been isolated and ostracized because of a medical condition called vesicovaginal fistula, symbolically don new dresses after life-altering surgery has cured them.
After receiving life-altering surgery to correct their vesicovaginal fistula, patients aboard the Africa Mercy take part in the Dress Ceremony in which they don new dresses to celebrate their new lives. / Photo courtesy of Africa Mercy

Dr. Sherif Emil is a pediatric surgeon at the Montreal Children’s Hospital and a professor of pediatric surgery at McGill. Dr. Emil was recently in Douala, Cameroon, on his third mission to the Africa Mercy. The Africa Mercy is the world’s largest civilian hospital ship dedicated to bringing hope and healing to tens of thousands of the world’s impoverished populations. This is the fourth instalment of Dr. Emil’s dispatches from aboard the Africa Mercy.

By Dr. Sherif Emil

It is Friday afternoon and we are winding down our day in the operating room quite a bit earlier than usual – around 2:30 p.m. We just completed the reconstruction of a young girl’s abdominal wall. After complications arising from surgery for ruptured intestines, she went on to have seven additional operations that left her with a massive abdominal hernia extending from her pelvic bone to her rib margin. She was fortunate to be alive but she was left with a severe disability. The surgery goes very well and we are elated with our immediate results. We now pray for healing without infection or other complications.

But I am also elated because today, for the first time, I will experience an Africa Mercy classic – the Dress Ceremony.

Photo courtesy of Africa Mercy

Like the case of our patient, most surgeons who come to Africa see and treat diseases they never see at home. One of those is vesicovaginal fistula – or VVF. The condition arises after obstructed labor, where no resources for Cesarean section are available. The severe pressure on the vaginal wall cuts off the blood supply and allows a fistula – an abnormal channel – to develop between the vagina and the bladder. These women are not incontinent – they are worse. They leak urine continuously all day long. Even pads and diapers are not enough. They develop a characteristic stench that leads to their rejection by their husbands and their communities. They are ostracized and isolated. It is a life sentence of misery, shame and loneliness. I first learned about this disease when I met Catherine Hamlin many years ago, an Australian missionary obstetrician/gynecologist who established the world’s first VVF hospital in Ethiopia, and brought this African curse to the world’s attention.

VVF is also a specialty of the Africa Mercy. And the Dress Ceremony is an iconic trademark of the Ship. It is a hot, humid day on the Ship’s open deck. But the Ceremony is standing room only, packed to capacity. Women who have been cured of their fistulas through operations by the Ship’s gynecologists are given the gift of a new African dress, shoes, and make-up. They are each made to feel like there is no one more important than them that day. Many hug the nurses and the surgeons. There is singing, dancing, and happiness everywhere. For many of these women, it is their first chance to smile and laugh in years. Dr. Andy Norman, a gynecologist from Nashville, Tennessee has performed these operations over the last month. He is beaming with joy as he shares in the women’s celebration. The Dress Ceremony is a celebration not just of cure, but of transformation. They come to the Ship with pain and shame and leave with hope and pride. Truly something to witness.

The halls and walls of the Africa Mercy bear witness to the innumerable transformations that have occurred on this Ship over the past many years. This Ship is not just a vessel at sea. It is a vessel of hope and healing.



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Danielle Groleau
6 years ago

Congratulation on your fantastic work and celebration of the profound life change that occurs for these women. I work on female genital mutilation in Africa ( Nigeria, Guinée) for the past few years and I am profoundly touched by your work as I am aware how fistula has tragic consequences for too many African women. If ever you want to collaborate research wise I would be more than welcome to participate in research on fistula with your team. I am a medical anthropologist, public health Phd and hold a post-doctoral degree in cultural psychiatry. My specialties are in qualitative research… Read more »