Healing the Wounds

When Dr. Josette Hunter accepted her calling to medical missions, she brought hope to hundreds of suffering women.

On one of her more challenging days, Dr. Josette Hunter called in her patient to deliver the bad news: The woman was not a candidate for the only surgery that might spare her a lifetime of misery. The patient fell to the floor at the doctor’s feet, crying, wailing and begging her to reconsider.

Although the Maine physician has experienced many difficult days while serving overseas, a strong call from the Lord has helped her survive, even thrive, as a medical missionary in Africa. Since early 2005, Josette, her husband, Doug, and twin sons, David and Caleb, have been serving in one of the poorest nations, Sierra Leone in West Africa.

An obstetrician/gynecologist (OB/GYN) by training, Josette practices at a hospital for women operated by the Christian charity, Mercy Ships. She specializes in treating women handicapped by complications during childbirth.

A Critical Need In the United States, Josette would monitor a woman’s labor closely, addressing any complications before they worsened. If serious problems arose, she would simply perform a cesarean section. But there are only eight OB/GYNs in all of Sierra Leone, and advanced obstetric/gynecological care is either not available, or financially out of reach for most of the nation’s 3 million women.

In the United States, a woman in labor can go to any hospital and they will care for her through her delivery. It doesn’t matter if she can pay,” Josette explains. “In Sierra Leone, however, women know that if they go to a hospital, they must be able to pay for it. Otherwise, they will be refused service.”

Josette encountered a typical case during her first trek into the African bush early in 2005. A woman was discovered in labor with the baby partially delivered. The child had died and was stuck in the birth canal.

If Josette hadn’t arrived, the woman might very well have died also. If the woman had managed to survive, permanent injury would have almost certainly been the result.

During extended labor, which lasts an average of four days, but has been known to last as long as eight, the baby pushes against the pelvic organs. Circulation to that area then is restricted, and the tissues begin to die.

“So you’re left with a hole called a [vesicovaginal] fistula,” Josette says. “It’s usually between the bladder and the birth canal, although it can also be between the rectum and the birth canal. [This causes the woman to become] incontinent day and night for the rest of her life. Our job is to try to close that opening with the tissue that’s left.”

According to the World Health Organization, there are more than 2 million vesicovaginal fistula (VVF) victims worldwide, with 50,000 to 100,000 more women joining their ranks each year.

Recently, Josette treated a 40-year-old patient, Iye Sowodie. When Iye gave birth to her youngest child, there were complications and she was left VVF incontinent. Her husband abandoned her, leaving her destitute.

Iye survived for a time by scrounging what she could from the jungle. Her best friend shunned her, as did most of the village.

Last fall, Iye learned that Mercy Ships was offering free VVF surgeries at a new women’s hospital, The Aberdeen Clinic and Fistula Center. She took a chance and made the difficult journey cross-country to Freetown, Sierra Leone’s capital.

Josette examined Iye, and she was accepted for surgery. The operation was successful and she spent about two weeks in recovery before going home dry.

The day Iye checked out of the Mercy Ships Fistula Clinic, the remaining patients and the national staff celebrated her departure with what has become a clinic tradition. They danced and sang their way around the clinic courtyard. Usually, Josette is the only international staff member to join in these “victory” dances. As she celebrates with her patients, Josette’s eyes light up with a joyous fire. She clearly loves her work and mission life. But her time in Africa is quickly drawing to a close.

The Hunters will complete their two-year commitment to Mercy Ships later this summer. But she is determined to enjoy each remaining celebration.

“I’m just going to experience all of this, and not let it become routine,” Josette says, fighting back tears. “I only have so many of these left.”

She has every confidence she’ll be back, saying: “Missions are in my future. God will work out the details. I have a peace about it.”

A Calling to Serve Josette’s faith is born out of a lifetime of hearing and responding to God’s call. She can remember the Lord tugging on her heart even at an early age. As a child she repeatedly answered invitations to accept Christ as her Savior.

“I never got enough of God, so I always went back up,” she says, remembering her feelings vividly. God also gave her an unusually strong empathy for the lost. She recalls one childhood incident in particular, a play performed by a church youth group.

“In the drama they talked about people who didn’t know Christ and they were lost,” Josette recalls. “And I just started crying. A youth worker came to me and asked ‘Why are you so upset?’ ‘Because all those people are lost,’ I said. I couldn’t understand why everyone wasn’t just in tears.”

During the summer between high school and college, God led Josette to travel with a mission team to Papua New Guinea to build a hospital. During the trip she passed through a nearly deserted village. She learned the community had been virtually wiped out by a preventable disease.

“That’s when I came back, and I said I’m going to change my major, and I was going to become a missionary doctor,” Josette says.

With the call to serve God through healing strong on her heart, the future doctor very deliberately chose obstetrics and gynecology as her specialty. She explains: “When a person is pregnant, it’s one of the times in [her life] when [she’s] motivated to make changes. Suddenly there’s another life involved. And because people are willing to make changes, I thought it was a good time to try to impact their lives.”

Her husband, Doug Hunter, came into Josette’s life during her undergrad years. And when she made her call to missions crystal clear, he wasn’t the least put off by it. He recalls: “I knew that she had this strong commitment to the Lord. That was the thing that attracted me to her. I wouldn’t have married her if she hadn’t been a woman of character.”

But as the years slipped by, life became more and more complicated. Josette had four years of medical school to slog through and four years of residency after that. College loans left the young couple deeply in debt. Then the Hunters were blessed with active twin boys in 1997.

With each new responsibility, the mission field seemed an ever more distant dream. So rather than packing their bags for some far corner of the planet, the Hunters headed for a far corner of the country. Josette entered a practice in Caribou, Maine, Doug’s hometown.

“At that point we decided maybe missions in our lives [would] happen later. Most of the people I’d worked with in New Guinea were retired. So we thought maybe that would be the way God calls us,” Josette says.

But over the next few years the call to missions grew stronger and stronger. The topic was suddenly popping up everywhere. In sermons, while reading Scripture and during their personal devotional time, service to others was a constant refrain. “I didn’t want my own desires to color my judgment,” Doug explains. “So I prayed, ‘Lord, you’re big enough to speak to me right where I’m reading now.'”

Doug ended up with 16 verses from his readings. James 2:15-16 topped the list: “If a brother or sister is naked and destitute of daily food, and one of you says to them, ‘Depart in peace, be warmed and filled,’ but you do not give them the things which are needed for the body, what does it profit?” (NKJV).

As Josette completed her residency, God continued to speak to her and her husband. So much so that the couple finally decided to speed things up and get on the mission field sooner.

An Open Door Providentially, the Hunters crossed paths with Mercy Ships. The Christian charity has been operating floating hospitals worldwide since 1978, but was soon to open a land-based clinic for VVF women in Sierra Leone. The Aberdeen Clinic and Fistula Center was tailor-made for the Hunters. Doug was invited to serve as the hospital’s administrator. Josette would perform fistula surgeries.

After several months of training in Texas and Ethiopia, Josette began performing VVF operations at the Fistula Center in April 2005. With the occasional assistance of visiting surgeons, Josette and colleague Dr. Jerry Putman have performed fistula operations on nearly 500 women. About 85 percent have gone home dry, a remarkable record for a very difficult procedure.

“The exciting thing about working in Africa is you have to totally depend on God,” Josette explains. “In America you feel almost like you’re in control of things. But here you realize you’re not in control. Here you see God come through more often. That was what attracted me to missions work. You can see things so much clearer.”

With her time in Africa growing short, Josette has signed a contract with a hospital in Maine to return to stateside practice. The arrangement gives her an extraordinary 10 weeks of paid leave each year.

She intends to spend eight of those weeks performing fistula surgeries somewhere in the world. It’s a demanding schedule, but Doug is confident she’s more than capable of maintaining the pace. “Josette’s like a rock,” Doug says. “She’s like a Green Beret or a Navy Seal or something! She’s tough.”

In fact, Doug can recall his wife getting really down only one time during their months in Africa. It was the day the patient fell at her feet, pleading with her to reconsider surgery.

Josette has placed this woman’s medical records in a special notebook, along with those of the other women she was forced to turn away. She prays over them often, and then listens, waiting for God to reveal what He has in store for their lives as well as her own.

“The [VVF] women come here with their heads down. They’re sad and shy,” Josette says. “But then they get their surgery, and suddenly you see their true personality come out. You get to see the beautiful person God created them to be.”