So inadequate!!!!

I am so inadequate!!!!!
I am NOT a Urologist or an Oncologist nor is there ANY in this entire country.
This week I had a patient sent to me from Nzara, which is the city 4 hours away where I was evacuated to when there was the insecurity. The Comboni nun Dr Sara sent her to me. She suspected the woman had cervical cancer as she had a fungating mass from her cervix in her vagina.
When I examined the women this was the case indeed. So I am here alone. I am the ONLY Gynecology Surgeon in this city, in this county, in this state and in this region!!!! So I felt I should operate and debulk (take away) as much of the cancer as we can. So with the brilliant Gynecology Oncology Attending's voices of my training in my mind, I went ahead and removed as much as we could. We removed her uterus, her Fallopian tubes, her ovaries, and the top portion of the vagina where the mass was attached.
The patient did very well. Sadly of course there was a piece of cancer stuck over an important artery and I did not remove it as it would cause her to bleed to death.
Thank you Dr Larry Puls, Dr Richard Boulay, Dr. Martin Martino for your amazing training and guidance during my residency.
You really helped this woman through me.
Although of course her 5 year survival rate is not good. We have no chemo or radiation therapy in this entire country!!!
These are very poor people who can't afford to go to neighboring Uganda for medical treatment.
Then I was sent a 20 year old woman from a closer neighboring village who has a very disturbing story. She was "given" by her older sister at the age of 14 to an old man who got her pregnant and she had a baby. I am told because she was very young and very small the baby got "stuck" inside her and died. Then the person at the health facility proceeded to pull the baby out and DISLOCATED HER HIP AND BROKE IT.  As a result this poor woman literally walks bent over and can NEVER straighten her leg. She was so traumatized by this experience that she would not allow an exam. She now pours urine from her vagina.
When I performed an exam under anesthesia, I could NOT believe what I was seeing. Her urethra is completely scarred closed. Her bladder is wide open into the very scarred vagina. Her introitus is open to the rectum only the rectal mucosa  is intact. Her vagina is scarred closed at about 3 cm into the vagina!!!
What a mess!!!!
I could not even get the smallest dilator into the urethra. It is scarred completely closed.
The SAD part is everyone thinks I can work miracles and were so happy when we were leaving the Operating Theater and I had to explain that I did nothing ABSOLUTELY NOTHING to help her.
How disappointed I was. Although her family was not because they think that I will some how be able to help her!!!!
This young woman makes me want to cry, as every day when I see her she is beaming smiling as though I am the greatest person ever. Little does she know that I am so inadequate. I greet her and hug her which is a big deal because NO ONE touches her as her fistula causes her to constantly leak urine. She smells of urine as well. But I DO NOT CARE. I want her to feel the love of a human being for once in her little sad life. I sit on her bed and hold her hand and tell her how today she looks "smart" which is their way of saying beautiful. I tell her I LOVE her.
How can good things happen to "bad" people and bad things happen to good people? Dr Martin Martino once said this to a patient with Ovarian cancer who after adopting 3 child from Korea found out she had metastasis to her brain. Thank you for that lesson Dr Martino.
Please God help me, help these beautiful women of South Sudan whom I love through my inadequacies.
Pray for me and please pray for these women who are dismissed by the world, by society, by their own families. The "unseen" people. The "invisible" people.
I SEE them, they are NOT invisible to me. I love them dearly and fiercely.