finding hope and sharing it

A Burden and A Joy – Guest Blog by Cara Brooks March 13, 2018

Filed under: Hope — Brooke F. Sulahian @ 6:48 pm
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One of our Hope for Our Sisters board members is currently serving overseas with another non-profit, Mercy Ships, and one of the areas of focus for this group is treating women with fistula. Here is a blog post she authored, interviewing a friend about the great victories and joys, but also the emotional burdens, of working with our beautiful sisters. “Photo credit to the Mercy Ships Communications Department”.

I wasn’t terribly familiar with fistulas prior to working with Mercy Ships. I had heard of conditions that caused women to leak urine and feces, but knew very little of the reasons for the problem, or the enormous magnitude. The World Health Organization estimates that over 2 million women are living with untreated fistulas between Asia and sub-Saharan Africa; this statistic doesn’t include poor places in northern Africa, or South and Central America. In the interview that follows with a friend, she told me that a gynecological surgeon from the US told her that in his 40 years of practice, he had only ever seen one case of fistula, and it was caused by a medical error. Fistulas are entirely a problem of poverty.

Meeting these women, even just as a nurse encountering them outside of the ward, changed me. In February 2017, I joined the Boston-based organization Hope For Our Sisters, Inc.  as a general team member, helping with mail-outs and prayer chains, assisting with the website revision and attending events. Later that year, I was asked to join the Board of Directors. It has been an incredible gift, and provides an outlet for my heart to serve these women from afar. (If this sounds familiar, it’s because I blogged about it not too long ago.)

Many times in women’s health, we share the stories of our most down-trodden, disadvantaged sisters and their victories through surgery to become dry. But women’s health, unlike many other specialties, doesn’t always have a happy ending. It’s black and white – women walk away dry, or wet. They are healed, or they are resigned to a life of rejection, shame and isolation. While we are better when we dwell in joy and hope, there is a real and serious emotional toll for the providers who work in women’s health. These nurses, doctors and surgeons see miracles, surely, but they also are called to the terrible task of telling women there is nothing more we can do for them – their defect is too big, or their scar tissue is too tough. We offer them prayers and support, we hope that even in their trials they have encountered the love of Christ and know, in their hearts, that they are cherished beyond measure, even when their villages drive them out, their husbands leave them, their families abandon them.

My dear friend, Mary G., has worked in women’s health for the last three years with the organization we both serve with abroad: Mercy Ships. Mary loves Marvel Comic Movies, her coffee, sleeping in and FaceTiming with her family. She is faithful and committed – she traveled to Utah and Maine in the span of one month to attend both my wedding and our friend Jarah’s. She has been a shoulder to me in some of the hardest hours of my adult life. And, above all, her heart for these women is beautiful to behold. I have had many conversations over the years with Mary about “the ladies”, as we call them, and the highs and lows of caring for this special population.

I would challenge you, as you read this, to pray in a special way for the people caring for our sisters. Their job is so hard, and they do it with so much love and grace. This season in Cameroon has been particularly difficult for the women’s health providers. There have been many women who have had multiple repair attempts already, with a subsequent build-up of scar tissue, forcing surgeons to try “last-ditch” methods with success rates as low as 20%. Women who cannot have their fistula entirely corrected surgically have even less options now than before. Manufacturers used to create “urethral plugs”, which didn’t heal fistula, but did allow women with continued incontinence to release their urine in more timely and appropriate settings, versus leaking constantly. Production of urethral plugs has stopped, because “no one needs them”… meaning, no one who can afford to buy them would need one, because it’s only poor women in Africa who need them. One of our annual fistula surgeons, Dr. Norman, has just a handful left to provide to women who cannot be helped surgically. Imagine how he, and nurses like Mary, and our team leader, Tam, will feel when the last of those are gone. What do we offer women then? What sustainable option, beyond diapering if a woman can afford it, is left?

Cara: Mare [as I call her], tell me a little bit about your nursing background and your initial impressions in being assigned to women’s health back in Madagascar.

Mary: Ha! My background was in medical/surgical nursing, specifically in orthopedics and trauma. I saw a lot of geriatric hip fractures. So when I was assigned to women’s health, I was excited, but nervous because of the different population. I just didn’t know what to expect. In general, the nursing care was very familiar – catheters, IV, pain medications – all of that was the same. Yet it was harder because fistulas are something you don’t see at home, ever. You don’t know anything about it, so you don’t even know what questions to ask the patient or what to focus on at the beginning.

Cara: It’s been 3 years since you started. Now, when you encounter these women for the first time, what are some of the things you’ve learned to do, or to take in?

Mary: I always try to GREET them specifically as a person. The relational aspect has become so much more important to me and I try to really talk directly to her and just be friendly. In so many of their situations, these women are not treated with kindness. There is just a sense of unfairness to this all. It’s not fair that they suffer with these problems that don’t exist in my country. It’s hard dealing with the injustice of it.

Cara: Do you feel like certain women over the last 3 years have changed you?

Here, Mary paused. We were sitting in the cafe on Deck 5, where there is a wall plastered with images of the women’s faces. Next to each smiling woman is a single word she gave us to describe herself both before, and then after, surgery. 

Mary: [looking at the wall]  I love all of their faces. There are so many stories and so many different things they deal with. There are just so many of them, and so many different lessons I’ve learned. Sometimes its the more middle-aged ones that surprise me, the ones in their 40s who developed fistulas around 30 years ago, who have been wet longer than they were ever dry – their perseverance and their ability to love other patients around them, it’s inspiring. They reach out to each other, even when they’re suffering, too. It’s hard to describe. There was a middle-aged woman in Madagascar with a fistula who met one of our teenage fistula patients at a screening site. The teenager had no family or guardian to come with her to the ship (a requirement for Mercy Ships for patients under the age of 18). The older woman took this girl under her wing and came with her to the ship as her caregiver even though they had just met hours before and she was going to have surgery herself. That action of love and service in the midst of her own suffering was a great example to me.

Cara: Do you feel like there are certain attributes you would ascribe to them at certain phases (pre-op, waiting for the catheters to come out, post-op)?

Mary: It sounds weird to say, but that they’re strong. It doesn’t sound like enough, but they’re resilient and strong, in the good news and the bad. These ladies are so tough. We had one lady here in Cameroon who had an abdominal approach, and so that’s a big incision, so much pain, and she was up 3 days post-op trying to dance in the hall with the other ladies. We tried to get her to stay in bed but she just wanted to be up and dancing.

Cara: Are there specific prayers you find yourself praying for these women?

Mary: There are always prayers in my heart for what will what happen when they go home. Many of them are vulnerable to having a fistula happen again, like by getting pregnant. They’re going back to the same situation where the fistula started so the likelihood of recurrence is high. Especially the young ones who came form abuse, and who are going back to abuse; I pray for safety and change.

Cara: What do you feel like have been some “themes” of women’s health for you?

Mary:  I feel like I think often of how overwhelming, just how HUGE, the problem is. It’s not just women having fistulas – it’s people as a whole not having access to health care and care throughout pregnancy. It’s a problem of poverty. How do you even approach it? We can fix the hole, but not the problem that causes the hole. Yeah, a lot of them have a potential of it happening again, or it happening to someone else they know. Other nurses that I’ve done exit interviews with have talked about needing a more specific debriefing process for women’s health, because it can be so difficult to cope with the things we see. Some days, though, are more hopeful because some leave dry and are so empowered and will teach others how to prevent it. It all depends on the day.

Here, I steal one of my favorite interview questions from Jen Hatmaker, whose podcast “For the Love” is funny, poignant and relevant. Every week, she asks this of her interviewees and gets a variety of answers, from silly to serious. 

Cara: When it’s 1:30pm and you’re preparing for a 2:00pm evening shift, and you’re tired and heartsick and broken and burned out, what is saving you right now?

[Our ladies aren’t allowed to climb stairs for about two weeks post-op, so they shuffle up and down the hospital hallway for hours each day, carrying their urinary catheter bags and singing songs of praise and joy.]

Mary: The singing. It’s something so special to them. Even when I’m laying in my bed, I hear them singing in the wards, and it’s so helpful and it’s so sweet. It’s so unique to women’s health. The women in Beds 1-4 the other day were still on bed rest, and Bed 2 started humming, so then Bed 1 joined and then all 4 were singing together. It’s all so sweet. Moments like that make me keep on trucking.


For more information about Hope for Our Sisters, please visit http://hopeforoursisters.org/.


Fleece Thrown…His Answer? February 20, 2018

Filed under: Hope — Brooke F. Sulahian @ 6:34 pm
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The door to 2018 stood ajar

Inviting me to walk through

Year seven for Hope for Our Sisters

I could not believe it…seven years of hope generation

Seven years of others coming alongside me to serve

beautiful women across the globe

Seven years of empowering our sisters and brothers to

change their culture for the better…

their choosing, their ownership, their version of better

Seven years of seeing God’s hand at work

more clearly than any other time in my life

However, sitting at the threshold,

I felt overwhelmed, stressed and confused

This is not what I expected

Hope for Our Sisters is my sweet spot, my calling

Even though I know this without a doubt,

doubt about carrying out this journey pops up from time to time

Feelings of being overwhelmed can take over when I least expect it

Stress creeps in when I forget that I am not the One in control

I share this because there are others like me…others like you

Serving out of our giftedness

Doing what we believe we were created to do

But feeling overwhelmed, stressed and confused at the same time

What we are doing is beautiful work, but also hard work and heart work

During my time at the door, I read about Gideon

I felt led to throw out a fleece

regarding Hope for Our Sisters


I did not take this lightly

I’m not sure I had ever done this before…ask God for an answer in this way

But my heart, mind and gut were clear…I needed to do this


When you throw a fleece, you need to be open to any and all answers

I had no less passion about my calling

I had no less drive or desire about this work

I saw new doors opening up for us in 2018

However, feeling overwhelmed, stressed and confused held me back

It scared me to do this…what if God said my time was up?

I still wanted to lead this effort, I still wanted to generate hope,

But I am doing this for Him, not myself

With a big gulp and prayer, I threw my fleece

I asked God to replace my current feelings with

Joy (not happiness), Delight, and Clarity

I went to bed…

Again, please don’t take this lightly

I only threw my fleece because I truly believe He prompted me to do so

How did He answer?

In faith, I threw my fleece and He responded

I awoke with a very strong sense of

Joy, Delight, and Clarity about 2018 and the years ahead

This does not mean I will never feel overwhelmed, stressed or

confused about my calling

But it does mean that leading Hope for Our Sisters

will continue to be my calling as I follow Him

© 2018 by Brooke F Sulahian


Unfinished Stories December 8, 2017

Filed under: Hope — Brooke F. Sulahian @ 4:18 pm
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One of my favorite books is Pillars of the Earth. It’s a 1,000+ page novel that tells a sweeping narrative of the building of a cathedral in twelfth-century England. I’ve read this book at least three times from cover to cover.  I know the plot. I know each scene by memory. And yet, each time a character enters a dangerous situation, I try to think of a new way out. I hope and believe with all my heart that maybe this time it will be different.
            But this novel is complete. It was written a long time ago, and there can be no different ending to any of the scenes within it. Nothing I hope for or imagine for my beloved characters will happen. The story has already been written, and it’s finished.
            However, our stories are not. Our stories, along with our sisters’, are still being written. So even as we experience or witness danger, violence, poverty, and pain, we know the story does not have to end there. We can help each other write new endings. We can imagine new beginnings. We can do this because we have hope.
             This hope is what motivates us to stick with a painful, uncomfortable, or challenging story. It’s what drives us to give generously of our time and resources. It’s what binds us together as sisters.
            And hope is what interrupts painful, merciless stories and redeems them into something beautiful. This year, we’ve heard shocking stories of abuse and rape. Unthinkable stories of neglect and gender-based violence. Uncomfortable stories that seem to have no light.
            But thanks to your generosity, prayer, and hope, these stories have not ended at the darkest moments. Our sisters-fueled by hope for a different, better, brighter story-stood strong. They fought for their futures, for their healing, for their babies. They lived, they thrived, and now they tell their new stories – hope stories.
            For Deborah, Solange, Esinam, and Elsabe, a painful story became one of redemption. But it doesn’t end with these four. Because women around them everywhere are watching. Women terrorized by gender-based violence, women living with fistula, women abandoned by their families and spouses, women recovering from painful deliveries and stillborn babies. These women continue to hope, because they see that good can prevail. They believe that a dark and painful story can become a hope story. And thanks to the help of sisters around the world, their stories are just beginning.
Written by Dianna Sawyer, Hope for Our Sisters Partner in Hope.
You can learn more about our precious sisters and help them write more hope stories at hopeforoursisters.org.

Was Admon’s Hope Story Coming to a Tragic End? December 1, 2017

Filed under: Hope — Brooke F. Sulahian @ 9:40 pm
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Below is Admon’s  hope story…a story you helped us write this year. (I wrote this to everyone who invested in Hope for Our Sisters this year by giving of their time, talents, treasure and prayers. Passing this story along to you as it is a favorite of mine. If you feel compelled to help women write stories of hope, you will see our website at the bottom of the blog. No pressure at all. Thank you for reading this story of hope!)
The day started as it always did. I left for work in the fields while my beautiful wife, Elsabe, swept the dirt floor of our home. With Elsabe nine months’ pregnant, we were very excited to welcome our first child. We knew this would mean one more mouth to feed and one more person in our small home, but the idea of a baby filled us with joy.
Can you imagine how Admon felt? With the upcoming birth of a child, writing hope stories comes easy. You have so many dreams and hopes for the child. You spend so much time wondering who your child will become. Admon was writing that type of story.
Returning home, I saw a site that stopped me in my tracks. My lovely wife, so full of life that morning, was lying on the floor, seizing out of control and unable to wake up. I thought she was dying. I feared for my wife. I feared for my unborn child. How could this be happening?
Unknown to Admon, Elsabe was having a seizure due to high blood pressure (eclampsia). He had no idea how long this had lasted while he was away. His hope story, in his eyes, was at risk of coming to a sudden end. However, he held on to hope.
I immediately ran out of our house and yelled for help. Friends in our community helped us find a vehicle to take Elsabe to the nearby hospital. I prayed. I feared she and our baby were dying. My other concern? We did not have the money to pay for a trip to the hospital. What would I do when we got there?
Elsabe was rushed to one of our partner hospitals, Central Evangelical Medical Center in Lubango (CEML), Angola. Can you imagine going to a hospital without the needed money or benefits coverage? It was with hope that Elsabe was brought to the hospital. Even when the situation looks dire, hope can carry us through. Thank you for investing in women and their families. You consistently help them write hope stories amidst loss and lack.
Once we arrived at the hospital, they took my wife and unborn baby into surgery. Again, I prayed. I worried. Would Elsabe survive? Would our baby survive? Would I return home without my family? How would I pay for this support?
Dr. Sarah Hudgins, HFOS Partner, performed an emergency cesarean section. Care is available at local state hospitals, but people fear them due to poor quality of care. Coming to CEML was a courageous choice for quality, safe care, even though it would be expensive.
A nurse from surgery approached me. Elsabe survived! My wife was alive! Guess what? Our baby, our son, survived too! I cried out with joy and thanks. I could not believe it!
Admon’s hope story was not over. It was only beginning. Thank you for investing in this story of hope.
Then I began to worry about payment. We did not have enough. I asked the nurse. She said the rest would be covered. We had enough! Could this day get any better?
You funded the rest of Elsabe’s surgery by investing in Hope for Our Sisters. This partial payment came from one of our new Maternal Health Funds.
I could not believe our good fortune. A successful surgery and help to pay for it. This is not the way I expected our son, Abilio, would enter the world, but I am so thankful I can enjoy my future with my family. Thank you for sending HOPE our way!
You, through your generous investments, partner with us as we together help our precious sisters and their families in Angola, the DR Congo and Nepal write stories of hope.
Honored to generate hope with you.
Brooke F. Sulahian
President & Co-Founder
Hope for Our Sisters, Inc.
P.S. Thank you for helping Admon, Elsabe and Abilio write their hope story. If you choose to invest in hope today to enable more and more stories of hope to be written tomorrow, go to our website at http://hopeforoursisters.org/donate/.

Creativity – I’ve Missed It September 29, 2017

Filed under: Hope — Brooke F. Sulahian @ 9:05 pm
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This summer was not as we planned

Peter’s heart-breaking anxiety over his injections

Lucy coming down with strep, pneumonia and walking pneumonia at the same time

Me processing my unexpected, physically challenging yet amazing trip to Africa

My own creativity was drowned out…

without my noticing


I am reading Loving My Actual Life by Alexandra Kuykendall

Great title…don’t you think?

The idea behind the title caught my eye and heart

Being present in the moment is tough

The urgency can crowd it out

My to do list can be louder than the call to be

present, quiet, rest, and create

I have ideas in my head about all of these topics

Today? Creativity


First of all, Peter’s anxiety is gone

He is rocking his shots

He is back to his funny, goofy, active self


Lucy is healthy

She is free to take on the world in her 9-year-old fashion


I am working on being present

One day I’ll share about my 8 minutes of pure quiet

Sounds nice, doesn’t it?

It is

Pure quiet with God rocks



In this book, Alexandra writes the following:

“We were made to create! It is in us, so when we don’t

allow that part of us to flourish, we wither.”

This hit my heart…deep within my heart

My creative self has been withering in my pursuit of goals, deadlines,

smooth mornings before school, being present with my family, etc.

All of these are very important and very good…but…

when we the last time I was creative for creativity’s sake?

Like writing these words right now?

How about you?


Peter often gets carried away with his 3-D origami

Lucy is often found with pen and paper in hand

ready to draw or create a story

How did I not see that my creative outlets were clogged?

When was the last time I made time to write?

Writing is one of my favorite gifts from God and yet

it’s been ages since I have carved out time to write


I did not enter into these moments on our back deck today

with a goal for this “blog”

Hmmm…if I think about it, what would be the goal?

It’s not to impress

It’s not to convict

Now that I think about it, I’d like to let my creative juices flow,

share my heart and encourage your own creativity


What inspires you?

What gifts have you been given in the realm of creativity?

May we all simply enjoy our creative gifts

May we all try not to evaluate our creativity

May we all not expect to live up to a certain standard

We don’t have to be a famous author, painter, inventor or singer to create

May we just set some time aside to

let our creativity flow

We were created in the image of the ultimate Creator

We were made to create


As I sit in my backyard next to Tim,

with Peter, Lucy and friends playing wiffle ball,

I think of the women we serve through Hope for Our Sisters

Their sheer joy at creating bags, hats, etc.

This organic growth is such a gift for our sisters

However, it is now requiring planning, structure and organization

May our efforts to support this new program not drown out

the real beauty behind it

The sheer creativity

The discovery of potential

The joy of learning what can be accomplished


Have you set time aside to discover your potential?

Have you set time aside to be creative?

In this book the author challenges herself to write for fun (she’s an author)

and to do something creative each day

I have not read the full chapter yet

The idea of daily creativity actually seems too big at this moment

but I want to try it

I’ll give it my best shot

I am sure I will find fun and simple ways to

tap into my creativity

I will do this because I believe those I love, serve, and enjoy will benefit

I also know and believe that I will benefit

Maybe I will benefit most of all


We were made to create

How will you create today?

© 2017 by Brooke F Sulahian


On The Outside Looking In May 28, 2017

When I turned 11 I found myself on the outside looking in.

I grew up in warm Southern California as the youngest of three.

I would describe it as an idyllic childhood…

Riding bikes with my brothers, lots of friends on our street and at school,

good grades, fun times of soccer and softball, and a loving family.

I also had a strong sense of who I was.

I felt anything was possible.

I felt I could conquer the world.

Then we moved…

My life was rocked to my core.

I no longer belonged.

I forgot who I was.

Moving to Texas at 11 is still one of the most impactful and difficult experiences in my life.

Not only did I move to a new town in a new state, but

I moved into a new and totally different culture.

I felt as if I had moved to a new country.

I did not have the right clothes.

My accent (or lack thereof) was wrong.

I even had different slang.

No matter what I did or how I tried to connect, I was constantly reminded that I was

An outsider looking in.

Once we entered Texas, I had lost my sense of who I was.

I did not feel valued but lost.

I felt as if I was stranded on an island, in the middle of an ocean.

Over time I found my way “in” through new friends

Who accepted me for who I was.

I made friends just being “me”.

I learned that I could overcome and rise above obstacles by being myself…

The one God created me to be.

As a child, I always cheered and spoke out for the underdog.

Now, I had become the underdog.

I had a new appreciation of the value of community and

This increased my life-long compassion for

Those on the outside,

Those considered less than,

Those considered not important or of value.

I should not have been surprised that the issue of fistula would resonate with me,

Even though at the time I felt it hit me out of the blue.

As I first read about fistula, the focus of Hope for Our Sisters,

I was not only struck by the injustice of the situation but

The aloneness,


And lack of community

Suffered by these sisters of ours.

At Hope for Our Sisters we extend our reach beyond fistula surgery and prevention

By directly investing in each woman.

Just like you and me, each one of our sisters has value.

Each one of our sisters has a story to tell.

Each one of our sisters has a contribution to make.

Each one of our sisters has the right to rejoin their communities.

Each one of our sisters has the potential to change the world.

(NOTE: A session with the organization Resonate helped me tap into this story behind my passion for HFOS. I fully believe God broke my heart for this issue but I also believe He used this very difficult experience of mine to help fistula resonate with my heart.)


© 2017 by Brooke F Sulahian




Motherhood is Eternal, as is Hope May 10, 2017

Springtime brings with it new life – flowers blooming, baby animals being born, the miracle of Easter. With our attention on creation, we as a society choose to mark a Sunday every May as “Mother’s Day”, pouring extra gratitude and love out onto the women who birthed us, raised us and supported us. We also reflect with reverence and fondness on the mothers in our lives who have passed away – some older, like our grandmothers, and some younger, dying of illness or accidents too soon.
There is a special group we are challenging you to consider in your prayers this year – women suffering with fistulas. Women who may or may not be mothers to living children, who may or may not have anyone celebrating them at all. According to a United Nations report from 2015, 70-80% of the babies born to mothers in obstructed labor (the mothers who are most likely to develop fistulas) will be stillborn.  Of those who do survive, there is a high risk of para- or quadriplegia, cerebral palsy and other defects related to low fetal oxygenation while the mother is pushing.
Motherhood is simply defined as “the state of being a mother.” This definition doesn’t exist solely in the present tense, it doesn’t have conditions. Famous artists, like Michelangelo with his Pieta, and famous authors, like Maya Angelou in Mom & Me & Mom, have tried to capture the spirit of motherhood and its endlessness in ways we all understand – but find so difficult to put into words.  Mothers who have departed from us do not stop being our mothers – so what of mothers who suffer on the opposite end of the spectrum? Are mothers who lose their baby or a child any less in that state of motherhood? Their child is with them always, a part of their existence and the course of their life. Whether their child lived thirty seconds or thirty years, the hopes, dreams and prayers for the life a mother supported likely differ little from those of every other mother around the globe. Surely the very act of hoping, dreaming and praying is an integral part of the transition from “woman” to “Mother”.
Women with fistula are desperate for new beginnings and life of their own – for repairs that will help them transition back to their communities and families, for cesarean sections that will bring their babies safely into the world with less risk of consequence from obstructed labor. They are desperate for HOPE. Is there a better place from which to honor our own mothers than from a mother’s constant place of generosity, support and love? As Mother’s Day approaches, we invite you to partner with us to honor our own mothers and these beautiful mothers in other parts of the world with your prayers.  Additionally, if you feel so moved, please consider making a gift for a mother in your life by supporting fistula care and prevention programs, whether by way of a Mother’s Day card or any other donation format available at hopeforoursisters.org.
Motherhood is eternal, as is hope. Thank you for your support of the sisters we care so deeply for at this special time of year.
Written by Cara Daniels, Hope for Our Sisters Team Member & Hope Generator