By Katy Migiro, 3 December 2013
When Naima's husband came home after the birth of their first child in a village in rural Somaliland, there was a rank smell of urine in the house.
He asked his wife what it was.
"This happened to me after I gave birth to our son," she said. Her body had been torn during her prolonged labour, leaving a fistula, a hole between her vagina and bladder.
At least two million women in developing countries live with fistula, a devastating childbirth injury which results in uncontrollable leakage of urine and/or faeces.
The story of Naima (not her real name) is told by Edna Adan Ismail, a midwife who founded a hospital, speaking to Thomson Reuters Foundation in the Somaliland capital, Hargeisa.
Naima's husband instantly disowned her and told her to go back to her family. "You are damaged goods," he said. "I cannot have you leaking and dirtying my house."
He grabbed the baby out of her arms. Naima tried to snatch him back.
"He takes a knife and he goes: 'Let go of the baby.' And he puts the knife through here," said Ismail, pointing to the middle of her chin. The blade went up through Naima's tongue and hit the roof of her mouth.
SLASHED FROM EAR TO EAR
Undeterred, she lunged for her child again. This time, he slashed her from ear to ear along her chin and left with the baby.
Naima crawled out of the hut to her neighbours, who sutured her with a needle and thread, and carried her to the nearest hospital in Burao.
Days later, the hospital in Burao telephoned Ismail, asking her to send an ambulance to collect Naima - a six-hour journey - and bring her to Ismail's hospital, the Edna Adan Hospital in Hargeisa.
Ismail, who could not spare her only ambulance, asked if they could put her on a truck. "And she says: 'I cannot because the truck drivers refuse to carry this woman because she smells."
"I said: 'Ok. Go into town. Get the most foul, smelly perfume that you can get. Get a couple of big plastic bags. Put as many padded things as you can on her. Punch holes on the sides of the bags and put them on her as Pampers (nappies)," she said.
"Put her on a truck and tell the driver Edna will give you $30 if you will bring her auntie to her."
And so Naima made it to Ismail's hospital and had surgery to repair her fistula. She worked in the hospital kitchen for several months while she recovered her strength.
Ismail offered to help Naima prosecute her husband.
"If you want to take that man to court, I will stand on my head to put that man on trial because that is attempted murder," she told Naima. "If it's the last thing I do, I am willing to support you and to bring that man to justice."
Naima refused. "No, I can't do that to my child's father," she said.
Ismail doesn't know what became of Naima after she left the hospital. She is just one of hundreds of women who Ismail has helped since 2002 when she started holding fistula camps, at which visiting surgeons carry out operations.
Around the world, more than 50,000 new fistula cases occur each year, the overwhelming majority in Africa. Only one in 50 of those women receives treatment.
In Somaliland, which broke away from Somalia in 1991, the number of new cases is dropping thanks to Ismail's work, both in treating fistula and in training more midwives to help women deliver their babies safely.
She feels blessed to have been able to help so many women. Patients usually start crying when they use the toilet normally for the first time after the operation, she said.
"And that's when we start crying too because we are so happy that one human being has been given back life," she said.