KEY POINTS:
Outcast women shunned by their villages because of pregnancies gone wrong are being helped back to a normal life by a Kiwi off the coast of Africa.
Former Middlemore nurse Kylie Bentham, 30, has swapped the rich-world poverty of South Auckland for medical problems now rarely seen in developed nations.
Children born with cataracts, cleft lips or club feet are left to grow up blind or deformed, war wounds are left untreated while a poor diet produces goitres and facial tumours.
Girls are married off as young as 10 or 11, often before puberty. When they get pregnant, their babies often can't get out because the mother's body is too small. But the modern solution - a caesarean - is impossible because there is no hospital nearby or, if there is, its fees are prohibitive.
Ms Bentham, the theatre manager on a floating charitable hospital of 350 volunteers now at the port of Tema in Ghana, sees the results.
"The mother could die," she says. "But generally what happens is that the baby dies inside the woman. The head usually gets stuck in the vaginal vault.
"It starts to decompose and get smaller, and she will finally deliver within seven to 10 days.
"During that time, the baby's head has put pressure on the pelvis and the bladder reducing some of the blood supply to the bladder. Once the baby is delivered, the tissue where its head was goes necrotic, leading to a permanent hole."
Urine leaks out, making the young women stink. A study of such women in Ethiopia found that half had been abandoned by their husbands and a British charity says more than a million are waiting for surgery worldwide.
"They are sad cases because they have been rejected by society," Ms Bentham says. "Some have had it for 20 years before they get to us."
The women stay on board the M/V Anastasis for about three weeks after their operations. Then they are sent home with a new dress and a voucher for two free caesareans in case they get pregnant again.
"They get accepted back into their communities. Often their husbands will take them back and they can start contributing to their community," says Ms Bentham.
It's a long way from the bush-clad Waitakeres, where she grew up, having heard about the US-based Mercy Ships, founded by Youth With A Mission, early in her nursing career. She then set about getting the necessary training needed to manage two surgeons and 16 other staff in three operating theatres, taking up the role last June.
Instead of being paid, Ms Bentham pays US$277 ($403) a month for her board and is using her own savings and funding from Vodafone.
She and an Australian nurse share a tiny cabin - "probably the size of your bathroom". Breakfast starts at 6.30am, followed by devotions, and she's at her post in the operating rooms before 8am.
Patients are booked in by an advance team that publicises the ship's visit far and wide.
"They come from the local area, up the country, neighbouring countries," Ms Bentham says. "They travel for days, some of them, and sell everything they have so they can come."
So when they turn up on their appointed day, they get their surgery. The surgery team keeps going with the operations until they are finished, often missing meals and working as late as 3am.
Ms Bentham gets a break at weekends, when she is only on call for emergencies and tries to get to the local markets or up country. "You can get cabin fever if you're not careful," she says.
Mercy Ships does not only provide one-off operations but is involved in building projects, installing wells and promoting health. It has also started two land-based services in Sierra Leone; a clinic to repair women's bladders and a rehabilitation centre for people requiring artificial limbs.
Ms Bentham has just helped out with the ship's 1000th cataract operation since it arrived in Tema in June. Tauranga ophthalmologist Neil Murray removes each cataract in about 20 minutes, doing 15 operations a day.
Where the money comes from
* Every Kiwi with a Vodafone cellphone is helping Kylie Bentham's work in Africa through the World of Difference programme.
* The programme pays up to $55,000 a year, plus $30,000 for training or expenses, to up to six people a year to work fulltime "for a cause they feel passionate about". This year, the scheme is focusing on work with child- or youth-related charities.
* Applications for 2007 awards will close in August.
