The book is the story of two women and how they help each other.  One has a physical problem with her body after childbirth, called a fistula; the other is struggling mentally to deal with various events in her life.   It's about how they connect and help each other. 

What is a Fistula?

A Fistula is a connection between 2 things which shouldn't be connected - for instance guts and skin, or commonly after childbirth goes wrong, between bladder and vagina, or guts and vagina.   This means that urine and/or stool leaks uncontrollably and constantly, never stopping.  Women who have this problem have almost always lost their babies, and will usually lose their place in life - their husbands taking a new wife.  They are left alone, wet, in pain, bereaved and destitute.   No-one wants them around, and the future looks very grim.  It doesn't need to happen! It's almost unheardof in societies or countries where women can get access to a midwife or a doctor to help with childbirth.
 

Is it a True Story?

The medical parts have all happened and continue to happen in different times and places.  The characters and settings are fictional.  I guess you mostly write what you know, some of which has been lived, some witnessed and some imagined.

Why did you want to write the book?

I mostly wanted to tell the story of the fistula patients, who are heartbreakingly unheard in the world.   Many are very young when they get a fistula, and face a lifetime alone.   I also had things I wanted to say about being a surgeon - hopefully conveying the joy of it, and the amazing satisfaction at having such a trusted role in people's lives, but also the hard parts. I think the most difficult thing is dealing with things going wrong - cancers coming back for instance.  It's hard to find the strength to carry on when things don't work out the way you wanted.  It's an inevitable part of practising medicine, but not something people tend to talk about.  

How can people help with fistula work?

Buy the book!  Proceeds will go towards preventing and treating fistula.  But also, talk about it and about the shameful reality in so many places worldwide where childbirth leaves many women injured and voiceless. Our charity (UCIF) is on the charities page of this website - we are all about treating childbirth injury, but prevention is even more important...

How can childbirth injury be reduced?

By improved access to healthcare - to midwives, to a place where an emergency caesarean section could be done if required, Access is limited for millions of women because there are no facilities within reach, or because they cannot afford healthcare.

What do you hope will be achieved by the book?

I really hope that an increased awareness of the preventable injuries and even death which many women face in childbirth will lead to governments and health organisations prioritising improved maternal care.  That's a big longterm ambition for sure!